HomeMy WebLinkAboutTorell, Arthur iii�..
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JUDITH T.TERRY � _ y
� Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. Box 1179
REGISTRAR OF VITAL STATISTICS O P �� Southold, New York 11971
1� Fax (516) 765-1823
MARRIAGE OFFICER \#4, COs 0 Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER .1 `1► 0�1• P
FREEDOM OF INFORMATION OFFICER ,ii"
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1696 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : ARTHUR R. TORELL
Address 1 : 377 THOMAS PLACE
City St Zip WYCKOFF NJ 07481
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #R10-97-0075
Name Of Owner TORELL, ARTHUR R.
Mailing Address 1 377 THOMAS PLACE
City St Zip WYCKOFF NJ 7481
Property Address 1 WESTWOOD LANE
City St Zip GREENPORT NY 11944
Tax Map No. section 32.00 block 2 lot 10.000
Cross Street MOORES LANE
Building Permit Number Cross Reference:
Issue Date: 7/08/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
. . ,
76
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JUDITH T.TERRY �i G' A•% Town Hall, 53095 Main Road
TOWN CLERK % o 114 P.O. Box 1179
% Southold,New York 11971
REGISTRAR OF VITAL STATISTICS O . • Fax(516) 765-1823
MARRIAGE OFFICER ### O�''�� Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER 1 * *s"ad
FREEDOM OF INFORMATION OFFICER ,.'�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD 2 ' ''
TO: Southold Town Building Department r_`,
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 27, 1997
Transmitted herewith is a copy of application No. 1766 for a Cesspool/
Septic Tank Construction Permit submitted by:
Arthur R. Torell
Please review the application and location map and advise if the project
has received Suffolk County Health Department approval and if this office
may issue the permit.
Please complete the form below and return it to me.
Thank you.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments:
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Dated
OFFICE OF THE TOWN CLERK ,•
Town of Southold ��,.''1' OfUIkt% iii:• Application No.
Judith T. Terry, Town Clerk �, y'�
Town Hall, 53095 Main Road ; � = Construction
P. O. Box 1179 ; v "rnZ
Southold, New York 11971 • cn yrAlteration
Telephone p,�� �Qr,is� $10.00 - Residential
(516) 765-1801 = Ol ,•' 25.00 - Non-Residential
iii,i , ,• $
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ \ , ')- (4, let, 9)
DA gip J
APPLICANT NAME: A-1/2%-'-'1"1". "->" ---T-75 f I
APPLICANT ADDRESS: -37 7 -O WtA-
SEPTIC CESSPOOL
DESCRIPTI N OF PROPOSED CONSTRUCTION OR ALTERATION
NiQu) -SN INeL.z_ _- Cary ci--RU c
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: AS -42iC) VE-----
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER CONTACT PERSON: otO ( ' -et I 3D 43
—
TAX MAP NO. : Sec on /00 0 Block 3 - v. Lot 1 00
CROSS STREET : LoTO N LA)12.,S Woc D LAIN/a LAIN/aoPF Moots LANE. (sr-ta Af A
r)
BUILDING PERMIT NUMBER CROSS REFERENCE:
Ali
r v4411 , j/ 77146ef.
Signature • Applicant
RECEIVED B Y : (A)".. /G. ----
T wn Clerk's Office
DATE: (p(9,-) y?
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