HomeMy WebLinkAboutCantwell, Richard st Cr)
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�••` Town Hall, 53095 Main Road
,
• P.O. Box 1179
4 ��,•" Southold, New York 11971
JUDITH T.TERRY FAX(516)765-1823
TOWN CLERK TELEPHONE(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 648 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : RICHARD CANTWELL
Address 1 : MAIN ROAD
City St Zip JAMESPORT NY 11947
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 7/24/90.
Name Of Owner CANTWELL, RICHARD
Mailing Address 1 BOX 615
City St Zip JAMESPORT NY 11947
Property Address 1 525 CEDAR BIRCH ROAD
City St Zip ORIENT NY 11957
Tax Map No. section 15.00 block 8 lot 26.006
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 10/15/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
00,OOOOOOO
6
Town Hall, 53095 Main Road
�+p� 0 �� P.O. Box 1179
01 ,. ��� 'i� Southold, New York 11971
JUDITH T.TERRY „moi/�i�o TELEPHONE
TOWN CLERK516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK in)L C L U Wi '5rR'���
TOWN OF SOUTHOLD
rx
OCT
To: Southold Town Code Enforcement OfficerUt.
From: Linda Cooper, Southold Town Clerk's Office --- _ ,�
Dated: October 3, 1990
Transmitted herewith is a copy of application No. 663 for a Cesspool/
Septic Tank Construction Permit submitted by:
Richard Cantwell
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: q„ ,,� � Q . ' g._ 1-
fr-v, .11 Q.1/41/4\fie
RECEIVED
OCT 1n19 J \C,16.4.
'` ' .
Signature
won Clerk °';' td
lcs `i\ °W
Dated
1141
)FFICE OF THE TOWN CLERK C10C,{'
Town of Southold �y
Judith T. Terry, Town Clerk C Application No.
Town Hall, 53095 Main Road ccn cx,. Construction
P. O. Box 1179 : '
.'� Alteration
Southold, New York 11971 �-
TelephoneOlL r ��� Residential
(516) 765-1801
Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE OGT ( 70
APPLICANT NAME: t k Arce tl} N 1-CA/
e
APPLICANT ADDRESS: 5��---Ez ��— ` � � 4c/ mc�,vy /21-j
SEPTIC V CESSPOOL V ( I7
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
/N e Ai tit N7 Gc/G// / it/
MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: TcA, c< � AN Turc (1
OWNER MAILING ADDRESS: - --- ��.
OWNER PROPERTY ADDRESS: { ,� L5-02
TELEPHONE NUMBER OF CONTACT PERSON: 7a2 5- 75/3
TAX MAP NO. : Section n (c Block Lot •
CROSS STREET:•
Pa/
BUILDING PERMIT NUMBER CROSS REFERENCE:_.
Signature of Applicant
RECEIVED BY:
Town Jerk's Office
DATE: C 3 /c
•
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