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HomeMy WebLinkAboutCooke, John .g1/II ^ =per ?©����` Town Hall, 53095 Main Road P.O. Box 728 Kt eio,/ ,of1�• Southold, New York 11971 JUDITH T.TERRY TELEPHONE Towry CLI'.Rli (516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD September. 29, 1986 John C. Cooke 24 Ivy Lane Setauket, New York 11733 • Dear Mr. Cooke: - Enclosed herewith is the Construction, Alteration or Modification Permit for a Septic Tank or Cesspool System for which you applied. Please be advised that each owner of real property operating an on-site sewage disposal system, such as a septic tank or cesspool must, prior to such operation, possess in the name of the owner an Operation Permit for the system. The Operation Permit is issued by the Town Clerk's Office. The fee for an Operation Permit is ten dollars ($10.00) for residential use and twenty-five dollars ($25.00) for non-residential. Please have the owner complete the enclosed Application for an Operation Permit and return it to this office along with the proper fee. For your general information I have enclosed an Informational Bulletin regarding the Scavenger Waste Laws adopted by the Southold Town Board. Should you have any questions pertaining to either permits or the Scavenger Waste Laws, please do not hesitate to contact this office. We will be glad to assist you in any way possible. Very truly yours, Judith T. Terry Southold Town Clerk Enclosures (3) JTT/Ijc • • OFFICE OF THE TOWN CLERK c.OFULA'e,� Town of Southold �G Judith T. Terry, Town Clerk Town Hall, 53095 Main Road P. O. Box 1179 • Southold, New York 11971 O O�- s, Telephone ( * (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 43 Residential xx Non-Residential Fee $ 10.00 Septic Cesspool XX PERMIT ISSUED TO: NAME: John C. Cooke ADDRESS: 24 Ivy Lane Setauket. New York 11733 DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION New Home LOCATION OF PROPOSED CONSTRUCTION or ALTERATION: OWNER OF PROPERTY: John C. Cooke OWNER MAILING ADDRESS: 24 Ivy Lane Setauket, New York 11733 OWNER PROPERTY ADDRESS : Little Neck Road Cutchogue,New York TAX MAP NO. : Section 103 Block 4 Lot 17 CROSS STREET: Moose Trail BUILDING PERMIT NUMBER CROSS REFERENCE: 15210Z °Ir4" Southold Town Clem DATE: September 29, 1986 (TOWN SEAL) OFFICE OF THE TOWN CLERK Town of Southold RECEIVED Judith. T. Terry, Town Clerk Application No Town Hall, 53095 Main Road SEp 2 61966 Construction P. O. Box 1179 Southold, New York 11971Alteration T„,, rt,,k SO'uth;ot' Telephone Residential c� _ (516) 765-1801 Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 142L02.- Fee $ 53 DATE Ve 26 / Jf66 APPLICANT NAME: 0j-- 10, e. eejnitC APPLICANT ADDRESS: 2$e .,L c V• e a►� - T3 SEPTIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION 4<0.4,/ y,00.mo _ LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: OWNER MAILING ADDRESS: OWNER PROPERTY ADDRESS: TELEPHONE NUMBER OF CONTACT PERSON: V /C ' fik"SeOZ., TAX MAP NO. : Section /03 Block le Lot 41- CROSS STREET: ,i3OIG?,fi .Q/7 BUILDING PERMIT NUMBER CROSS REFER -► E: 1S--- .2 /U -a— jaw L. AIM • ature of Applicant RECEIVED BY: 4 a— .40— Town/ lerk's '%ffice DATE: ..I . .• SUFFOLK CO HEALTH DEPT. APPROVAL i ... _r , H. S. NO. - ' `'i ikV \-/t- r' : L s�, 1 . Y MOOSET A.1 L ;;,� is 1 s'‘''...........\....A.,1 FY I I Aly STATEMENT OF INTENT ( U r i�`; Q THE WATER SUPPLY AND SEWAGE DISPOSAL I — A Q� SYSTEMS FOR THIS RESIDENCE WILL . _ ....%`;"<Z7( CONFORM TO THE STANDARDS OF THE C7 4' , SUFFOLK CO. DEPT. OF HEALTH SERVICES. 1? ds< i i (S) if• l APPLICANT I ` _`�40‘,.. � SUFFOLK COUNTY DEPT. OF HEALTH m1 •, i Q SERVICES - FOR AP R71 /AL OF (r 1.Demc�.) i-" "�,:e P I CONSTRUCTION ONLY . , , Q HAS. RET. 171(7.-----Y10 S0' Q `." (�Ne - O� APPROVEj�:a.4 i J 1 n r i /: �V O -i [� 61 0 E. ^_,�_ - 1770 c,A� �\�lv 1 SUFFOLK CO. TAX MAP DESIGNATION: r_ ._____.._ _ $� DIST. SECT. BLOCK PCL. 2' q) r\ _---_- Qv 1000 iG� 17 { i • ' . �: j'``1,,_Q OWNERS ADDRESS: Ih r_ . + 1,"___ aE-' �+L.i�E7" !�Y. 11733 t, ,.., , ,,_, - I. - , ��- ` f. _ > L t•<if) `Ur/'E NiT ► C5;6) 941 -4°70 C V' X i - - 11. ( DEED: L.NIA P. 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