HomeMy WebLinkAboutCornell, John �,ii "•F
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r 1 Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
JUDITH T.TERRY TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OE VITAL STATISTICS OFFICE
��OyyF��TQQHE SSTQQOWrr��N CLERK
SOUTHOLD WASTEWATERF DI�;] L PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 339 R Residential X Non-Residential
Fee $ 10. 00 Septic Cesspool X
PERMIT ISSUED TO:
Name : GARDINERS BAY CONSTRUCTION CO.
Address 1: ROGER CULLEN BUILDER
Address 2 : 81 GARDINERS BAY DRIVE
City St Zip SHELTER ISLAND NY 11965
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY HEALTH
DEPARTMENT.
Name Of Owner CORNELL, JOHN AND CLIFF
Mailing Address 1 325- WILLOW POINT ROAD
Mailing Address 2
City St Zip SOUTHOLD NY 11971
Property Address 1 27754 R.O.W. OFF MAIN ROAD
Property Address 2
City St Zip ORIENT NY 11957
Tax Map No. section 18. 00 block 6 lot 21. 300
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 5/16/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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"' Town Hall, 53095 Main Road
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�1 " � Southold, New York 11971
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JUDITH T.TERRY TELEPHONE
TOWN CLI-RK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
May 13, 1988
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 343 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by Gardiners Bay Construction Co. for John & Cliff Cornell
Please review the application and location map and advise if the
project has received Suffolk County Health Department approval
and if we may issue the permit.
Please complete the form below and return it to my office.
Thank you.
eireede46e140,..../000.00°
Judith T. Terry
Southold Town Clerk
* * * * * * * * *
I have reviewed the application and location map of the project
cited above and make the following recommendation:
APPROVE - )(
DISAPPROVE - 1� nr
COMMENTS: Q.e c�.�.$ cineL Q. e le 14�.._)` U[
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Signature
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Date
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OFFICE OF THE TOWN CLERKc�VFF0C /
Town of Southold 0�� CSG Application No. 3y-5
Judith T. Terry, Town Clerk pp
Town Hall, 53095 Main Road Construction
P. O. Box 1179 *�J Alteration
Southold, New York 11971 * �t-
alt �" Residential
Telephone
(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 $ fd "
DATE
APPLICANT NAME: AC4 I Ne-krS6A1 c-° r✓s (�, e Dric kr c...,ui(ce/u (SottAf r
APPLICANT ADDRESS: C774ei t►ve.4f's ,I: Ortc r 1 S _ .
-20 of g .
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
/UeA-3 . C D/11S 1T
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ',TOL y'1, r.... VC), I .
OWNER MAILING ADDRESS: -3)__ E c,J)lJ oL,J
c rt J d7
OWNER PROPERTY ADDRESS: pviilP-Te" QJ . CePe•& r •
TELEPHONE NUMBER OF CONTACT PERSON: IN q d/ e -2--
TAX
TAX MAP NO. : Section D I g . Block 0 Lot D , S
CROSS STREET: 4 L)
BUILDING PERMIT NUMBER CROSS REFERENCE:
/ /
Signature of Applicant
RECEIVED BY: c.cz' K grkc —
Town
e
DATE: V/3/er
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MAIN RoA D(s.R. 25) .9. (9, �.
TEST HOLE ;"c'sseo \ \
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BROWN
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LOAM 3,2 � O � �� N /0/ F SEYMOUR WHITE a ANNA M. WHITE
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SAND 3 ` f
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COARSE T.H. 40 Q
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The water supply & sewage disposal sys• 1
toms for this residence will conform to the !1
standards of the Suffolk County Depart- 1 I S. 59° 33 50�� W.
2\7(--;
70. 2 7'
msnt of Health Services.
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THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FRothinD I N /0/F L A N.D O F D O R N A U E R
OBSERVATIONS AND OR FROM DATA OBTAINED FROM OTHERS_. \ •
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9. LOT 4 a• 7•
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` ��-i vi. co-LI 1�,'� �► �.``,,�� AREA 66 , 427 S Q. FT
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PECef�l CeLS';,''%/EYI a ENGINEERS, P. C , w
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P. O. '� '' •:090$y0 LOT NUMBERS REFER T0:"
M AIN ' sCATNEV'J MADE FOR JOSEPH a EDWI:
SOUTHOLD , 1.Y. 11971
4 a,
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TtARDINER'S BAY CONSTRUCTION CO.
P. O.
BOX 604
s• PELTED ISLAND, N. Y. 11965
��016)4,2,t49 0182
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o TOPOGRAPHICAL SURVEY N''' ''''`
o OF PROPERTYco �r
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ORIENT
• TOWN .OF SOUTHOLD
/ SUFFOLK COUNTY, N.Y. •
• 1000 - 018 - 06 - P/O 21. 3
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N V E61�� 1987' • SCC U l )'�_ . t. ;: ,1'NiY C'PARTMENT CF t* ALTII SERVICES U
IC.:: .rF� V/.L Or CONSTRUCTION ONLY
l �/ r�partd in accoraance witn rue ..
DATEYf F. N � S1 r�� standards for title surveys as establisheu oy
ti$ R the L.I.A.L.S. and approved and adopted
for such use by The New York State Land
APPROVED �-��� Title Association.
TO:°MAP OF MINOR SUBDIVISION "
EDWINA HATAI ER
. CONTOUR LINES ARE REFERENCED TO N .G.V. D. .
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