HomeMy WebLinkAboutCorwin, Scott //, �,/
$44
Town Hall, 53095 Main Road
P.O. Box 1179
����� Southold, New York 11971
JUDITH T.TERRY (2 �,/�,• TELEPHONE
TOWN CLERK (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. 370 R Residential X Non-Residential
Fee $ 10. 00 Septic Cesspool X
PERMIT ISSUED TO:
Name : CORWIN, SCOTT
Address 1: P. O. BOX 276
City St Zip GREENPORT NY 11944
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 7/5/88.
Name Of Owner CORWIN, SCOTT
Mailing Address 1 P. O. BOX 276
City St Zip GREENPORT NY 11944
Property Address 1 ROW OFF NORTH ROAD
City St Zip GREENPORT NY 11944
Tax Map No. section 40. 00 block 3 lot 3.005
Cross Street QUEEN STREET
Building Permit Number Cross Reference:
Issue Date: 7/22/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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'x - A Town Hall, 53095 Main Road
�+'�� ,' / P.O. Box 1179
�� �� '__��� .-1- �`�IL �o'� Southold, New York 11971
JUDITH T.T ' 'Illirlill ---,,,,,,0'1 TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Victor Lessard, Southold Town Building Department
From: Linda Cooper, Southold Town Clerk's Office
Dated: July 19, 1988
Transmitted herewith is a copy of application No. 381 for a Cesspool/
Septic Tank Construction Permit submitted by:
Scott Corwin .
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 Y
DISAPPROVE nn
Comments: 4, .A.,.., u4lel 1sn c a Sifin. 1 4 r S.
IS . . A % .
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Signature
-71 a_o t tl
Dated
OFFICE OF THE TOWN CLERK �c,VFFDL -
Town of Southold ( Application No. 3Iff
Judith T. Terry, Town Clerk �.
Town Hall, 53095 Main Road a _ j�C Construction
P. O. Box 1179 ' J
Southold, New York 11971 Alteration
Telephone �l * , 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
APPLICANT NAME: c Q1 C21$VlM
APPLICANT ADDRESS: e0, a--)6 �-do rf�
16V 'v �. 444_,
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SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION OA ogj
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: k;,Ct � �W I
OWNER MAILING ADDRESS: d ` O� U a.-1(
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OWNER PROPERTY ,ADDRESS: I 4 wo ,Q.r .�t - �ak-a
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NUMBER OF CONTACT PERSON: f ,
TELEPHONE �{ ) L1C Ir
TAX MAP NO. : Section 90 Block S Lot
CROSS STREET: (NG(_
BUILDING PERMIT NUMBER CROSS REFERENCE:
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Sire o Applicant
R ECE I �,,��,,Y��,,:� '46-1(-Cl e----
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*oho Town Cierk' Offi e
DATE.JW 119 1988
Ton CIS Southold
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SUFFOLK CO. HEALTH DEPT. APPROVAL
H. S. NO.
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STATEMENT OF II*TENT.T..... .-1,4,
THE WATER SUPPLY AND SEWAGE'DISPOSA
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CONFORM TO THE STANDARDS: Or-11H
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