HomeMy WebLinkAboutCummings, Keith go
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4® :' �0�-,��� P.O. Box 1179
Southold, New York 11971
JUDITH T. TERRY '-'#i�� io° TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
October 30, 1987
Keith Cummings
22 Galahad Lane •
Nesconset, New York 11767 •
Re: 155 Corey Creek Lane
Southold, New YOrk 11971
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 withthe 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 ?tours,
Judith T. Terry
Southold Town Clerk
Enclosures (3)
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OFFICE OF THE TOWN CLERK •
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Town of Southold ��F UrC��
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road ;P ,
P. O. I3ox 1179
Southold, New York 11971
Telephone �l 1,/
(516) 765-1801 .
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 243 Residential • x
Fee $ 10.00 Non-Residential
Septic Cesspool x
PERMIT ISSUED TO:
NAME: Keith Cummings
ADDRESS: 22 Galahad Lane
Nesconset, New York 11767
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling with Cesspool System
APPROVE[) as per Suffolk County Health Department approval
LOCATION OF PROPOSED CONSTRUCTION 'or ALTERATION:
OWNER OF PROPERTY: Keith Cummings
OWNER MAILING ADDRESS: 22 Galahad Lane
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Nesconset, New York 11767
OWNER PROPERTY ADDRESS: 155 Corey Creek Lane
Southold, New York 11971 -
TAX MAP NO. : Section 78 Block 4 Lot 29
CROSS STREET: Main Bayview Road
BUILDING PERMIT NUMBER CROSS REFERENCE:
Judith T. Te
Southold Town Clerk
DATE : October 30, 1987 ,\`\` U!
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s Southold, New York 11971
JUDITH T.TERRY
TOWN CLFR1: TELEPHONE
REGISTRAR OF VITAL STATISTICS (516)765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
October 27, 1987
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 247 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by Keith Cummings
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.
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erX4 %or/. 4.004.40410y.........
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 - X(
DISAPPROVE -
C .' COMMENTS: Q� ����„p-(}n
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Signature
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Date
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OFFICE OF THE TOWN CLERK c0FOC,-
Town of Southold
Judith T. Terry, Town Clerk ,� , �
• Application No. ' 7
Town Hall, 53095 Main Road51 ' " :f Construction
P. 0. Box 1179 `P ' 4 *.7 Alteration
Southold, New York 11971
Telephone *1 Alt � , '� Residential
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE f0/Z ,/s7
APPLICANT NAME: x..)11-1 C.A.)1-1,(4 /1lJ(r'S
APPLICANT ADDRESS: ZZ 6-04(_,A.1.44b eat).
/JCS G 75 pY //76 7
SEPTIC K CESSPOOL )C
DESCRIPTION OF PROPOSE CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONST UCTION OR ALTERATION:
OWNER OF PROPERTY: 0 )4 C.)/hm ix,Jg
OWNER MAILING ADDRESS: S C2.-7-14_4_, q^ r�
OWNER PROPERTY ADDRESS: /5.5 C eNP..e_
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TELEPHONE NUMBER OF CONTACT PERSON: sic) 7Z4/" X60.
TAX MAP NO. : Section 7S Block Lot 2.-el
CROSS STREET: / lam VU/Li. T , b.
BUILDING PERMIT NUMBER CROSS REFERENCE:
Si:nature of Applicant'
RECEIVED BYc.r
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DATE:
DCTZ7 198/
Southold Town Cfert.
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EXPIRES TWO YEARS FROM DATE OF APPROVAL � 3 -
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E4}'p DATE: DISPOSAL SYSTEMS FOR THIS RESI-
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