HomeMy WebLinkAboutBruch, Barbara crs Town Hall, 53095 Main Road
y0 •1, P.O. Box 1179
� „••�� Southold, New York 11971
JUDITH T.TERRY =�.�,,,,i���/ FAX(516)765-1823
TELEPHONE(516)765-1801
TOWN CLERK
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. 516 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : ROGER CULLEN
Address 1 : GARDINERS BAY CONSTRUCTION CO.
City St Zip SHELTER ISLAND NY 11965
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED. NOTE: CAREFULLY FOLLOW INSTRUCTIONS OF THE
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES 7/19/89.
Name Of Owner BRUCH, BARBARA
Mailing Address 1 110 BEVERLY ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 BEVERLY ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 52.00 block 2 lot 39.000
Cross Street COUNTY ROAD 48
Building Permit Number Cross Reference:
Issue Date: 8/08/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
lo‘czy
Town Hall, 53095 Main Road
�++U' �� P.O. Box 1179
►�••B • =•...11.04-2 `�1{_ `C ��� Southold, New York 11971
II IN JUDITH T.TERRY „ 00TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
E i ! E --'
t9g I
To: Victor Lessard, Southold Town Building Department
From: Linda Cooper, Southold Town Clerk's Office BLDG.DEPT.
Dated: July 20, 1989 TOWN OF SOUTHOLD
Transmitted herewith is a copy of application No. 529 for a Cesspool/
Septic Tank Construction Permit submitted by:
Gardiners Bay Construction Co. (Roger Cullen) for Barbara Bruch
•
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: ct, 1 tQ QAT) (),A,1
C �,,QL ��> a Tr Co .
Signature
-�1 <\lc\
pVG Dated
•
OFFICE OF THE TOWN CLERKOC��FF0i,,'`,O
,‘
Town of Southold Qom. G Application No.cJ 02
Judith T. Terry, Town Clerk ZEdF. `' .' ;. pP
Town Hall, 53095 Main Road ( .: =r' '� Construction
cn
P. O. Box 1179
Pc-443b. . . Alteration
Southold, New York 11971
d �� 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 $ 7 —
DATE 1bJD\ c\ .
APPLICANT NAME: 41.6- tki ( rj. 1er GNsra, )
APPLICANT ADDRESS: 'l 64.nd •JtrN 86,4 Dr. skewer (s(, ,(
d ', II "5T
SEPTIC CESSPOOLV
DESCRI TION OF PROPOSED CONSTRUCTION OR ALTERATION
alAted.,%r Lthfft ti.40titeltad
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: B+a6Ar241, seA ('Vc...t\
OWNER MAILING ADDRESS: / 1 0 Eet)-er )011o(d IA /WV
OWNER PROPERTY ADDRESS: 13evof(1 ed . SQUttd t4 ithi,J / (4/ 7
TELEPHONE NUMBER OF CONTACT PERSON: 745-- 50 ‘ Q
TAX MAP NO. : Section 3-01., Block Lot 3 9 .
CROSS STREET: 13C.A9�r1ki .. RI %JOr t2 0q-
BUILDING PERMIT NUMBER CROSS REFERENCE:.A121{)
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QD , , 1E4
ignature of Ap.lic•%t
I
RECEIVED BY: •
' .n Clerk's Office
DATE: JUL 2 01910
Town Clerk Mad
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PLAN OF PROPOSED • Cg50/1°-KEY MAP
0. SEPTIC SYSTEM - �� i"=soo
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z st. NORTH ROAD ( C.R. 48
2 d , Prepared in accordance with the ntirr�qum
3 standards for title surve*s as established by
the L.I.A.L.S. and approved and adopted
i•) for such use by The New York State Land
i t` M GL'yve//„.7' Title Association.
("oub/ic �va,tcr
NioiF GEOR a MARY sANTIS AREA= 9 79 6 SQ. FT.
to tie line
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fOls APPROVAL OF C�NsraLi ON ONLY
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toms for this residence will conform to the
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f' ,,.Th ,r ABSTRACT
STkN1 y a-to ,Q T ARSH AMOMAQUE
` TOWN OF SOUTHOLD
SUFFOLK COUNTY N.Y. '
,c LANDS 1000 - 52 - 02 - 39
�y0 a tka ec, .1-- Scab 1' a 20'
' -? 46o Sip! 28, 1987 6.
I p Ea, ,3 Nov. 16, 19871r.Wsea)
__ * Nov. 28, /988
itil ..N FEB. 3, 1989(r.vise) ,
• AI6 • ' . NO. 49668 MAY It, /959(revis,on)
F ONI i SUR -7''-'?`141�'',1-1r:: HERS, P.C.
1-1-I 765'5020
".0. BOX 909 CONTOUR L INE AND ELEVAT IONS ARE REFERENCED TO N.G.V.D.
AIN ROAD -=-^
SOUTHOLD, N.Y. 11971 0 xpa S/on f oa 1
1 8.7. -786
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