HomeMy WebLinkAboutD&D Cycles JUDITH T. TERRY ; Town Hall, 53095 Main Road
TOWN CLERK O T P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS U'' Southold, New York 11971
MARRIAGE OFFICER = 3
yOo'� 0�, Fax )'�� Telephone (516) 766) 5-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 41 N Residential Non-Residential X
Fee $ 25.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : D & D CYCLES, INC.
Address 1 : 22355 ROUTE 48
City St Zip CUTCHOGUE NY 11935
Descripton of Proposed Construction or Alteration
CESSPOOL SYSTEM FOR NEW RETAIL SHOP.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #C10-93-009
Name Of Owner D & D CYCLES, INC.
Mailing Address 1 22355 ROUTE 48
City St Zip CUTCHOGUE NY 11935
Property Address 1 40535 ROUTE 48
City St Zip SOUTHOLD NY 11971
Tax Map No. section 59.00 block 10 lot 2.000
Cross Street TUCKERS LANE
Building Permit Number Cross Reference:
Issue Date: 11/10/93 Judith T. Terry
Southold Town Clerk
[TOWN SEAL)
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JUDITH T. TERRY1&"'
.G Town Hall, 53095 Main Road
TOWN CLERK &O T P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS � Southold, New York 11971
MARRIAGE OFFICER =�Q Fax (516) 765-1823
�� Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: November 1, 1993
Transmitted herewith is a copy of application No. 1091 for a Cesspool/
Septic Tank Construction Permit submitted by:
D F, D Cycles Inc. •
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: .2027 ca 4/47 �f ,- ' v U 9
MOVED
NOV w 44J
Signaturr
Date
•
•
e.
•
OFFICE OF THE TOWN CLERK
Town of Southold �� t:r Oi /�
• �
Judith T. Terry, Town Clerk
✓ Application No. c' /
Town Hall, 53095 Main Road • c i.'::,. r J-, Construction
"
P. 0. Box 1179
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Southold, New York 11971 r Alteration
Telephone 0l )1 ��i Residential
(516) 765- 1301 " • Non-Residential•
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TOWN OF SOUTHOLD
•
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
•
APPLICATION
•
•
• for
CONSTRUCTION or ALTERATION PERMIT •
SEPTIC TANK or CESSPOOL
Permit No, .
Fee $ S
•
• DATE X drof f
APPLICANT NAME: "4-b ' iC S•
y tJZ
APPLICANT ADDRESS: C;U =',« 1(e-E..-,YF &' ('�X' • •
•
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATIONCz.
204Q,l •
•
•
LOCATION MAP: • Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
• OWNER OF PROPERTY:•
•
OWNER MAILING ADDRESS: `T-
OWNER_ PROPERTY ADDRESS: .L�;(( Lc i t -
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TELEPHONE NUMBER OF CONTACT, PERSON: 5(4, 731 ? v 6;f( O :
TAX MAP NO. : Section / Block .e; Lot lC _ C,
CROSS STREET:
•
BUILDING PERMIT NUMBER CROSS REFERENCE:.. /
6//
Sicjnatu e of Applicant
RECEIVED BY: : 6�C--`
fY Town Clerk's Office •
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1 / 7 / APPROVED FOR CONSTRUCTION ONLY
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// / / This approval is granted for the construction of the sanitary
a' / / / disposal and water supply facilities pursuant to Articles VB and
'Q 0 7 of the Suffolk County Sanitary Code and is not an expressed
/ / / r ^y.0 nor implied approval to discharge from or occupy the
/ / gA structure(s)shown. THIS APPROVAL EXPIRES TWO(2)YEARS
04' ti // // / I 19 FROM THE DATE BELOW.
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