HomeMy WebLinkAboutDignan, Patrick ,,,,oc��FFOIKc�G==
JUDITH T. TERRY z . ; Town Hall, 53095 Main Road
TOWN CLERK : =v rya
P.O. Box 1179
U' Southold, New York 11971
REGISTRAR OF VITAL STATISTICS '7.200A,
Fax (516) 765-1823
MARRIAGE OFFICER y �O �� Fax
(516) 765-1801
RECORDS MANAGEMENT OFFICER ' 1 � ►'
FREEDOM OF INFORMATION OFFICER = ,,,�,1
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1192 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PATRICK AND PATRICIA DIGNAN
Address 1 : 11 BROMPTON ROAD
City St Zip GARDEN CITY NY 11530
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY
DEPARTMENT OF HEALTH SERVICES. SCHD REF. #R10-94-0057
Name Of Owner DIGNAN, PATRICK AND PATRICIA
Mailing Address 1 11 BROMPTON ROAD
City St Zip GARDEN CITY NY 11530
Property Address 1 LONGVIEW LANE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 88.00 block 5 lot 4.000
Cross Street BAYVIEW ROAD
Building Permit Number Cross Reference:
Issue Date: 8/29/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY :,' 4 % ; Town Hall, 53095 Main Road
TOWN CLERK : P.O.=v T Box 1179
VS � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = V �. �p Fax (516) 765-1823
MARRIAGE OFFICER _ //�� �� �s' Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER '�m/1 i►'
FREEDOM OF INFORMATION OFFICER =".�..•ail/iii°.�
OFFICE OF THE TOWN CLERK rt, (-,D
l Q }U [;
TOWN OF SOUTHOLD 0 ,
F.`i 2 41994
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office I BLDG.DEP'
TOWN OF SOUTHOLD
DATED: August 24, 1994
Transmitted herewith is a copy of application No. 1238 for a Cesspool!
Septic Tank Construction Permit submitted by:
Patrick and Patricia Dignan •
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 G/
DISAPPROVE �`
Comments: SC/ AC )`-''XIZleO-- 5 eoS--7
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,INED
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Signa- re ,
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lows Cletk Southold
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OFFICE OF THE ;OWN CLERK c$FOUr.
Town of Southold
Judith T. Terry, Town Clerk _* : Application No.1 a3
Town Hall, 53095 Main RoadCr3 . Construction ✓�
P. 0. Box 1179V�� `� J
Southold, New York 11971 O • Alteration
Telephone ! s*t Nt .' Residential Vim- f
•
(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 $
DA E 8i)-(Pjq "
APPLICANT NAME: Pk + ICI A' till r 1`‘I(}
APPLICANT ADDRESS:
60,611 C�� iy � Kao
SEPTIC CESSPOOL
DESCRIPTION OF PROPO D CONSTRU TION OR,ALTERATION
o 1
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONST ' UCTION OR ALTERATION:
OWNER OF PROPERTY: I ..W{I
OWNER MAILING ADDRESS:
•
OWNER PROPERTY ADDRESS: /\.617/7 ��- /J4
TELEPHONE NUMBER OF CONTACT PERSON: 3/�ra -
TAX MAP NO. : ction ee Block �- Lot eq
CROSS STREET: \j..QLA..) c4,410.
BUILDING PERMIT NUMBER CROSS REFERENCE:
Zigzipo Signaterf
RECEIVED BY: QUI`^
To rk s Office
DATE: E/•
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Prepared in accordance with the minimum 0 5'
standards for title surveys as established A 4 �'
by the L.1.A.L.S. and approved and adopted O ,
for such use by The New York Stale Land \., C
Title Association.
ELEVATIONS ARE REFERENCED
TO AN ASSUMED DATUM
I
am familiar with the STANDARDS FOR APPROVAL SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
.ND CONSTRUCT/ON OF SUBSURFACE SEWAGE FOR APPROVAL OF CONSTRUCTION ONLY
1ISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES
and will abide by the conditions set forth therein and on the n R10-'4-0057
)er�ni/ to construct. DATE "" ---9 S. REF. NO.
APPROVED C.....A'1 %.%--Aet_
•
SURVEY OF
LOT 49
"TERRY WATERS"
FLED DEC. 29,1958 AS MAP NO. 2901
AT BA YVIEW
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NY.
h0 1000 - 88 - 05 - 04
'S Scale: 1" = 30'
0
�s May 10, 1994
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f'i •.- * N.Y.S. LIC. NO. 496/8
�F ~`"4 I5I-fir.c, 4� .0 ORS, P.C.
4REA = 17,500sq.ft. P. =-•D•os
ctiwc//( , �,C/f /occzf,�� "n'r/!'w'' ) MA/N ROAD
9 SOUTHOLD, N.Y. 1197/
94 - 171