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HomeMy WebLinkAboutEdson, Lewis (4) e,�o��FFOLkcoG JUDITH T. TERRY _ . Town Hall, 53095 Main Road TOWN CLERK : • q!s--- r)E.- ©ig 0 vi i ,,-,..i",7 ,,,,,,,,,,,,, . - €" MAY 2 2 ''h'''ome �Gy�►; JUDITH T. TE�t ' : Z ` ; Town Hall, 53095 Main Road TOWN CLER ` r- :. :jp T P.O. Box 1179 REGISTRAR OF VITAL TATIS & ;` Southold, New York 11971 MARRIAGE OFFI Au �y0` ��, Fax (516) 765 1823 __7Liol ��0�,• Telephone (516) 765-1801 llt OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Southold Town Code Enforcement Officer From: Linda Cooper, Southold Town Clerk's Office Dated: MAY 21, 1992 Transmitted herewith is a copy of application No. 868 for a Cesspool/ Septic Tank Construction Permit submitted by: LISO CONST. COPR. FOR LEWD EDSON • 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. *-1-----X-e-i--{.------- Linda J. Cooper * * * * * * * * * * * * I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE XIky DISAPPROVE 70., Comments: . , ' .‘ cM .� • ./ a ./ _� .I � . I L_.,4/447 Clift.a.bAj 11 %.C.,..1.1... . av) 4\11\1z._ \(3. .... A, - 4-4-IQ Signature 9 .1-13\1 1.__ Dated t OFFICE OF THE TOWN CLERK �FFU ," Town of Southold 40' ��; Application No. F6 Judith T. Terry, Town Clerk Town Hall, 53095 Main Road g Construction c/ P. O. Box 1179 Alteration Southold, New York 11971 Telephone .4e1 a *�O .. 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 71 APPLICANT NAME: . S 8 C-G i S L C- ' R-'P . APPLICANT ADDRESS: 'o B a ,4,y--i g- oft.- . /l "7 7 SEPTIC VC-ESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION L rL L= w O Fo+n-, �-�2' �- C.l►.� !�E 4 LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY:L w► S D S v v--1 OWNER MAILING ADDRESS: hp-c NI 410 SU L,LiAc< LC) N-1/4-1. OWNER PROPERTY ADDRESS: R d u 6,4 L A.1K,E CC- c-lc. a v>` TELEPHONE NUMBER OF CONTACT PERSON: — L P-P-4 TAX MAP NO. : Section /a/ Block Lot /a?, CROSS STREET: Vitbet,14 017. BUILDING PERMIT NUMBER CROSS REFERENCE: 410 �1�►� -i _ _-- Signature o pplica RECEIVED BY: X. Cle9-- .} Town ark's Office DATE: off- (,(5 1 - n/.SZ •*,z0-s. - 198.36 t k ria614 Q 24 :4\ o , 14 t y __------/— \ die d t( STATEMENT OF INTENT q/av' en 30�•°,— •4 I THE WATER SUPPLY AND SEWAGE DISMAL. - _ We 0 .b• , 0 4 SYSTEMS FOR THIS RESIDENCE WILL 1�' 6 . ��—_--"""J— i • • y* '�0 I CONFORM TO THE STANDARDS OF THIS -- "'�" 5 ;'�' '� 0 j SUFFOLK CO. DEPT. OF HEALTH SERVICES /z - � 0'- 'I 1 (5) .T-_ Are ‘ 4a APPLJCANT sstrc . Q v , 'V - SUFFOLK COUNTY DEPT. OF ALt �0- / f SERVICES FOR APPROVAL val i' "'e� si* V CONST . • a r�►J ' -41&7S- K. S REF. I r . — h �'a. SO OA' lG � �! APPROVED: r � �r/ $a a•IF Ay% A' alio— 3 / W?FOLIC CO TAX MAP * . k r' ! 'o j • t� �f MST. SECT. BLOCK ' kJ Y '`,`. OWNERS ADORE ,l X . - erg Pro, " rr tilllF t. b - / 54,4* --.; ,� SE 1vT'1� v St t1`f X71 -34. ag 6 11 �� j'e`o r.1. ?4$ 'Z "~�J / v" c tt wait-. WED: t.. MAP':'" P ..•••••••••1 FAMILY DWELLING ONLY 4 TEst i 'EAS'FROM DATE OF.APPROVAL - s F a, .-„,,n 4/ VIn:,r t of F^ ,+' '4 xra Ears Yet Swat • ! r 'ILC L /. f Co;lis Cf*PI tteti►In4l,floc bun* tn.,Iz,�d surveyoe"s Inked sad or 1 MAP O F Lor No. 1 _ 1 i:: x e vad seal sive net beesnsidi d 4. H ? SCALL'• SQ'= l., (Jae 1 to bp avalid trwoop% ;,fK... C Q o W N LAND LANE " Cuarr+neea person indicated ohm sharhes rid i me -_-- ori = 4 S �6/ Sf�F1' 'Q�'�+Ilm� tnty n the person for vMxxre the Il�tsFfr) it n rea.end on hts Whitt to L"k? , 654/0:01.04.44 CO. nil P Vo. 6289 r� r n,. In- ;t:1; O s P►f PE ,`_ut:on'item!,c-en r��^ r! ! �/ ..9 Cfthoi: rR 17.-1- t c.. lel rCHOQaii jb . T . ,, ^serenott s x`41 L c. s:itutions a su - .sant i SU tz VdrY110 F.O,e 1 I LE vvI S L.. E DS ON � SEAL, _--- -- --- ...___ /;NFw r