HomeMy WebLinkAboutLengyel, Bill Town Hall, 53095 Main Road
JUDITH T. TERRY ''�
TOWN CLERK P.O.r= P.O. Box 1179
tls ��� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ‘‘VA,, � Fax (516) 765-1823
MARRIAGE OFFICER ,�n �� ,I' Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER = "K/ 4. ,.00
FREEDOM OF INFORMATION OFFICER iiii,,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1085 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : INLAND HOMES INC.
Address 1 : 315 WESTPHALIA ROAD
City St Zip MATTITUCK NY 11952
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 #93-SO-92
Name Of Owner LENGYEL, BILL
Mailing Address 1 212 HIDGES ROAD
City St Zip PATCHOGUE NY 11772
Property Address 1 LITTLE NECK ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 103.00 block 10 lot 9.000
Cross Street BALDWIN PLACE
Building Permit Number Cross Reference:
Issue Date: 1/04/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY % y` Town Hall, 53095 Main Road
TOWN CLERK : p r= P.O. Box 1179
to � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS "-V46, ,' Fax (516) 765-1823
MARRIAGE OFFICER , .O �1 Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER "'VJ •4 ��
FREEDOM OF INFORMATION OFFICER ..�„„,,aP°.l ”,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD ,;ell s;
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TO: Southold Town Building Department jac
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FROM: Linda J. Cooper, Southold Town Clerk's Office 0
DATED: December 28, 1993 ;
Transmitted herewith is a copy of application No. 1120 for a Cesspool/
Septic Tank Construction Permit submitted by:
Inland Homes inc. for Mr. Bill Lengyel •
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 1-- —
DISAPPROVE
Comments: ,c- !i/p-e Se /770 i-/ 93 .5o 9Z
. .-----'Sign ture
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Dated
OFFICE OF THE TOWN CLERK c.VC(
Town of Southold �� .
Judith T. Terry, Town Clerk �;'r�` �; ' � Application No.//
Town Hall, 53095 Main Road ! : ";'"
cn _ '� Construction Gy
P. O. Box 1179
�` � ' ` �`� r Alteration
Southold, New York 11971
•Telephone r �1t' Residential
(516) 765- 1301 r��
Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
•
APPLICATION
•
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
•
Permit No.
Fee •$
DATE
APPLICANT NAME: Inland Homes Inc.
•
APPLICANT ADDRESS: 315 Westphailia Rd. , Mattituck, N.Y. , 11952
SEPTIC CESSPOOLrx
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
Single Family Dwelling
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Mr. Bill Lengyel
• OWNER MAILING ADDRESS: 212 Hidges Rd. ,Patchouge,N.Y. ,11772
OWNER PROPERTY ADDRESS: Little Neck Rd. ,Cutchouge,N.Y.
TELEPHONE NUMBER OF CONTACT PERSON: Inland Homes 2989696
TAX MAP NO. : Section 103 Block 1A 09
Lot
. CROSS STREET; Baldwin Place
BUILDING PERMIT NUMBER CROSS REFERENCE:..
IP
' • Signature ofApp icant
RECEIVED BY: ,rj
" Town Cler-Ic"s Office
•
DATE: �9��
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