HomeMy WebLinkAboutMcCoy, Harold . • 4
Town Hall, 53095 Main Road
V, e .r ��` P.O. Box 1179
----I'd" .��00'. Southold, New York 11971
JUDITH T.TERRY =—,-,T,.-'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. 440 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MCCOY, HAROLD
Address 1 : 4270 WUNNEWETA ROAD
City St Zip CUTCHOGUE NY 11935
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES 12/7/88.
Name Of Owner MCCOY, HAROLD V.
Mailing Address 1 4270 WUNNEWETA ROAD
City St Zip CUTCHOGUE NY 11935
Property Address 1 5655 NASSAU POINT ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 111 .00 block 13 lot 3.000
Cross Street LITTLE PECONIC BAY ROAD
Building Permit Number Cross Reference:
Issue Date: 1/05/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
ate 13I'I
BLDG. DEPT. . ^ Town Hall 53095 Main Road
L TOWN OF SOUTHOLD "" ' ��
O *,�� P.O. Box 1179
44 /
Q �� i' Southold, New York 11971
JUDITH T.TERRY 111°. TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Victor Lessard, Southold Town Building Department
From: Linda Cooper, Southold Town Clerk's Office
Dated: December 13, 1988
Transmitted herewith is a copy of application No. 447 for a Cesspool/
Septic Tank Construction Permit submitted by:
Harold V. McCoy
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.
C7646
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments: @,, GA ,,,s, nu441 oire.,,LLS1
. N Z ► .\-,`t/
Signature
Dated
OFFICE OF THE TOWN CLERK ,lFD„I�
Town of Southold ZQ\► w : ".4%jpt, Application No. /7/1/7
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road a a t
Construction
P. O. Box 1179 �'
Southold, New York 11971 0 �. Alteration
Telephone
Ol 3t Residential �/
(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 $A)
DATE ?hy/FF
APPLICANT NAME: //4-g6c.,9 U • M P C�
APPLICANT ADDRESS: `/2-76 t/ r` .1/Ow E7.4 r{p
C'�7cNo�..,: N- ' 1199)—
SEPTIC
199)—
SEPTIC CESSPOOL v
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION S,E.P?!cv COsiPoe
7404-A< f=a R / w ,d ✓ST
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: MeddC-O U, c C.4
OWNER MAILING ADDRESS: 4427° &) i 4) A/ew %rg 2a
Cu C Cue
OWNER PROPERTY ADDRESS: 56 SS it/Ars'A0 147: A
ti-r cNeav% ,v y J/ q76'
TELEPHONE NUMBER OF CONTACT PERSON: /-71.,,,cca� 7351-7p 7/
TAX MAP NO. : Section /// Block J3 Lot 3
•
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:.
tPeU.47c
Signature,6f Applicant
RECEIVED BY:
own CJYerk's Of ice
DATE: / 3/c
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