HomeMy WebLinkAboutMcGahan, Doug ,,.
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o T ; Town Hall, 53095 Main Road
�`� P.O. Box 1179
yam. , ��. .r .' Southold, New York 11971
JUDITH T.TERRY :1 + FAX(516)765-1823
%.�,i./�,�. FAX
(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. 574 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MCGAHAN, DOUG
Address 1 : P. O. BOX 602
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 ON 11/27/89.
Name Of Owner MCGAHAN, DOUG
Mailing Address 1 P. O. BOX 602
City St Zip CUTCHOGUE NY 11935
Property Address 1 235 WICKS ROAD
City St Zip NEW SUFFFOLK NY 11956
Tax Map No. section 110.00 block 8 lot 22.000
Cross Street NEW SUFFOLK ROAD
Building Permit Number Cross Reference:
Issue Date: 1/10/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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BLDG. DEPT. . tri . Town Hall, 53095 Main Road
TOWN OF SOUTHOLD
y0 P.O.P.O. Box 1179
'=__ ►0 b 0" Southold, New York 11971
JUDITH T.TERRY ,006
- 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 20, 1989
Transmitted herewith is a copy of application No. 587 for a Cesspool/
Septic Tank Construction Permit submitted by:
Doug McGahan
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: ra,„ �,,, c, a31 a
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IMMO Signature
DEC 261969
Dated
Town Clerk Southold
OFFICE OF THE TOWN CLERK .c FO C.
Town of SoutholdTown Clerk ~ D 8-7
,
Application No.
Judith T. Terry,
Town Hall, 53095 Main Road j' Constructiontrl
L
P. O. Box 1179 **��� Alteration
Southold, New York 11971 aim �Z-�.
Telephone �l �� 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 .$
DATE :D- :1 -
APPLICANT NAME: DOUG M ( -P}t 'YJ
APPLICANT ADDRESS: P 0 , j3DX C�oZ
c u Tc_tf do 6,vc ( N``{ s�9 3 'IP-
SEPTIC
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
fc•-vv`.S ��►3e� � v,� -t- t QO S .
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LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 'Jou
OWNER MAILING ADDRESS: V •0 , 15c5"/ o z
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OWNER PROPERTY ADDRESS: 23 g ""D
TELEPHONE NUMBER OF CONTACT PERSON: 6
TAX MAP NO. : Section ( t O Block g Lot 2Z
- CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
*''
re 's 'Applicant
RECEIVED BY:/J
Town Clerk's Office
DATE: /4 — 5-61 - ��
• . 'I INS-' SUFFOLK CO. HEALTH DEPT. APPROVAL
` , ' ( t(t- ....: . -14---S--110---...--
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�. ���N Requires s.4.0, tank
,50. ver to grade.
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M ,,,-- NOVA \ STATEMENT OF INTENT
> '�'7.. 21,E E E . , l �o- e7_'„'_"' _ � ^''J THE WATER SUPPLY AND SEWAGE DISPOSAL
' 'S-- eA .WI 14 f 'Ce' --14--- ---"I ��(I �y�� SYSTEMS FOR THIS RESIDENCE WILL
O SHCfl _ a '� �' f_ f`��J ) 1/1" CONFORM TO THE STANDARDS OF THE
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,�T.11. , N / ' ---� F,00�r i ��Z� --- -- ~ — — SUFFOLK PT. OF LTH SERVICES.
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Iso �r �' t t 1. f, ` ES BO1JL )Lt SUFFOLK COUNTY 'DEPT. OF HEALTH
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_._�. _ ._-___.____.��._�._-____-_______ SERVICES — FOR APPROVAL OF
�,,(,�5` _ J 1' . A( - CONSTRUCTION ONLy,
NOV 27 ,989
't1u.�• V \ — - H. . REF. NO.: .,------5-1:17--5 .--Cr/r../Ps---
- - i r I • �. \ t.''A N �rF `w J''i11�,L j, fr AP ROVED: - \
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1Nf LLQ`0ya HOUC,C �-� ir
_ , - Noir�.rlt t.--- IS TO stzouWD WATE2, SUFFOLK CO. TAX MAP DESIGNATION:
HOUS t J .J 'i POINT 42 eELow G.W. \ r DIST. SECT. BLOCK PCL.
fi r - Ikii t (oWNEt25 2EPOCLT) \ _.1Q00 t j Q a 22.
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OWNERS ADDRESS:
- - - s u ( 1TO NEW e:31,02 roL \
wIcIl rr
Ji `b WELL '9., • -- - - \ NE W `�U ?l. Lk- i�.iif lt�i
1,J,`73 21���WC 1� Q \ -
4 c; tni�o wNT (734-7480)
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TEST HOLE STAMP
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