HomeMy WebLinkAboutLand, Mary Karen ,o1 oFFO(,rco
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ELIZABETH A.NEVILLE �h �y �� Town Hall, 53095 Main Road
TOWN CLERK i P.O. Box 1179
co, Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ; Fax(516) 765 6145
MARRIAGE OFFICER `
RECORDS MANAGEMENT OFFICER `may*0 40.1 Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER =��• I• •
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2099 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MARY KAREN LAND
Address 1 : PO BOX 913
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-97-0064
Name Of Owner LAND, MARY KAREN
Mailing Address 1 PO BOX 913
City St Zip MATTITUCK NY 11952
Property Address 1 MEADOW LANE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 116.00 block 2 lot 6.000
Cross Street NEW SUFFOLK AVENUE
Building Permit Number Cross Reference:
Issue Date: 7/01/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE �44 O�f�`� Town Hall, 53095 Main Road
TOWN CLERK Z y - P.O. Box 1179
_ Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
O Fax(516) 765-6145
RECORDS MARRIAGE OFFICER ` Telephone (516) 765-1800
FREEDOM OMANAGEMENT 00 '/ORMATION OFFICER `y��'� 4 'i,.. P
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 22, 1999
Transmitted herewith is a copy of application No. 2187 for a Cesspool/
Septic Tank Construction Permit submitted by:
Mary Karen Land
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.
PAt-6(""`"-
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE ✓
DISAPPROVE
Comments:
ignatu
Dated
` OFFICE OF THE TOWN CLERK , AVglir
TOWN OF SOUTHOLD ''s'OC COGApplication No. , ,i .37
ELIZABETH A.NEVILLE,TOWN CLERK X
P.O.BOX 1179 : Construction
SOUTHOLD,NEW YORK 11971 `sl=O
Alteration
Telephone .rOif� s0se $10.00 - Residential
(516) 765-1801 = �l �''� $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE (.O - 01 I - 9 9
APPLICANT NAME: n _._6( r K.areT\ Land
APPLICANT ADDRESS: O tr c--6( �+
SEPTIC/CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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la 01 (c-l! D fill�t„_._�/ ,
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: fl()eA6,0A;v 1 e,-ne,G..{`rktfite
OWNER OF PROPERTY:
OWNER MAILING ADDRESS: -P�; l I
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MO&i r K. , ftj 119 s 0
OWNER PROPERTY ADDRESS: YY\f t / ,--- -, /., Ct
TELEPHONE NUMBER OF CONTACT PERSON: 3 a`3 -(9-SCQ o),
TAX MAP NO. : Section 7/ 62. Block 0 Lot 6
CROSS STREET: /Vf,,_) (_ 1----i O LC 10 '--e •
BUILDING PERMIT NUMBER CROSS REFERENCE:
CW
nature of Applicant
RECEIVED BY: tr Z ,a14_
Tow CI k's Office
DATE: 6/D—/
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SUrFOI.K CO(Itr7'Y DEPAIC'fMgN >F1EAL?N SERVICES
PERMTr��Apl'ROVAL OF CpTOFA1ST►�jp >�'A, rA11�1 QED r ,
AMILY RES;DENCE ONLY Ma A FDRSANITARY SYSTEM
DATE BY HEALTH DEPARTMENT I
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APPROVED
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