HomeMy WebLinkAboutHolden, Alice 4
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ELIZABETH A.NEVILLE Q� � y Town Hall, 53095 Main Road
TOWN CLERK o= 1 'r P.O. Box 1179
ti 2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS I Fax (516) 765-1823
MARRIAGE OFFICER `0
RECORDS MANAGEMENT OFFICER 414 11 Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER Ol * ..ro 1
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1986 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : BARBARA KUNEN
Address 1 : P.O. BOX 103
City St Zip PECONIC NY 11958
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 #R10-98-0004
Name Of Owner HOLDEN, ALICE AND ANNE
Mailing Address 1
City St Zip 0000
Property Address 1 185 BURTIS PLACE
City St Zip PECONIC NY 11958
Tax Map No. section 67.00 block 4 lot 15.001
Cross Street MILL LANE
Building Permit Number Cross Reference:
Issue Date: 12/31/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE , y�\O C�G.y n Town Hall, 53095 Main Road
TOWN CLERK ; 0 1 P.O. Box 1179
REGISTRAR OF VITAL STATISTICS H O Z., Fax (516) 765-1823 Southold, New York 11971
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER Z ?,f0� �-0,000. 1Telephone (516) 765-1800
1
FREEDOM OF INFORMATION OFFICER •
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: December 31 , 1998
Transmitted herewith is a copy of application No. 2066 for a Cesspool/
Septic Tank Construction Permit submitted by:
Barbara Kunen .
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:
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ERK
OFFICE
TOWN OFSOUTHOLD s'�''���FF��k�O Application No. ae��
Ri I7ABETH A.NEVII.I.E,TOWN CLERK
P.O.BOX 1179 Construction '—
SOUTHOLD,NEW YORK 11971
Alteration
Telephone ,1' �Q��' $10.00 -Residential
(516) 765-1801 �l 001
$25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
VIC 10101P104006
APPLICATION
for NU OS 330
CONSTRUCTION or ALTERATION PERMIT Gmetwo
SEPTIC TANK or CESSPOOL
Permit No. •
Fee $
DATE f3o ,J / S
APPLICANT NAME: thp.4A.,04 vv NC IJ
APPLICANT ADDRESS: P ° ?0X 103
Peccr.e►ic
SEPTIC CESSPOOL ✓ /I
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION NomJ £S-I-rVd
5'1 �e � f �`/ 111 �- 27s1' "'✓1
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:: f_
OWNER OF PROPERTY: 4-{( c 101.0A,_/ vc. ll° (a`_✓L
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS:, AAri 4UitT)S.
1'�C�1C N l/ S rQ'
TELEPHONE NUMBER OF CONTACT PERSON: rl6 7“--664-1
TAX MAP NO. : Section C,7 Block LV Lot /5
CROSS STREET:BUILDING PERMIT NUMBER CROSS REFERENCE:
k4
Signature of Applicant
RECEIVED BY: i(L9-L
Town Clerk's Office
DATE: 14-019Y
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' PRO4 E� sewage disposal system
i•T I: 4Y1,_' ; .,:,' a 4111,-; .,..,,'"'S design by:
.4J Joseph Fischetti, PE
EX?G T +i- ',''./-i cat') h , ,-o, vAL, 1 Hobart Road
Southold,NY 11971
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EXCAVATION INSRECTIOtN REQUIRED
FOR SANITARY SYSTEM IIII8.w,rNlzomysfAxvi0
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