HomeMy WebLinkAboutLong, Gary ELIZABETH A.NEVILLE Town Hall, 53095 Main Road
TOWN CLERK c - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS cn Southold, New York 11971
MARRIAGE OFFICER Fax (516) 765-1823
RECORDS MANAGEMENT OFFICERy�fol ���' • Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER
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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. 1955 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : GARY AND LINDA LONG
Address 1 : P. O. BOX 1016
City St Zip CUTCHOGUE NY 11935
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 #R10-98-0064
Name Of Owner LONG, GARY M. AND LINDA M.
Mailing Address 1 P. O. BOX 1016
City St Zip CUTCHOGUE NY 11935
Property Address 1 THAR LANE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 83.00 block 4 lot 14.000
Cross Street DUCK POND LANE
Building Permit Number Cross Reference:
Issue Date: 10/19/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
/11571
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ELIZABETH A.NEVILLE j .ZO oy s Town Hall, 53095 Main Road
TOWN CLERK Z P.O.1 '4, Box 1179
cn Z
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS �'$ Fax (516) 765-1823 F
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER Z ?, � Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER '/ l Pli 1`a�00
o's°-
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: October 13, 1998
Transmitted herewith is a copy of application No. 2031 for a Cesspool/
Septic Tank Construction Permit submitted by:
Gary and Linda Long
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:
S. nature
0 / gib jcSr
Dated
OFFICE OF THE TOWN CLERK �C.31FO1,k .
JudithTTwn of y, Town Clerk �� ^� CG
Terry, thold
Application No. /
Town Hall, 53095 Main Road c Construction
cna;-
P. O. Box 1179 . • Alteration
Southold, New York 11971
•
Telephone Y* 1 ,
• 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 1(3- 13-9 fr
APPLICANT NAME: GAC-%1 M Lu�3c1A 111- Lor.1G-
APPLICcANT ADDRESS: P•0. 15‘16 1016
y uq 35
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
ME u. CoisiSTEucnog .
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: (3 aLy and L,i a to IYt_ LoJG-
OWNER MAILING ADDRESS: P U (5e.c (D I(,
tai-c ko%Luz_ Ny \L°136
OWNER PROPERTY ADDRESS: -MA LANE
c ., , II
TELEPHONE NUMBER OF CONTACT PERSON: 7314-7132.
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TAX MAP NO. : Section - $"b Block y Lot Iy
CROSS STREET: L OCk P'osk3b LANE
BUILDING PERMIT NUMBER CROSS REFERENCE:..
Q°Dxda ' Q°
Signature of Applies
RECEIVED BY:
Clerk's Office
DATE: /o fi ��
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