HomeMy WebLinkAboutFlatau, Carl rto-
Town Hall, 53095 Main Road
%0 P.O. Box 1179
;' �l � �b f. Southold, New York 11971
JUDITH T.TERRY / TELEPHONE
TOWN CLERK (516) 765-1801
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. 321 R Residential X Non-Residential
Fee $ 10. 00 Septic Cesspool X
PERMIT ISSUED TO:
Name : TWIN FORK SIDING CO
Address 1: P.O. BOX 41
City St Zip MATTITUCK NY 11952-0000
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM
APPROVED AS PER SUFFOLK COUNTY HEALTH DEPARTMENT APPROVAL
Name Of Owner FLATAU, CARL AND WIFE
Mailing Address 1
City St Zip CORAM NY 11727-0000
Property Address 1 SEBASTIONS COVE ROAD
City St Zip MATTITUCK NY 11952-0000
Tax Map No. section 100. 00 block 3 lot 11.700
Cross Street EAST MILL LANE
Building Permit Number Cross Reference:
Issue Date: 4/08/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
ir3
A :71-7 rn(
APR 51988E t
L-11 TC•f=1 T-7-;
BLDG. DEPT. , .'+' Town Hall, 53095 Main Road
TOWN OF SOUTHOLD -.'a "`M.. w P.O. Box 728
r` Southold, New York 11971
JUDITI I T.TERRY TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
April 4, 1988
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 325 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by Twin Fork Siding Co. for Mr. & Mrs. Carl Flatau •
Please review the application and location map and advise if the
project has received Suffolk County Health Department approval
and if we may issue the permit.
Please complete the form below and return it to my office.
Thank you.
elre401146,41•
Judith T. Terry
Southold Town Clerk
I have reviewed the application and location map of the project
cited above and make the following recommendation:
APPROVE - X
DISAPPROVE -
COMMENTS: Cti j..,,,„ c.c s&, taut C,fA4-.. :y 1F
en X111
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Signature
Lt/LQ
Date
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OFFICE OF THE TOWN CLERK %C3IFO1,4
Town of Southold -}
Judith T. Terry, Town Clerk Application No.3a
Town Hall, 53095 Main Road , Construction v
P. O. Box 1179 O ��� Alteration
Southold, New York 11971
Telephone _�1i Residential
(516) 765-1801 I
Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ (O. ,y
DATE
APPLICANT NAME: ,,v 6;0 ''/(. �O
APPLICANT ADDRESS: PQ Qo)4 ( /774 ( ( , j,/G/i I ( / ,
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
/V f- .
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: /4/24 MIS_ Ge¢-/ L 1- L ,r{-T�( c)
OWNER MAILING ADDRESS:
Ltidi, /7 7 .2- 7
OWNER PROPERTY ADDRESS: 5�3A Si,'Orc 5 ( p rJL "OA
(1 `tom_
TELEPHONE NUMBER OF CONTACT PERSON: /
TAX MAP NO. : Section /c9 0 Block 3 Lot ll "7
CROSS STREET: , /`4oc--� Lft
BUILDING PERMIT NUMBER CROSS REFERENCE:
1 / 4 r
Signat a of Applicant
RECEIVED BY: 't` u--
Town CI k's Offi e
DATE: I / 4 /1'0f
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; JC ,CiPR•�COi�/<< ` SUFFOLK CO. HEALTH DEPT. APPROV
H. S. NO.
Poagx cf/
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STATEMENT OF INTENT
Mil 18THE WATER SUPPLY AND SEWAGE DISPC
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B SYSTEMS FOR THIS RESIDENCE
r CONFORM TO THE ST/ DARDS OF
�^ �'� ��i�/�c� ' �`/ SUFFOLK . EPT. F_MEALTH SERV
tjalliSES APP ICAN
SUFFOLK COUNTY DEPT. OF HE;
.,� A T SERVICES - FOR APPROVAL
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CONSTRUCTION ONLY
f . 7- 777 JCt'< , •-1,4 DATE:
H. S. REF. NO.: I '
APPROVED: .► Lam\
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(:)ti SUFFOLK CO. TAX MAP DESIGNATIOI
DIST. SECT. BLOCK PC
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R¢DERICK VAN TUYL, P.C. F o •t ,0 ,.1
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LICENSED LAND SURVEYORS
GREENPORT NEW YORK