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JUDITH T. TERRY ;�• :1C Town Hall, 53095 Main Road
TOWN CLERK O P.O. Box 1179
REGISTRAR OF VITAL STATISTICSFax (53
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Southold, New York 11971
MARRIAGE OFFICER Q ��0�,,� Tel ph nel(516)765-1
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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. 683 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : KEVIN AND THERESA FLYNN
Address 1 : 2860 PINE TREE ROAD
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 2/11/91 .
Name Of Owner FLYNN, KEVIN AND THERESA
Mailing Address 1 2860 PINE TREE ROAD
City St Zip CUTCHOGUE NY 11935
Property Address 1 ORIOLE DRIVE (LOT37)
HIGHPOINT MEADOWS, SECT. II
City St Zip SOUTHOLD NY 11971
Tax Map No. section 55.00 block 6 lot 15.001
Cross Street THTH I LL ROAD EXT.
Building Permit Number Cross Reference:
Issue Date: 3/20/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
•
1JIQR 9Q� Town Hall, 53095 Main Road
�., P.O. Box 1179
twit$ O Southold, New York 11971
JUDI .TERRY f TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Southold Town Code Enforcement Officer
From: Linda Cooper, Southold Town Clerk's Office
Dated: FEbruary 26, 1991
Transmitted herewith is a copy of application No. 703 for a Cesspool/
Septic Tank Construction Permit submitted by:
Kevin and Theresa Flynn
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 n
Comments: u„... �.r.�.c � D (' ,•,et, . 0 n Y �C
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Dated
OFFICE OF THE TOWN CLERK c\C��F�J(,r
Town of thold
Town Clerk E� `� �y Application No. -7D�
Judith T. Terry, • ,. .G
Town Hall, 53095 Main Road c
r-- .: "iSaY '—n—n - Construction
P. O. Box 1179 cr)
O. '� `% Alteration
Southold, New York 11971 /
Telephone01 r � Residential 'v
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE j &4 -9(
APPLICANT NAME: < �!�/N -
(
APPLICANT ADDRESS: 256c) 7 e E /26,
6.rr-41-0 be ivy i' 3 s—
SEPTIC 'CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
4'rr fa-1L/ / — c›1__ Poo (--
LOCATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: FI }/iv/i ,. P._111//4/ T 7) 3/� •
OWNER MAILING ADDRESS: StE 0Ye-
OWNER PROPERTY ADDRESS: ) i if 38 j...114.14-Pew/v1— A4L-7OwS
SSA rld-o c, /1/7 fi l?/
TELEPHONE NUMBER OF CONTACT PERSON: 7,3q— 79 on
TAX MAP NO. : Section , -t- Block Lot � p /I- /
CROSS STREET: j2 ,x,-„I/S/6 "I
BUILDING PERMIT NUMBER CROSS REFERENCE:..
411
4 Id IkAy A A I rari tel
ip ,FT!rw. re • •plicant
RECEIVED BY: kit ,
Town Clerk s Office
DATE: 4-- - &.67-9/
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�JiFCL'n CC:I dTY CZ P RT'1'c.t:T i'1- i-.LAI' : SURVEY FOR
KEVIN M. FLYNN 8 THERESA FLYNN
P .'.,,;a:. .. -'-TKLOT N0.38,I�HIGHPOINT MEADOWS,SECTION TWO"
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AT SOUTHOLD DATE AU(
:. _4.7.:- FEB 1 ' 1991 . . I- ,,,� 0 .0 0TOWN OF SOUTHOLD SCALE r"_
j - —� SUFFOLK COUNTY, NEW YORK NO 90
• �L('/• 7�j��, ruwuTHORIZED ALTuATIOM ON AOD,+IoN TO THIS GUARANTEED T • pF
—M(WvTr E A vIELIDuC of!LAW OON OF THE TICOR TITL A�iEANTE�
NEI• rORk STAT[ lDUCATION L•W
J1 .�I'' F f'., `.l ACOPIES 0! THIS SURVEY NOT AEARMG THE LAND �p
/ '��?� SUR AC YONS IMRED SEAL OR EMSOSS[O SEAL SMALL O,� �S'.
7j Y /
NOT A(CON SIO E RED TO N A VAL10 TRuE COPY
AGUANANT(ES INDICATED NEREON SHALL RUN OILY TO 41 r H
HEALTH DEPARTMENT-DATA FOR APPROMU.TO CONSTRUCT TH(PERSON FOR WHOM TME SWINE, ,s PREPARED
ANO ON NIS SENALF TO THE TITLE COMMMr,GOVERN-
•MEANEST WATER lAIN_MI ' *SOURCE OF WATER PRIVATE_►UKIC_ MENTAL AGENCY ANO LENDING INSTITUTION LISTED `i►;J
■SOF CO. TAX MAP DMT.JQQQS(CTION�SLOCN�-LOTO(AJD•I HEREON,AND TO THE ASSIGNEES OF THE LENDING ��.�_
N THERE ARE NO DWELLINGS WITHIN 100 FEET OF TMS PROR(RTr INSTITUTION GUARAM ARE NOT TRANSFER/M.1
OTHER THAN THOSE SHOWN HEREON TO ADDITIONAL INSTITUTIONS ON SU•SEOU(MT H� '
M THE WATER SUPPLY AMC MUSK DISPOSAL SYSTEM FOR THIS RESIDENCE OWNERS 'O
WILL CONFORM TO.-ME STANDARDS OF THE SUAOLA COUNT♦ MDISTANCES SHOWN NERCO/. FROM ►NO►ERT♦LINES
0/MEAL TM SOlV,10Ef TO CAWING STRuC TURES AR(FOR •SPECIFIC
APPLICANT. /Z PURPOSE AND ARE NOT TO SE USED TO 11114JI 4...„....... PROPERTY LINES OR FON THE ERECTION OF FENCES
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