HomeMy WebLinkAboutHabitat For Humanity JUDITH T. TERRY ., Town Hall, 53095 Main Road
TOWN CLERK
REGISTRAR OF VITAL STATISTICS o t�+ P.O. Box 1179
�• Southold, New York 11971
O �� Fax MARRIAGE OFFICER ® .� F (516) 765-1823
��0 ��®4�� Telephone (516) 765-1801
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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. 864 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : HABITAT FOR HUMANITY OF
Address 1 : SUFFOLK, INC.
City St Zip ROCKY POINT NY 11778
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH SANITARY SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 6/24/92.
Name Of Owner HABITAT FOR HUMANITY OF
Mailing Address 1 SUFFOLK, INC.
P. O. BOX 148
City St Zip ROCKY POINT NY 11778
Property Address 1 FLINT STREET
City St Zip GREENPORT NY 11944
Tax Map No. section 48.00 block 2 lot 26.000
Cross Street 9TH STREET
Building Permit Number Cross Reference:
Issue Date: 7/08/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY ,t, Town Hall, 53095 Main Road
TOWN CLERK P.O.`, t Box 1179
REGISTRAR OF VITAL STATISTICS �` Southold, New York 11971
MARRIAGE OFFICER �1�. Fax (516) 765-1823
�_�0 ®��! Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK �.�=3,:?
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TOWN OF SOUTHOLD I ``;' .._,1,1._, •`�_` '
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TO: Southold Town Building Department 11 JUN a
FROM: Linda J. Cooper, Southold Town Clerk's Office i '�,CI j'sem.�`, e:
DATED: June 30, 1992 �'�lfi `� ` "'�s
Transmitted herewith is a copy of application No. 889 fora Cesspool/
Septic Tank Construction Permit submitted by:
Habitat for Humanity of Suffolk Inc. (48-2-26) .
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: p.-Q Co , \ 6 "-N
(912ACkl-
(....zau44(2,
Hca.
Signature
Dated V •
OFFICE OF THE TOWN CLERKcJ�rFUtifr
Town of Southold CO
Judith T. Terry, Town Clerk ��� . -� ' Application No. ?-(f-2
Town Hall, 53095 Main Road o Construction
P. O. Box 1179 U'
Southold, New York 11971 •
Alteration
Telephone �1 tltly�O 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 $ ID
DATE V/1/;:2-
APPLICANT NAME: //-4,6,77,-.7-/v/e4,92/54447'Q' ace®Aki A� .
APPLICANT ADDRESS: r it)' 1 %'
•
AG7 �r ), /77‘
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
‘424/61-4_ A;91-toi 9/ /
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: , �f/ AT,e it
OWNER MAILING ADDRESS: � "Rat- J'f
(jzy , t/v //774?
OWNER PROPERTY ADDRESS: 3 'e ft .�., / /.'/7- 3'7'7
TELEPHONE NUMBER OF CONTACT PERSON:446 ' ' ' Pc"?/-Sl"
TAX MAP NO. : Section & 618 Block c=09 Lot ? C
CROSS STREET: 9741L-C7----42e-e-7—
BUILDING PERMIT NUMBER CROSS REFERENCE:.
411#
'ignatureof Appli ''nt
RECEIVED BY:
Town Clerk's Office
DATE: •
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an ' Date
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� zaF Ivor :?°�291Js 6/s'cfiF lies /� Certified 7`0: f/A8/TAT FO,� HUMAP,IITY
X1,9 s,�,2 „--k — Zio` \/ •-�' OF SUFFOLK
{D `3, /SD i) GLD ¢#2 - , - &REENPo.QrLICNT DEPT - -�--`
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---owiTER MAIN 35 SUFFOLK COUf�TY DEPARTMENT OF 1°IEA S CES (�
k_-ATI "y.sx FLINT ST key`/ FOR APPROVAL Of COPISTRUCTION OF S U l ���� D, SUF���/ 1 CO NY NY.
Single Family Residence Only
OiAerwise
JUN 24 992, N0. l�nou/n As
2 ----- 'x - ... DATE- ` - `%:'" GR E E N PO R T DRIVING PARK
APPROVED _ _doom � s��- L o T 79
* EXPIRES -3 YEARS FROM s- E OF • RDYAL AREA:S625fl I- 1 D'r t •10001 DRAeo BY 1-2
CES -----
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of 78 /es PLJ 1 o�.._ ------ Piop ffa'a://7644 ;6[ ofseAe8 111 = 20 ,
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