HomeMy WebLinkAboutHabitat For Humanity (2) ' fin,
JUDITH T. TERRY Town Hall, 53095 Main Road
P.O. Box 1179
TOWN CLERK h
REGISTRAR OF VITAL STATISTICS J' Southold, New York 11971
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MARRIAGE OFFICER Fax (516) 765-1823
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Pr Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 863 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 24.000
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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#Jo. I N. ��®��_�A
JUDITH T. TERRY A' '.
Town Hall, 53095 Main Road
� a P.O. Box 1179
TOWN CLERK ® knN 4
REGISTRAR OF VITAL STATISTICS q Southold, New York 11971
MARRIAGE OFFICER ��� '�, Fax (516) 765-1823
rv® �o�®�e! Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK t.`�'C�. (-�-' i C+/'i`r
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 30, 1992
Transmitted herewith is a copy of application No. 888 for a Cesspool/
Septic Tank Construction Permit submitted by:
Habitat for Humanity of Suffolk Inc. (48-2-24) .
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 X
DISAPPROVE
Comments: _ - ' , _; 1 1 _ NI116,1 r01,
I ,� Ii� . 1
k.9\ -L\' °‘1•..
\C.,.(7.1-, cia...,...,Q._
Signature
1\2.—Xli -..--
Dated
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OFFICE OF THE TOWN CLERK c.''..1F0/., ` ,'
Town of SouTowtl =d, i O� Application No. ��,
Judith T. Terry, Clerk
Town Hall, 53095 A lain Road o
v' r'` - Construction ,�/
P. O. Box 1179 �� ' tt ES
Southold, New York 11971 - Alteration
u
Telephone ie;1 rc l ,fi Residential
(516) 765-1801 ,r�T� Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for ' , ,
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ /O
DATE .S c i ' 3c) /992—
,
APPLICANT NAME: ,//r/,e/74j /=&/2 /-M0/4/1//T)"- D/= Sc.(Fi DL/(T, //t/C.
APPLICANT ADDRESS: /90 8 ox- /,c p
gocKy pc. ,A,;, NY //77C
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
S/rv9/e Atry,(/y -t s-0/f/ f?e.StOe cC
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION// OR ALTERATION:
OWNER OF PROPERTY://"/9B/747 /-Ui2 /Ainy,N'7 pF_ 5uFr=oma/c /,v .
OWNER MAILING ADDRESS: 47/ 0)( /$J2
i?ot i / Ai ni, ill y //77,r
OWNER PROPERTY ADDRESS: 56 ' /-----L f,'-- Cr—
LTi E e-,u /O 47— A f
TELEPHONE NUMBER OF CONTACT PERSON: /FogeyAlpi,it fa, _537
TAX MAP NO. : Section 0 ilf Block : Lot
•
CROSS STREET: X77 7_
BUILDING PERMIT NUMBER CROSS REFERENCE:.
I
4-) / r4 ,
Signature of Appli cl nt
RECEIVED BY:
Town Clerk's Office
DATE:
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