HomeMy WebLinkAboutHoffman (2) Of Mir
JUDITH T.TERRY ,' - Town Hall,53095 Main Road
TOWN CLERK ' g P.O.Box 1179
1,1 Southold,New York 11971
REGISTRAR OF VITAL STATISTICS : O / Fax(516)765 1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER `- ?jECORDS e.MAN (516)765-1800
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1339 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : WINDS WAY BUILDING CORP.
Address 1 : 1020 GLEN ROAD
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #R10-95-0045
Name Of Owner HOFFMAN, GEORGE AND EDITH
Mailing Address 1 17 HAWTHORNE ROAD
City St Zip GARDEN CITY NY 0000
Property Address 1 EVERGREEN DRIVE
(THE WOODS AT CUTCHOGUE)
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 102.00 block 1 lot 4.006
Cross Street DEPOT LANE
Building Permit Number Cross Reference:
Issue Date: 6/01/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
I e 33/-c
w`.
JUDITH T. TERRY : Town Hall, 53095 Main Road
TOWN CLERK ® rri P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = ® - _ „Oro ,"' Fax (516) 765-1823
MARRIAGE OFFICER 11
RECORDS MANAGEMENT OFFICER `= ® Telephone (516) 765 1801
FREEDOM OF INFORMATION OFFICER rte'
Ifrq
OFFICE OF THE TOWN CLERK , d L t
9,1!
TOWN OF SOUTHOLD L P[ q1Ili,st
11 19 g
f
TO: Southold Town Building Department Toirtiv oril-faia• f�—
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: May 18, 1995
Transmitted herewith is a copy of application No. 1388 for a Cesspool/
Septic Tank Construction Permit submitted by:
Winds Way Building Corp. •
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.
•
�rr�c.cL�
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
AI?PROVE
DISAPPROVE
Comments: ofG. -
REIVED
Signatur-
MAY,371 1995
Dated
lawn Clerk Soutltb1
.3;,,5-0p
OFFICE OF Ti-IE TOWN CLERK .,'""""'%
Town of Southold ,•'s'���FFULK0 , Application No. /0
Judith T. Terry, Town Clerk ,0 .,-.. ,,,.. - l/y - 0 D
O t. It
Construction
Town Hall, 53095 Main Road Z
P. 0. Box 1179 .% v _ �'cT,
Southold, New York 11971 .LP yc 1Alteration
Telephone ;`'0� ' c $10.00 - Residential
(516) 765-1801 ---_ 44 ile P, ' $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE „f/a/91 .
APPLICANT NAME: 40rwAJ W 4+«/4,-;
APPLICANT ADDRESS: /0)0 o(j ow Rot, titoofr
SEPTIC V CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
-t. TbaG... bi f G�..w. — c. ... -� t„0 6 at'aa S.
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: CCvltrtr6-F EbFrt4 it, ....,
OWNER MAILING ADDRESS: j) 141arg s pMrvlir 114 Gt4(mb6.w (-i t‘? iak
•
41 OWNER PROPERTY ADDRESS: i)(\ L �,".. os GW060k ;4,764. 14/
l�„ ``3
C £)Q C+. e. /V JC 1
TELEPHONE NUMBER OF CONTACT PERSON: 7(,r-1,374(--
TAX MAP NO. : Section lo'-- Block I Lot cl, C,-
CROSS STREET: Pt-',o L Ago t'
BUILDING PERMIT NUMBER CROSS REFERENCE:
.1G
Signature o pplicant
RECEIVED BY: `A - ' 1 -'
1),-
. Town Clerk's Office
DATE: 5— /1,i9 � .
. , /
N
P-
' •a.
CESSPOOL
1 SUFFOLK CO.HEALTH DEPT.APPROVAL
so
MAP F' PROPERTY I " 5 NO
iI
W S'uraVEYE0 pQQ ,
n i _ vE.0 2GF e PDIT;-1 Hut MACS;- '
. , AT
,9 —^
cuTCHOGUE STATEMENT OF INTEIGT
c 5.) Z e-
W LC THE WATER SUPPLY AND SEWAGE DISPOSAL
--- W ,eto - 50 S Posed TOWN OF SOUTHOLC NY. 1 SYSTEMS FOR THIS RESIDENCE WILL
4.3 CONFORM O. TH S'A DA DS OF THE
U< y /1 t ! ; SUFFOLK
!/ �EAERVICES
IgD±TO WELL 7 �� ,� 1 l I (SI qqrN6"� -Ga`/*�.+ ./�,.
r s 1 W 01- `CT'b'�, ) ! ��V..., 4.0.. u ,,t�, �«, ,-
�r L/
/ \ 1Z•l0.ty-92. I SUFFOLK COUNTY DEPT. OF HEALTH
SERVICES - FOR APPROVAL FOR,
/ \ S` _ ; / I CONSTRUCTION ONLY ApR 0 71005.
9 --
D AG
t
- • % �' N_92.14 00 E. 273.95 r i. ! I i DATE.
R F N. L 0'"' S�0 0 • '
I - \CiD Cc ....,. .�
PQQR Dvn/E - - -- - --- i APPR••' 0 i
Q. a----- ; --- % �/ tea!
(L� a C N / f i SUFFOLK CO-TAX MAP DESIG ATION:
` J . C .. I j i DIST SECT. BLOCK ��L.
1 i f / i
40% 1-.N.--- -4- --- IAO -�
4P,� -�/ T / SCALE-SO',{ i OWNERS ADDRESS.
��� \/ / I / ARFJI=4g I-72 5.1"--. ( HAWTHORNE AVE•
‘3›., I ..Z• / �/ j] GAO.DERl CITY,NY_11530
QtO
= 1VUMEFJT -
a=TACKED HUB
v /,., / -J Z
i
CPt�L 1E;I / f�• / v DEED.L. N/A P
pgcsivED
,�rvuOP.WELL �� TEST HOLE I STAMP
•y. / 4L
MAR 24 1995 - , 1 rr ..
,� PLEASE NOTE
wLdceObel5Ofh' ,
ee ! -
VOTES: I - i i c'9 N O. I p
`I
I,Lar MO S.IZEI=E2 TO MAP OF THE WOODS AT C 11TC4 4OGUE, • `d3 �, i ,
FIF.ED;N 71-It GUFF: O.CLeraCs OFFICE As MAP I .8717. WELL I O ! �I --�-�
2 CC?NTt7UR REFERS MEAN 5A LEVEL. i W Zd Dvr. r.„, I LL I i -_,,-377.---4,;,c,
SEAL
1LY DWELLNG ONLY GUARANTEED TO i I :A "*t'4N
SINGLE Fri S FR061 OATS OF APPROVAL
>JD O---
L-SO. :HICAG�7 TITLE-71C012.MID 10 uE cwNE25 '`.-:. ,2 r
FYDIQ�S THREE Y` Cvrc� I I As SUrLv4YED __ ;995 t' ...:1�
RODERICK VAN TUYL.P C. ,
�. '✓ T I - . -_-
I LICENSED LAND SURVEYORS L
I
•
GREENPORT NEW YORK
•._DYIE POST •,{,::E