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OFFICE OF THE TOWN CLERK
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Town of Southold CSG
Judith T. Terry, Town Clerk yz
Town Hall, 53095 Main Road & '
P. O. Box 1179 .u'
Southold, New York 11971 �O� �;�
Telephone 1 *
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION. PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 107 Residential x
Non-Residential
Fee $ 10.00
Septic Cesspool X
PERMIT ISSUED TO:
NAME: Timothy Hough
ADDRESS: P.O. Box F
Coram. New YO,rk 11727
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New one-story. 2300 ft, ranch - Residential
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Timothy Hough
OWNER MAILING ADDRESS;,P,O. Box F
Coram. New York 11727
OWNER PROPERTY ADDRESS : Aldrich Lane
Laurel. New York
TAX MAP NO. : Section 125 Block 2 Lot p/o 1 .3
CROSS STREET: Main Road (Route 251
BUILDING PERMIT NUMBER CROSS REFERENCE: Unknown
Judith T. Terry
• Southold Town Clerk
DATE: February 10, 1987
• (TOWN SEAL)
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OFFICE bF THE TOWN CLERK
Town of Southold Application No./i
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road Construction
P. O. Box 1179
Southold, New York 11971 Alteration
Telephone 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. /O7
Fee $'v
DATE
APPLICANT NAME: I "M,ol'k o wgh
APPLICANT ADDRESS: l i ktaL LoktLQ J
SEPTIC )6 CESSPOOL /
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
IJ tw Vo(4-1 #4.300 sF Li -
LOCATION MAP-: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: k;A, \AA ,S\
OWNER MAILING ADDRESS: Q.Q, Qa•A CorCim, w7a,7
OWNER PROPERTY ADDRESS: \ Lam, La 1,X ,
TELEPHONE NUMBER OF CONTACT PERSON: (516 - —13a - 1409
TAX MAP NO. : Section M5 Block 01. Lot ?I o 113
CROSS STREET: PG(
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature tplicant
RECEIVED �� 1
� �` own C rk's Off e
DATE: FEB 1 01987
Town Clerk Southold
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SINGLE FAMILY DWELLING ONLY 1
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SURVEY FOR
TIMOTHY HOUGH '
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES JULY 29,1985
AT LAUREL DATE JUNE 27, 1985
FOR APPROVAL OF CONSTRUCTION ONLY TOWN OF SOUTHOLD SCALE I" : 100'
( (�(� ()_ SUFFOLK COUNTY, NEW YORK NO 85-593
DATE [it W r HS NO• U S� - v 1 S--3 N UNAUTHORIZED ALTERATION OR ADDITION TO THIS GUARANTEED TO:
SURVEY R A VIOLATION OF SECTION 7209 OF THE
NEW YORK STATE EDUCATION LAW , EQUITY ABS •F !f�
APPROVED N COPIES OF THIS SURVEY NOT BEARWG THE LAND NO.850: ���• • y
/ SURVEYORS INKED SEAL OR EMBOSSED SEAL SHALL • O
qtS 0 Q? Q G) NOT BE CONSIDERED TO BE A VALID TRUE COPY TIMOTH H �6 0 W y .�*
�yVV VV l NGUARANTEES INDICATED HEREON SHALL RUN ONLY TO Q Q
HEALTH, DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY IS PREPARED ? .:� G
AND CN HIS BEHALF TO THE TITLE COMPANY,GOVERN- 1.
* NEAREST WATER GAIN MI.. *SOURCE OF WATER P��METE `� UGI.10_ MENTAL AGENCY AND LENDING INSTITUTION LISTED L' �- ..
*SUFI CO. TAX MAP 01ST 1000-SEC TION 12S_BLOCK 4- Lor r/O 1.3 HEREON, AND TO THE ASSIGNEES OF THE LENDING �j�.'t•-r�
*THERE ARE MO DWELUINBS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION GUARANTEES ARE NOT TRANSFERABLE )
TO ADOITIONAL INSTITUTIONS OR SUBSEQUENT ' t`'''
OTHER THAN THOSE SHOWN HEREON OWNERS
N THE WATER SLIMLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RLS I OENCE *DISTANCES SHOWN HEREON FROM PROPERTY UNES TA' •'E., '. 145 .
WILL CONFORM TO THE STAN��O���F TN SUFFOLK COUNTY DEPARTMENT TO EXISTING STRUCTURES ARE►OR A SPECIFIC 4
OF HEALTH SERVICES. /��1a %fHkC PURPOSE AND ARE NOT TO BE USED TO ESTABLISH ��.9 ( N SURVEyO/
APPLICANT. M/Gyp •�,q� PROPERTY LINES OR FOR THE ERECTION OF FENCES
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ADDRESS /S f/° edei.0r/-
'o4BOO OSTRANDER AVENUE
$ca d,$�ilc.� 0/ I/1�9
TEL S/G� �� & 3 • YOUNG YOUNG RIVERHEAD, NEW YORK
NOTE ■ = MONUMENT AREA _ 2.310 ACRES •
ALDEN W.YOUNG,PROFESSIONAL ENGINEER
RE: LOT 3 MINOR SUBDIVISION OF AND LAND SURVEYOR N.Y.S.UCENSE NO.12845
RICHARD 6 DONNALEE RELYEA '1
O =STAKE . HOWARD W.YOUNG, LAND SURVEYOR
*THE LOCATION OF WELL(W),SE.PTIC TANIC(ST)®CESS►OOLS(CP)SHOWN HEREON N.Y.S.LICENSE NO.45893
ARE FROM FIELD OSISER11MTIONS AND OR DATA OSTAINEO FROM OTHER S
BRANOIS & SONS INC. 1046 - -