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Town Hall, 53095 Main Road
a P.O. Box 1179
�®� j '� Southold, New York 11971
JUDITH T.TERRY - . ��..n FAX(516)765-1823
TOWN CLERK TELEPHONE(516)7654801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 596 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : EDWARD AND PATRICIA HUDSON
Address 1 : 78 WAKEMAN ROAD
City St Zip HAMPTON BAYS NY 11946
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 12/6/88.
Name Of Owner HUDSON, EDWARD AND PATRICIA
Mailing Address 1 78 WAKEMAN ROAD
City St Zip HAMPTON BAYS NY 11946
Property Address 1 BRIDLE COURT
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 102.00 block 8 lot 17.000
Cross Street BRIDLE LANE
Building Permit Number Cross Reference:
Issue Date: 4/16/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
' A ¢ ►-� Town Hall, 53095
BLDG. DEFY. Main Road
TOWN OF SOUTHOLD �"1. p ��� P.O. Box 1179
i®i Er a ��. Southold, New York 11971
JUDITH T.TERRY ���..0,A00of 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: April 5, 1990
Transmitted herewith is a copy of application No. 611 for a Cesspool/
Septic Tank Construction Permit submitted by:
Edward and Patricia Hudson
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 )c •
DISAPPROVE
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Dated
OFFICE OF THE TOWN CLERK ' "''%.
Town of Southold ..".C91fgbre,.
Application No.(.e 1/
Judith T. Terry;- Town Clerk
Town Hall, 53095 Main Road ; Construction
P. O. Box 1179 "=c
Southold, New York 11971 P'v
• •• Alteration
Telephone D,j� $10.00 - Residential
(516) 765-1801 = �l1111 $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ JOEU ) �/ /�
DATE `/ 5�`- 96
APPLICANT NAME: G /MP q" P/q7-4/019del_TA/
APPLICANT ADDRESS: /0r /.--"�J/QV eD
'/7n1 im vs ,uV I19e/1
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
S 6rCE -141'111 0/ C11cJ7T-'
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LOCATION MAP: Must be attached hereto before permit may be issued.
' LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: EboL)/ ,4-17/1--Teaf j/2S'OA/
OWNER MAILING ADDRE S: )% �jev
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OWNER PROPERTY ADDRESS: ervLC CooPrO TO/ S D A) V
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TELEPHONE NUMBER OF CONTACT PERSON: Vn) 765— lc a 336 --)
TAX MAP NO. : Section /Oc ,/jO Block 6 i-.6 b Lot 617,660
CROSS STREET: 'Bop LL (A/6
BUILDING PERMIT NUMBER CROSS RE - ' ENCS:
•
4#1/1 LIP I ti •
Signa ure of Applicant
RECEIVED BY:
mem Town Clerk's Office
DATE: ® 19`i
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SURVEY FOR
AA-FOLK COUNTY DEPARTMENT Of HtAL111
�ENVICI- EDWARD HUDSON & PATRICIA HUDSON
LOT 20, 11HIGHLAND ESTATES`I
NOV 30,/988
FOR APPROVAL OF CONSTRUCTION ONLY AT CUTCHOGUE DATE: OCT. 6, /988
4 TOWN OF' SOUTHOLD SCALE: /"z 40'
SATE « HS REF. NO 0— I SUFFOLK COUNTY, NEW YORK NO. 88-•//84
II UNAUTHORIZED ALTERATION OR ADDITION TO THIS
SURVEY IS A VIOLATION OF SECTION 7209 OF THE
4PPROVED NEW YORK STATE EDUCATION LAW S\P•{E OF �y8�
y `---
J' *COPIES OF THIS SURVEY NOT,,BEARING THE LAND •
`
`,� NOT BE CONSIDEE D SEAL OR EMBOSSED SEAL RED TO BE A VALID TRUE COPY 11.-
se% W DP
*GUARANTEES INDICATED HEREON SHALL RUN ONLY TO 1.....°
y0 \HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT TME PERSON FOR WHOM THE SURVEY IS PREPARED Zti•
ANO ON HIS BEHALF TO THE TITLE COMPANY,GOVERN— ;-
#NEAREST WATER RAIN_RI.± *SOURCE OF WATER: PRIMITE / PUBLIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED }�' '� 0K SUFF CO. TAX MAP DIST/�2SECTION 22 BLOCK�-LOT O/7 HEREON,AND TO THE ASSIGNEES OF THE LENDING*THERE ARE NO DWELLING! WITHIN 100 FEET OF THIS PROPERTY INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE 41 ^OTHER THAN THOSE SHOWN HEREON. TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT
K T.HE WATER SUPPLY AND SEAM( DISPOSAL SYSTEM FOR THIS RBI DENCEOWNERS <�; 9 .rKDISTANCES SHOWN HEREON FROM PROPERTY UNES Cep' 4�889'� ' ,A`WILL CONFORM TO THE STANDARD!OF THE SUFFOLK COUNTY DEPARTMENTTO EXISTING STRUCTURES ARE FOR A SPECIFIC z �`OF HEALTH lERVICEl. ,;s ;,,, •r uAPPLICANTS PURPOSE AND ARE NOT TO BE USED TO ESTABLISH ND SURsiE�� '°`
- PROPERTY LINES OR FOR THE ERECTION OF FENCES °
ADDRESS
�` YOUNG a YOUNG 400 OSTRANDER AVENUE
RIVERHEEAD, NEW YORK
or MONUMENT U=STAKE ^,-")I' '
SUBDIVISION MAP F/LED IN THE OFFICE OF THE CLERK OF SUFFOLK ", f ALDEN W.YOUNG,PROFESSIONAL ENGINEER
COUNTY ON APR.26,/977 AS F/LE NO. 6537 ' » AND LAND SURVEYOR N.Y_S.UCENSE NO.12845
r
HOWARD W.YOUNG, LAND SURVEYOR
*THE LOCATION OF WELL(W),SEPTIC TANK(ST)B CESSPOOLS(CP)SHOWN HEREON '41' N.Y.S.LICENSE NO.45893
ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS
OW14
BRANDIS & SONS, INC. 1618
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