HomeMy WebLinkAboutHydell Town Hall, 53095 Main Road
® P.O. Box 1179
ieSouthold, New York 11971
JUDITH T.TERRY ��� FAX(516)765-1823
TOWN CLERK TELEPHONE(516)765-1801
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. 507 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : HYDELL, CAROL
Address 1 : 32125 NORTH ROAD
City St Zip PECONIC NY 11958
Descripton of Proposed Construction or Alteration
EXISTING BARN INTO SINGLE FAMILY DWELLING WITH ASSOCIATED SEPTIC
SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 5/10/89.
Name Of Owner HYDELL, CAROL
Mailing Address 1 32125 NORTH ROAD
City St Zip PECONIC NY 11958
Property Address 1 HENRY'S LANE
City St Zip PECONIC NY 11958
Tax Map No. section 74.00 block 2 lot 37.001
Cross Street NORTH ROAD
Building Permit Number Cross Reference:
Issue Date: 6/27/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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0-3 ¢� ,� gab 0� Town Hall, 53095 Main Road
�® � ZAN*r'� 4 P.O. Box 1179
BLDG DEPT �� , i► Southold, New York 11971
JUDITH - = .'. ! N_OF SOUTHOLD /�/ TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Victor Lessard, Southold Town Building Department
From: Linda Cooper, Southold Town Clerk's Office
Dated: June 16, 1989
Transmitted herewith is a copy of application No. 518 for a Cesspool/
Septic Tank Construction Permit submitted by:
Carol Hydell .
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: q., a,,, OEM cQin q..
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Signature
Ci)Cfb?
Dated
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OFFICE OF THE TOWN CLERK (\Cj\VFM A'?
Town of Southold . (/
Judith T. Terry, Town Clerk ; r ' Application No.
Town Hall, 53095 Main Road ` w Construction
P. O. Box 1179
Southold, New York 11971 ,y OSI Alteration
Telephone 01 l t / Residential X
(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 $/() , (2�
DATE 61/')/6
APPLICANT NAME: (1_0`('p ) )--/ /O-e- l
APPLICANT ADDRESS: 2./ 25 , . ar-
2C U Yl i (—
SEPTIC CESSPOOL ,-
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION T 1 h
L)L_) 1`[' ca_Vci ,0 ;hTd 1
60 Ste_
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATIO
OWNER OF PROPERTY: 0..-0-X
J t-f C
OWNER MAILING ADDRESS: PZ L�„ ) 6{1i'
EGohzC-)
OWNER PROPERTY ADDRESS: /71-e_ hr S the
pec
TELEPHONE NUMBER OF CONTACT PERSON: Coco 14 . c e- / -1(03.
TAX MAP NO. : Section 7+ Block Lot IJ
CROSS STREET: /U0 r+ -� .
BUILDING PERMIT NUMBER CROSS REFERENCE:
aire a
Signature of Applic n
RECEIVED BY:
, '. , rn Clerk's Office
DATE:
JUN 1515b�
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, i �O--------""4,: SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
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FOR APPROVAL OF CONSTRUCTION OF
. Single Family Residence Only •
- : DATE .. ��l_ HS REF. NO. 8'. u -� 3 -- - . •
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APPROVED �l • -
EXPIRES TWO-YEARS FROM DATE OF APPROVAL - i
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TELEDYNE POST NE t329
• • SUFFOLK CO. HEALTH DEPT. APPROVAL
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H. S. NO. . . .
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• !� as ?"ter %�
�6d,'� STATEMENT OF INTENT
--,*. V' i ir,i D193 THE WATER SUPPLY AND SEWAGE DISPOSAL
t, r6tiSYSTEMS FOR THIS RESIDENCE WILL
CONFORM TO THE STANDARDS OF THE
\ ,,.C. La's r. OF
't ' EFS S. iVi;�_3 SUFFOLK CO EPT./�F H THrrICES.
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/ \ APPLICANT
� - - ,%' SUFFOLK COUNTY DEPT. OF HEALTH,
? -`-=';?'' '' `� • SERVICES - FOR APPROVALf OF,
;,�_i ;'3 c �al.s CONSTRUCTION
5=�-:' r ONLY
-.N. . ±..-i DATE:
I �_ , r ��'CaIe : 36I=f.. H. S. REF.,NO.:'
a>• '* APPROVED: ,
`'� !�z'�Pa • ZOO) 164 .51. f¢.
SUFFOLK c0. TAX MAP,DESIGNATION:. -
_Q'_ P% e DIST. SECT. BLOCK • PCL.
• ._,3b OWNERS ADDRESS:
3Z12.5" e i dd/e1i ad '
Pecot"'c, rJ. Y. 11958
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GREENPORT NEW YORK �r�CS 256��,JL
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