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JUDITH T. TERRY
Town Hall, 53095 Main Road
TOWN CLERK ( 9 1 P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER Fax Fax (516) 765-1823
02 b® it 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. 1023 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : INLAND HOMES INC.
Address 1 : P. O. BOX 117
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED.
Name Of Owner INLAND HOMES INC.
Mailing Address 1 P. O. BOX 117
City St Zip MATTITUCK NY 11952
Property Address 1 SILVER COLT ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 95.00 block 4 lot 18.035
Cross Street I KD SADDLE LANE
Building Permit Number Cross Reference:
Issue Date: 7/08/93 Judith T. Terry
Southold Town Clerk
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JUDITH T. TERRY " `� i
o® BLS bi"I"own Hall, 53095 Main Road
TOWN CLERK • = = : "- TOWN OF S®MOLD •,,O Box 1 179
REGISTRAR OF VITAL STATISTICS IP Southold, New York 11971
Fax (516) 765-1823
MARRIAGE OFFICER ' ® r®� •
=_ lit_�,y®� ' �� ��� Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: July 2, 1993
Transmitted herewith is a copy of application No. 1052 for a Cesspool/
Septic Tank Construction Permit submitted by:
Inland Homes Inc. .
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 recom ndations:
APPROVE
DISAPPROVE
Comments: ,f i/
X
JULRWIVID
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- Signature
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OFFICE OF THE TOWN CLERK
Town of Southold
Judith T.. Terry, Town Clerk Application No./OS,?
Town Hall, 53095 Main Road Construction
P. 0. Box 1179 -`-
Southold, New York 11971 Alteration
Telephone Residential
(516) 765-1001 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
• for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
• s -
Permit No.
Fee $
DATE 7/2/93
APPLICANT NAME: Inland Homes_Tnc,�_
APPLICANT ADDRESS: P.O. Box 117 MattjtuckN.Y. X952_
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
1 Family Dwelling
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Inland Homes Inc
OWNER MAILING ADDRESS: Po Box 117 Mattituck
OWNER PROPERTY ADDRESS: Silver Colt Rd. Cutchouge ,N.Y.
TELEPHONE NUMBER OF CONTACT PERSON: 298-9696
TAX MAP NO. : Section 95 _ Block 04 Lot 18.35
CROSS STREET: Old Saddle Lane
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Appi c
RECEIVED BY: 11
o n Clerk's Office ar_
DATE: •
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tiF Box 117+Mattituck, N.Y. 11962
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