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OFFICE OF THE TOWN CLERK c FUL
Town of Southold $ Olj
Judith T. Terry, Town Clerk .� y
Town Hall, 53095 Main Road • .•G
P. 0. Box 1179 .to �- ' w
Southold, New York 11971 Ory �O�- �•�
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Telephone l * „
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 337 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool X
PERMIT ISSUED TO:
NAME: Inland Homes, Inc.
ADDRESS: 315 Westphalia Road
Mattituck, New York 11952
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling with Cesspool System.
Approved as submitted and as approved by the Suffolk County Health Dept.
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Inland Homes, Inc.
OWNER MAILING ADDRESS: Box 117
Mattituck, New York 11952
OWNER PROPERTY ADDRESS : Little Neck Road
Cutchogue, New York 11935
TAX MAP NO. : Section 103 Block 4 Lot 16
CROSS STREET: Eugenes Raod
BUILDING PERMIT NUMBER CROSS REFERENCE:
• �+ -
Judith T. Terry
Southold Town Clerk
DATE : May 10, 1988
(TOWN SEAL)
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LI" ;.� r;f_ y Town Hall, 53095 Main Road
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JUDITH T.TERRY TELEPHONE
I OWN CLERK (516) 765-1801
RLGISTRAR oI•VIr1L SCATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
May 10, 1988
Inland Homes, Inc.
315 Westphalia Road , P.O. Box 117
Mattituck, New York 11952
Re: Little Neck Road
Cutchogue, New York 11935
Enclosed herewith is the Construction, Alteration or Modification
Permit for a Septic Tank or Cesspool System for which you applied.
Please be advised that each owner of real property operating an
on-site sewage disposal system, such as a septic tank or cesspool must,
prior to such operation, possess in the name of the owner an Operation
Permit for the system. The Operation Permit is issued by the Town
Clerk's Office.
The fee for an Operation Permit is ten dollars ($10. 00) for
residential use and twenty-five dollars ($25. 00) for non-residential.
Please have the owner complete the enclosed Application for an Operation
Permit and return it to this office along with the proper fee.
For your general information I have enclosed an Informational
Bulletin regarding the Scavenger Waste Laws adopted by the Southold
Town Board. Should you have any questions pertaining to either permits
or the Scavenger Waste Laws, please do not hesitate to contact this
office. We will be glad to assist you in any way possible.
Very truly ours,
Judith T. Terry
Southold Town Clerk
Enclosures (3)
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''TOWN OF SOUTHOLD . ' N,, --,,,,,,, ,,„,,,,,%,c-
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, �-6P.O. Box 728
JUDITH T TERRY = Southold, New York 11971
TOWN CLFR} TELEPHONE
REGISTRAR OF VITAL STATISTICS (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
May 9, 1988
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy
341 .for a
CONSTRUCTION or ALTERATION Permit for laccesspoolation No.or septic system
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 we may issue the permit.
Please complete the form below and return it to my office.
Thank you. '
•
efree
,..„„,,4 6..,0 so r,-es grioct,C...m....
Judith T. Terry
Southold Town Clerk
* * * * * * *
*
I have reviewed the application and location map of the project
cited above and make the following recommendation:
APPROVE - X
DISAPPROVE -
COMMENTS: ". c cs. ciZeA cS -
‘,1 h .....sag, ----- zet.
VA:tat, C,4)4:44
Signature
Siio/lti
Date
OFFICE OF THE TOWN CLERK
• Town of Southold
Application No3 V/
Judith T. Terry, Town Clerk
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
APPLICATION
.art 3351-2-773.2.ass ara 20
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE _May 6, 1988
APPLICANT NAME: INLAND HOMES, INC.
APPLICANT ADDRESS: 315 Westphalia Road
Mattituck, N. Y. 1195?____
SEPTIC CESSPOOL X
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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: Box 117L_MattituckN. Y. 11952
OWNER PROPERTY ADDRESS: Little-Neck Road, -
Cutcho_gue, N. Y.
• TELEPHONE NUMBER OF CONTACT PERSON: 298-9696
TAX MAP NO,. : Section 103 _Block 4 Lot pet. 16
CROSS STREET: En enes Road
BUILDING PERMIT NUMBER CROSS REFERENCE:
Robert '�niatIrez of Ap ant
RECEIVED BY: Y...-UX-Ce
RECEIV DTown C rk's Of ice
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DATE:_ „+,
Town Clerk Southam
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� t• SUFFOLK CO. HEALTH DcPT. APPROV; '
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H. S. NO.
,' ,a k SUFFOLK COUNTY
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', Riv.DEERPHTE',/ AU t;' Y. 119
01
!PR 2a 10 32 111'1 '06
STATEMENT OF INTENT
THE WATER SUPPLY AND SEWAGE DISI \.: .
SYSTEMS FOR THIS RESIDENCE ,
A • CONFORM TO THE STANDARDS OF .
4.1.,--� G -~ 1'1-7 0, ' f, i �-� • SUFFOLK CO. DEPT. OF HEALTH SEW, . •
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APPLICANT
C/O/1��/ 2:-/...)-c..5:7411,'-----:),..7- `f" Y SUFFOLK COUNTY DEPT OF Hi •
r' 7;47-- SERVICES — FOR APPROVAL.
1 � 1 CONSTRUCTION ONLY �f
DATE: �•
t10 H. S. REF. NO i J , r , '
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• �` if APPROVED: ,� --(-{
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• OWNERS ADDRESS:
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DEED: L. 7072 3 P. :•:•'„:5--",•-:.
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RODERICK VAN TUYL, P.C.
LICENSED LAND SURVEYORS .;
GREENPORT NEW YORK -