HomeMy WebLinkAboutInland Homes (2) It"%Vita; 1
., . �'• �a Town Hall, 53095 Main Road
-e1' �,, P.O. Box 1179
® ®�i!�' Southold, New York 11971
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JUDITH T.TERRY '=� ����.fovoiAlr 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. 523 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : INLAND HOMES, INC.
Address 1 : 315 WESTPHALIA ROAD
City St Zip MATTITUCK NY 11952
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 2/2/89
Name Of Owner INLAND HOMES, INC.
Mailing Address 1 BOX 117
City St Zip MATTITUCK NY 11952
Property Address 1 505 BAYER AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 139.00 block 3 lot 14.000
Cross Street GRANT BOULEVARD
Building Permit Number Cross Reference:
Issue Date: 8/08/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
p u6 [ OwC I
of,-, '9..4_
es ter
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BLDG. DEPT.
TOWN OF SOUTHOLD EgfT• f s
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4 ;Ta Town Hall, 53
095 Main Road
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P.O. Box 1179
°e3'® Y r;` Southold, New York 11971
JUDITH T.TERRY -a • 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: August 2, 1989
Transmitted herewith is a copy of application No. 536 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 recommendations:
APPROVE X
DISAPPROVE _
Comments: oa �;, Q� 4 , ck3Cro,c
\Ci
EC :4;, Signature
D
411'7 ®6198,E Dated
rem, Viler Ivouto
' l
OFFICE OF THE TOWN CLERK
' Town of Southold w `
Judith T. Terry, Town Clerk Application No.
Town Hall, 53095 Main Road Construction
P. O. Box 1179
Southold, New York 11971 Alteration_
Telephone Residential
(516) 765-1001 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
�.. Fee $ 10.00
DATE_nv1St 2, 196.9
APPLICANT NAME: INLAND HOMES, INC.
APPLICANT ADDRESS: 315 Westphalia Road
Mattituck y_ I_l X52_
SEPTIC CESSPOOL.7
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 117
Mattituck, N. Y.
OWNER PROPERTY ADDRESS: 505 Bayer Rd. _M
Mattituck, N. Y.
TELEPHONE NUMBER OF CONTACT PERSON: 298-9696
TAX MAP NO. : Section 139 Block 3 Lot 14
CROSS STREET: Grant Blvd.
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applica Al&
Robert E. Hiltz
RECEIVED BY:
/own Clerk's Office —
DATE:
j Ii FOR APPROVAL OF CONSTRUCTION of
, /8 / 7 ! �,�,� `'� <`„ Single Family Residence Only
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