HomeMy WebLinkAboutDempsey ��� cy, ..���"
tk* o? Town Hall, 53095 Main Road
'1 P.O. Box 1179
;_ ® �� i'� Southold, New York 11971
74
JUDITH T.TERRY `Ls ,.i!° TELEPHONE
TOWN CLERK �
(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. 414 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 9/22/87.
Name Of Owner JOHN R. DEMPSEY, INC.
Mailing Address 1 P. O. BOX 5
City St Zip CUTCHOGUE NY 11935
Property Address 1 HAYWATER ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 111 .00 block 11 lot 12.000
Cross Street CARRINGTON ROAD
Building Permit Number Cross Reference:
Issue Date: 10/18/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
_ `
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+$ � X00, TELEPHONE
JUDITH T.TERRY ...woo
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: October 14, 1988
Transmitted herewith is a copy of application No. 420 for a Cesspool/
Septic Tank Construction Permit submitted by: a
Inland Homes, Inc. for John R. Dempsey, 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.
4-e-----x-
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: a, 0 , -ok cA L
L.s?y Cx J.� •.Ij -Sa. OY1 9/ Z2/3 7
\i(lej- 0.4_ (-2,.. ft
Signature ,r<
In\) -1\ii v.'
Dated
OFFICE OF THE TOWN CLERK
Town of Southold
Judith T. Terry, Town Clerk Application No. 1-720
Town Hall, 53095 Main Road Construction
P. O. Box 1179 — -`-
Southold, New York 11971 Alteration
Telephone Residential 1
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
.Y ._._^.-,,=_ ,c =1
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ 10.00
DATE _19L7.ZLa
APPLICANT NAME: TNL.AND HOMER., INC.
APPLICANT ADDRESS: 315 Westphalia Road
Mattituck, N. Y. 119_52
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: .Tnhn R Dirnparey4
OWNER MAILING ADDRESS: P.O. Box 5
Cutchogue, N. Y. 11935
OWNER PROPERTY ADDRESS: w/s of Haywater Rd. s/o Carrington Rd..
Nassau Point, N. Y.'
TELEPHONE NUMBER OF CONTACT PERSON: 298-9696
TAX MAP NO. : Section 111 Block 11 Lot pcl. 12
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
OJPF
Signature of Aps i nt
Robert E. Hiltz
RECEIVED BY: a
E ; Tewn Clerk's Office
DATE: : 1988
Town Clerk SoetfiofiP
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• lA SUFFOLK CO. HEALTH DEPT. APPROVAL
, H.S. NO.
,UFFOLK OOUNI"t
J
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RIVER' ' t' ' „ „Si GLE FAMILY DWmELLING OItiLY
pI ESfO YEARS FROM'tDATE OF APPROVAL.
STATEMENT OF INTENT
THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS FOR THIS RESIDENCE WILL •
• CONFORM -TO .THE STANDARDS OF THE '
SUFFOLK CO, DEPT. OF HEALTH SERVICES. '
' (S)
APPLICANT •
SUFFOLK COUNTY ., DEPT. OF HEALTH / '
- __SERVICES. - FO`R . APPROVAL 0.F,/___
- CONSTRUCTION ONLY 9/2,y/,7— - " .
DATE:.. Q�]
H.S. REF. NO., U l , t w
APPROVED: '
4 ' I POOL IOkel , �" 50
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I `'0 1 SUFFOLK CO. TAX MAP DESIGNATION:
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SCALE. �1O 4 t DIST. , SECT. BLOCK PCL.
A►ZeA,2a3t,S46S.F. L000 .-. • 1 I 1 --- _ I I ' la .
;f•1 ?NU.+ll44ENT OWNERS ADDRESS:
•0j_)Cw0Ir1 PIPE • - • - P.O. SOX 5 •
' CUTCHOG IE WY 11935
754- 6058 ,
• DEED: L.514I 'P.598 L`l'EP' •
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LICENSED LAND SURVEYOR •. 17 23,q I 01 1, [S 25g�� `��`I •
GREENPORT NEW Y RK ��1-AND Ss" .