HomeMy WebLinkAboutKearney ,.44'4f DLit fj-
JUDITH T. TERRY ;;j o Town Hall, 53095 Main Road
TOWN CLERK ® tai P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �` Southold, New York 11971
MARRIAGE OFFICER ] O 44 Fax (516) 765-1823
® �! 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. 915 R .Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : GERARD KEARNEY
Address 1 : 146 YALE STREET
City St Zip ROSLYN HEIGHTS NY 11577
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 9/23/92.
Name Of Owner KEARNEY, GERARD
Mailing Address 1 146 YALE STREET
City St Zip ROSLYN HEIGHTS NY 11577
Property Address 1 WESTWOOD LANE
City St Zip GREENPORT NY 11944
Tax Map No. section 33.00 block 2 lot 14.000
Cross Street INLET POND ROAD
Building Permit Number Cross Reference:
Issue Date: 10/14/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK . ® P.O. Box 1179
REGISTRAR OF VITAL STATISTICS X VS Southold, New York 11971
' ��' Fax (516) 765-1823
MARRIAGE OFFICER ® _�-
��® ��® �� Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK �A ,,
TOWN OF SOUTHOLD i 1 `f' r- i �'
. ii14•
y<i „ SEP 2 8 199/ i
TO: Southold Town Building Department 1.1 ' ' `
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: September 28, 1992---'..1.. :----=ww.:'L_,.ti',, j
7
Transmitted herewith is a copy of application No. _ lerfor a Cesspool/
Septic Tank Construction Permit submitted by:
Gerard Kearney -- -
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,----7...Ce ce-
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above •
and make the following recommendations:
APPROVE K -
DISAPPROVE
Comments: p� cl)r-v1/44 /. CO. 9 ,Q,�
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Signature fitlijOSE g l®
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Dated
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OF THE TOWN CLERK OF O(,�`;• q3
Town of Southold n A Or•
Judith T. Terry, Town Clerk` Application No.
Town Hall, 53095 Main Road cm :c"tConstruction
P. O. Box 1179
7?1)" y
Southold, New York 11971 � Alteration
Telephone ! ri 1y ,fi Residential
(516) 765-1801
Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT •
SEPTIC TANK or CESSPOOL
Permit No.9' ? 9
Fee •$ /0
DATE q' 23 , 9'z,
APPLICANT NAME: arii c[ )6, 14,
APPLICANT T AD DRESS: /4(0 !4LI . Cv
51 yM--s, y- 77
SEPTIC CESSPOOL I
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
/1-2-<-)
-2-< )
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: )E 12141e,C1 (.6Alait)
OWNER MAILING ADDRESS: j/U,r.%'.
OWNER PROPERTY ADDRESS: Lo1' ob 1,067-0604 1iA )8
TELEPHONE NUMBER OF CONTACT, PERSON: CA -- 62,7 4-Q
TAX MAP NO. : Section 3 Block Lot /9
•
CROSS STREET: ( - /QC9
BUILDING PERMIT NUMBER CROSS REFERENCE:_
r ,
•
Signature of Applica
RECEIVED BY: 64 • r
Town erk's Office
DATE:
Lrriamiiiar.with the Standards for Ao rova! anr! SUFFOE( CatlY, tiEPARTMENTS'H LT V
Construction of Subsurfe.ce Samp Di','•;7o::ai ett''rns
itA ;;;n -;imily Resu2ence3 and will ableby tine ' its `# VAt'OFcONSTRUCTION O
, Single:Tamar Residence Onty
Eoildi•ikms;;u to;th tharein Znd on the pen-nit to p��
oonstruct. SEP 2 3 1992-
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J/ DATE K HS LIQ �' --algnature ✓� APPROVED -_ . -- ` •� 7,�J _
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pt
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RIECERVED
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,�/ S.C. DEPT. O:F
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.h 0 , . , HEALTH SERVICES' . • .
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