HomeMy WebLinkAboutThomas (2) OFFICE OF THE TOWN CLERK - c.gFU(iri, -
Town of Southoldj
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_ Judith T. Terry, Town ClerkTown Hall, 53095 Main Road ,;At.
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P. 0. Box 1179 .v' xF
Southold, New York 11971 O ' er `` �`" •
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Telephone - 1 el ,r.
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
- Permit No. 210 Residential x
Fee $ 10.00 Non-Residential
Septic Cesspool x
PERMIT ISSUED TO: --
NAME: Richard B. Reilly
ADDRESS: Box 1072, New Suffolk Avenue
Cutchogue, New York 11935
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling with Sanitary System
APPROVED as per Suffolk County He§rlth Dept. approval.
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER, OF PROPERTY: Elisa L. Thomas and Richard B. Reilly
OWNER MAILING ADDRESS: 855 Brigantine Drive _
Southold, New York 11971
OWNER PROPERTY ADDRESS : Ryder Farm Lane
Orient, New York
TAX MAP NO. : Section 15 Block g. Lot 2
CROSS STREET: Rpute 25 -
BUILDING PERMIT NUMBER CROSS REFERENCE:
Judith T. Terry U
Southold Town Clerk
DATE : August 7, 1987
(TOWN, SEAL)
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3 �. ,� „ i Town Hall, 53095 Main Road
*`` �- ,' P.O. Box 1179
40, �i "®de Southold, New York 11971
-JUDITH T. TERRY � '
"
� TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
August 7, 1987
Richard B. Reilly
Box 1072
New Suffolk Avenue
Cutchogue, New York 11935
Re: Elisa L. Thomas
Richard B. Reilly
Ryder Farm Lane
Orient, New York
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 (yours,
• (6.0141747.......
Judith T. Terry
Southold Town Clerk
Enclosures (3)
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3 1."•E" ,• ,CICS
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OFFICE OF THE TOWN CLERK c0FDL,r
Town of Southold �� � '-- COG
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Application No. c2'/.3
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road ` c Construction
P. O. Box 1179W J
p _ y Alteration
Southold, New York 11971 ,y,. ��
Telephone �! 44 N� �c 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. 7/O
Fee $/G
DATE g/7/g7
APPLICANT NAME: �lQ.h�9--i) . RF-1 -�
APPLICANT ADDRESS: grOX 101 A 00 5[d iFOLK {a d
G r� r /7) .y /i93
SEPTIC CESSPOOL
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: aisSA L. . 1-110mss cc, R;c419•,Q® Pj . k'c a '/ ,
OWNER MAILING ADDRESS: 'S55
So oL...D 1i-\/. / 1911
OWNER PROPERTY ADDRESS: g\ Ol; F4M&rc L IJE
6/Z:1 lArr).
TELEPHONE NUMBER OF CONTACT PERSON: 1134- 5a3 5
TAX MAP NO. : Section 0/5 Block 3 Lot a
CROSS STREET: c4,5—
BUILDING
j, "BUILDING PERMIT NUMBER CROSS REFEREN E: _
AO-a-4C
Signature of Applicant
RECEIVED BY: G ._
ilerk )-feet Town 's
DATE:
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• STATEMENT OF INTENT
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CONFORM TO THE STANDARDS OF TH
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APPLICANT
SUFFOLK COUNTY DEPT. OF HEALT
SERVICES — FOR APPROVAL C
CONSTRUCTION ONLY
(, DATE: D7
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SUFFOLK CO. TAX MAP DESIGNATION:
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