HomeMy WebLinkAboutRogers (3) JUDITH T. TERRYTown Hall, 53095 Main Road
TOWN CLERK
C4;
f P.O. Box 1179
REGISTRAR OF VITAL STATISTICS 11P Southold, New York 11971
MARRIAGE OFFICER C) (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. 889 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : FRANCIS J. ROGERS
Address 1 : BOX 141
City St Zip GREENPORT NY 11944
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 6/23/92.
Name Of Owner ROGERS, FRANCIS AND SUSAN
Mailing Address 1 BOX 141
City St Zip GREENPORT NY 11944
Property Address 1 PARK AVENUE
(LONG POND ESTATES - LOT 20)
City St Zip SOUTHOLD NY 11971
Tax Map No. section 56.00 block 1 lot 2.011
Cross Street LONG CREEK DRIVE
Building Permit Number Cross Reference:
Issue Date: 7/23/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY 1 m Town Hall, 53095 Main Road
TOWN CLERK c ) ti P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ,P Southold, New York 11971
CO O r` Fax (516) 765-1823
MARRIAGE OFFICER (010, ���70. Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: July 17, 1992
Transmitted herewith is a copy of application No. 913 for a Cesspool/
Septic Tank Construction Permit submitted by:
Francis J. Rogers •
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. �'r,1I ;_IF_' ' 1`_ :, --'
Thank you. ,3 6 ,wy - --.__
E JUL 17 1992
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations: ,
APPROVE X
DISAPPROVE
Cornments: Mo. CLI cli,, 1 . j
(.2\ z�,sl qa
RECEIVED
\((1-:0144. IC:= .0f..--4.0\ a&CA
Signature Mit, 2Q i9G,
Dated .4. 9 `" Town Cl d
.
,
OFFICE. OF THE TOWN CLERK �cwrFJ(,lr
Town of Southold �, �O�
Judith T. Terry, Town Clerk Application No. ?/3
Town Hall, 53095 Main Road
t.._ - Construction
U
P. O. Box 1179 ' -v ' t.,l r -
Southold, New York 11971 Alteration
Telephone 1 x ly 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.
Fee $
DATE -1" 1a1�`1
APPLICANT NAME:' �'2Ac, \S i
APPLICANT ADDRESS: -?;.04 p ,2 t ���,� C-13013- Aeoe or3'S
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION C.JnsvaL ,C WNI
QONE -NI LI J�S�
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: F—'2Ar‘C 5
OWNER MAILING ADDRESS: .jt( f A joo, Acyrz-rnrt
as-
OWNER PROPERTY ADDRESS: i....(51-42-0 L.-01\4G ESrn CX-norCX-norl Csre
TELEPHONE NUMBER OF CONTACT PERSON: lir
TAX MAP NO. : •Section O5(3.®QBlock C) % . CIO Lot 002 Q01 )
CROSS STREET: l—t)s•-) CA —IC� We\ S LN
BUILDING PERMIT NUMBER CROSS REFERENCE:.
ignat ,f A.plicant
RECEIVED BY : , 1
if or Clerk's Office
DATE: ��
Mzlp/ Ep/re3r J` -icR4icl.0 • �U�4 A.! iqoGERS i
LOCATED AT ,QUTHOLO , TOWN OF fSOv 0z-- t4L° �v n , SUFFOLK COUNTY N.Y. •
LOT ��� l
MAP OF Lc ti,;G �oK/c �S 774 7±—k.5 SEC. / SS G_- is FPO j s,�� � , CO. CLK. N0. to 37 FILED /2 z 7 /9gg
SCALE 1" = L5 4-,<•G'�o1 ,FS • -'
SUFFOLK CO. TAk MAP DATA:- 1Ul �\14 : ® ,a '
DIST./O0O , SEC. 05G . OQ cV ,�o'vaP O o W VAc,4,-/T _
BLK.O/• 00 LOT 002. 0// `Q,
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b �i�N.ST L,..V LI ';;-:-.'2.3Jr,
1.: ! SURVEY, ARE FOP. ._ P "�/,QS ,�' uNv�
a�'�CItJC USE ONLY, AND JAN Y 9 1992 2s'oo �3 /® V� •
'SURVEYED /1/Iq y� .�O 198<o BY •
`_HOULD NOT I E USED h� p�/�
V CONSTRUCT! NOF FENCES /D��r Su2F) WILLIAM O R.
SIMMONS
eoMM ONS JR. ,
THE �TRU�TURES S.C. DEPT. OF (z)/gr
' o 4~ o EALTH SERVICES JAMESrORT, L. I., N.Y. 11847
FILE NO. /0� ¢/D PAGE 23 GRID,C. X12
71.72)
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