HomeMy WebLinkAboutRussell OFFICE OF THE TOWN CLERK cp:FOUri •
Town of Southold ho - ��
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Judith T. Terry, Town Clerk �:-
Town Hall, 53095 Mainwn HaPTErl,„,471
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P. O. Box 1179 •u' 4a
Southold, New York 11971 '.qt'
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Telephone of ,•,
(516) 765-1801 '
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 271 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool X
PERMIT ISSUED TO:
NAME: Dean Russell
ADDRESS: 5550 Bergen Avenue
Mattituck, New York 11952
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling with Cesspool System
APPROVED as per Suffolk County Health Department approval.
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Dean Russell
OWNER MAILING ADDRESS: 5550 Bergen Avenue
Mattituck, New York 11952
OWNER PROPERTY ADDRESS : Park Avenue (Long Pond Estates)
Southold, New York
TAX MAP NO. : Section 56 Block 1 Lot 2.5
CROSS STREET: Long Creek Drive
BUILDING PERMIT NUMBER CROSS REFERENCE:
esogasexis400,„
Judith T. Teri
Southold Town Clerk
If
DATE : December 15, 1987
(TOWN .SEAL)
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cri '" :`•?;;;1,3 Town•Hall, 53095 Main Road
,� P.O. Box 1179
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JUDITH T. TERRY tt•'.,,j'0°' TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
• TOWN OF SOUTHOLD
December 15, 1987
Dean Russell
5550 Bergen Avenue
Mattituck, New York 11952
Re: Park Avenue
Southold, New York
Dear W. Russell:
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, J
Judith T. Terry
Southold. Town Clerk
•
Enclosures (3)
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' f ' -•) "u ."-•-•4'x„ Town Hall, 53095 Main Road
'�" , ; ,, � � ' P.O. Box 728
"a 4Southold, New York 11971
JUDITH T TERRY TELEPHONE
Town CLI Rh (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
December 11, 1987
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 275 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by Dean Russell •
Please review the application and location map and advise if the,
project has received Suffolk County Health Department approval
and if we may issue the permit.
Please complete the form below and return it to my office.
Thank you.
Judith T. Terry
Southold Town Clerk
* * * * * * * * *
I have reviewed the application and location map of the project
cited above and make the following recommendation:
APPROVE - DC
DISAPPROVE -
COMMENTS: p,a rc-ctLcn 9-,414-)2 . Akcsln�
REcEvED
DEC 151997 0 ,...__ ,--
-OFA. -esIla...i. L
Signature
lawn Clerk Southold
11) i sAi 1
Date
l
OFFICE OF THE TOWN CLERK _ •
Town of Southold
Judith T. Terry, Town Clerk Application No. `�_
Town Hall, 53095 Main Road Construction
P. 0. Box 1179
Southold, New York 11971 Alteration
Tele hone Residential
P
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION .
for
CONSTRUCTION or ALTERATION PERMIT
SEPT-IC TANK or CESSPOOL
Permit No.
Fee $ l Z,), 0
DATE /2///e. 7
APPLICANT NAME: PF.,e9"./ PL C e___
APPLICANT ADDRESS: 'L $ 5Z7 �?-
8 C%Z1 40
447----_--/77-06- -/ .t- // 16-7
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SEPTIC CESSPOOL_
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION HT1/,/`-d--
tWo 6 ' Po o e_ .
LOCATION MAP: Must be attached hereto before permit may be issued.
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LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ,0.4 ✓n`' U -1.7c�C---
OWNER MAILING ADDRESS: 6332 8 6Ov jU
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OWNER PROPERTY ADD ESS: ,d 7 " -v�t., 46/ - 9✓ 0 f
U-0,43f DeJ S9 &5
TELEPHONE NUMBER OF CONTACT PERSON:
76.5.--
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TAX MAP NO. : Section ..) 1t...3 Block / Lot 2-r E
CROSS STREET: /--CieUCr- C€_GE! C_ O2f11
BUILDING PERMIT NUMBER CROSS RE , RENCE: A
L.- PIN:71 r
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RECEIVED BY: .1 -_.1,�/ //
` wn ' er 's Office
DATE:
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