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HomeMy WebLinkAboutMudd • OFFICE OF THE TOWN CLERK • c3�FFU(/�' , . Town of Southold DSO �� • Judith T. Terry, Town Clerk Town Hall, 53095 Main Road 8 TM P. O. Box 1179 .cra W Southold, New York 11971 0 •ca• ��t•• Telephone �l [ �,; (516) 765-1801 ' TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 165 Residential X Non-Residential Fee $ 10.00 Septic Cesspool x PERMIT ISSUED TO: NAME: Stephen D. Mudd ADDRESS: County Road 48 Southold, New York 11971 DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION New Sinc,Ie Family Dwelling APPROVED as per Suffolk County Health Services LOCATION OF PROPOSED CONSTRUCTION or ALTERATION: OWNER OF PROPERTY: Stephen D. Mudd OWNER MAILING ADDRESS: County Road 48 - Southold, New York 11971 OWNER PROPERTY ADDRESS: County Road 48 Southold, New York TAX MAP NO. : Section 59 Block g Lot 30.5 CROSS STREET: Ackerly Pond Lane BUILDING PERMIT NUMBER CROSS REFERENCE: Judith T. Terry, Southold Town Cl- k • DATE : May 22, 1987 (TOWN SEAL) rrrzz • • ko "' a4 > ; cr3 .;;�: - ' ; r Town Hall, 53095 Main Road P.O. Box 1179 es o Southold, New York 11971 JUDITH T. TERRY ..ateir,,1-0TELEPHONE TOWN CLERK (516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD May 22, 1987 Stephen D. Mudd - County Road 48 Southold, New York 11971 Re: New Single Family Dwelling County Road 48 Southold, 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 /ours, • Judith T. Terry Southold Town Clerk Enclosures (3) JTT/Ijc OFFICE OF THE TOWN CLERK /S�FFDCI� Town of Southold yQ�V Application No. / �5 Judith T. Terry, Town Clerk ,.. * ; Town Hall, 53095 Main Road ` 8 1 • "` Alteration Construction P. O. Box 1179 tri � ��t_ • Southold, New York 11971 Vii' ' - ��.i Telephone [ ��O �� 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 $ D 4-7 DATE s - ( a- APPLICANT NAME: St e.PiA1 "t, l� APPLICANT ADDRESS: 60 ' c3M4Q /A C ( (79>( SEPTIC �SSPOOL DESCRIPTION OF PROP044D CONSTRUCTION OR ALTERATION 14.12-JU.) fAlv(k2-cr ffe-e-ba LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION .OF PROPOSED CONSTRUCTION ORLTERA"TION:('� OWNER OF PROPERTY: ,_„Q �. �IC) OWNER MAILING ADDRESS: 0...4) ?_b '1(- So OWNER PROPERTY ADDRESS: TELEPHONE NUMBER OF CONTACT PERSON: 7CeS l0V-C11- TAX MAP NO. : Section O� Block C Lot 30. (^p CROSS STREET: 4C/264-7 ! OA-6 2/FH BUILDING PERMIT NUMBER CROSS REFERENCE: AeSignature of Applicant RECEIVED BY: ie, REC V own Clerk's Office DATE: p P -- LYqlfii 21 l�V1 Town Clerk Southold N \ \ 1,, /„ , ( ,, . 'A N - �", ` \__l- - ,. - Yom--=_ - M 0 fi / . ' �© / r,Q� 0 to Qr for41?Pr 4, . / tri Q QQ•3Q E 2�2 360 g°S tR5lee'DCOs c.,. S � VOX- G By ~fie �� s s o , / ,'T ',task / ' E yti 29/ C 1 -. • s 3 VI: it,, oo - �L / / ,9 7. s TO A. a \ # CO \ co w• -1-17v Y::: , s� !- yy 9. J O� 0 r 001 `r