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HomeMy WebLinkAboutPerry °I MILit *4* , 44.7A% XZ 1tr2 Town Hall, 53095 Main Road cf, P.O. Box 1179 ®_ ® ���' Southold, New York 11971 JUDITH T.TERRY 'l �i���l TELEPHONE TOWN CLERK "��Ali� (516) 765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 365 R Residential X Non-Residential Fee $ 10. 00 Septic Cesspool X PERMIT ISSUED TO: Name : PERRY, DONALD G. & SAUNDRA J. Address 1: P.O. BOX 454 City St Zip PECONIC NY 11958 Descripton of Proposed Construction or Alteration NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM. APPROVED ASSUBMITTED AND AS APPROVED BY SUFFOLK COUNTY HEALTH DEPARTMENT ON 5/10/88. Name Of Owner PERRY, DONALD & SAUNDRA Mailing Address 1 P.O. BOX 454 City St Zip PECONIC NY 11958 Property Address 1 INDIAN NECK LANE City St Zip PECONIC NY 11958 Tax Map No. section 86. 00 block 4 lot 1. 001 Cross Street MAIN ROAD Building Permit Number Cross Reference: Issue Date: 6/29/88 Judith T. Terry Southold Town Clerk (TOWN SEAL) 0I/ 0 +'r�UFQLi� ' J12T ° BLDG DEP1G "` a, °° ,. �'• . t;• t � TOWN OF SOUTH4 �b y J:. t� �k4r t.� - � Town Hall, 53095 Main Road �, ,1 P.O. Box 1179 4), �� Southold, New York 11971 JUDITH T.TERRY — ,,+ TELEPHONE TOWN CLERK (516)7 5-1801 REGISTRAR OH VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD 36- To: Victor Lessard, Southold, Town Building Department From: Linda Cooper, Southold Town Clerk's Office Dated: June 27, 1988 Transmitted herewith is a copy of application No. 368 for a Cesspool/ Septic Tank Construction Permit submitted by: Donald G. Perry 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. - { Linda J. Cooper * * * * * * * * * * * * I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE Y,:;- DISAPPROVE ' � .fir% c ac f4./¢.1- Comments: � .C.14 • Signature tel Dated OFFICE OF THE TOWN CLERKSUFFUL - Town of Southold ��� �r OG O �� ` Judith T. Terry, Town Clerk _ Application No. Town Hall, 53095 Main Roade ' Construction u.37P. O. Box 1179 a `=r �'® �� Alteration Southold, New York 11971 4 �-� Oj �� Residential Telephone (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 ((Z? irf APPLICANT NAME: 2fk.i1 C - I91 4-`-f (.5'40/.)bviof T. , ('( C ' APPLICANT ADDRESS: P. d • nflx 4(cy P�Co&U (c c r SEPTIC CESSPOOL .� DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION S £AA CR_ LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: /34CD £ S1-O rJ b/Z4- PJ B OWNER MAILING ADDRESS: P q©K L'.-'Y Pa-or.)( . JO ( ' OWNER PROPERTY ADDRESS: • � Y11A) ECG • c 4 )E PLC&#r C iJ ``"( TELEPHONE NUMBER OF CONTACT PERSON: 1 7—FSOQ (?),0iJ P&tr ' I TAX MAP NO. : Section S-(2 Block Lot l • 00 / / CROSS STREET: 714.4(6(l S f • BUILDING PERMIT NUMBER CROSS REFERENCE: Signature of Applicant RECEIVED BY614 • Town CI k's Office' DATE: JUN IN 2 71888 Town Clerk Southold •Isms...•110.111•amst..1.119.0. .Z..,. 3 . ' , .)r r..:.:: , .,- • -$:' s - - ' . 4 _... _._ i 1 4-,,i-• , , ,,,,i ..t :-,- slTi • c•,:c5 17 r i T.7:1- "."7.7) '..el F A 4. !SEA LEVEL . ...... '., . !.Y FLAT. I— - .... - 1 .- - ,' — HAP i ' .7. ....4-. N ,'\ ..-I.. k '-..I-t- , • 1 r-, , ....... NIA:,i... i ,-.);_ El,i 2,7, ;•,.'1.'"i-'i'i :._ . ! g . • , • 7 •1 , •-•- i .-- • “-t., '. '1.- . •i i R '-.,...,, A A., • LO-• 1 - i-..t••.:L.,'. . ••• ...-, 7C7'7‘7 - %.IC1 La —17t.7l; 1 n.\\FnA • .-----— . ../ 'II 0 1. 1 •-•• 0 i '..‘-i / .1-• t -.• 1 .-•• ' q 1 1 ' • , I 4 ) , t 1 - , 1 r-9,,r-t•I-1r- , 1 i i.,, 1 .:,:i•I'Vsli.:: .,',.,t•....: , -...2 I. i -,' Li) ' ' •=1.„ j .- • ' N 1 -p .,. 1\LC0,sV , L:__ . -)y- c - -3 •.. I iiI, ..r1 ,,--, • I ‘;',/ — . I 2.5 1 ii_l 1 , I, ; 1 - t, -- . -- _---- ‘• . ...- -.. • •— • - , • ..,\: -., , ;'''Iri0 P, ..-EPItC ..,• I - ,ft' •; ' ' • , • i . c-, • ., „,....,. , ' I ! , SE NOTF i_PI EA . , , .... __.... ___, . ..„.. . •:12. . , ___............_......, • . t _-,24,• - ••• • , Requires septic 4 an't cover to oTaritl 1 ,, _ : , _ - Li 1.o a 1 k\1 '.t..%;:•:•-''i i. ....--- . .. % ---- i-±-----,:.- - i''e,l','' \Ai• !;-??' I, -t-' • • .,- . • "—rw SUFFOLK CO. HEALTH DEPT. APPROVAI s-f.ic', • 1---Aq\114:11';'‘ - "r f • ,:i, 4 , V.t)loi•OlePm. • it.) . ,t l 26 1988 . , e S.0 DFPT. OF i` 9 �,- rte' t I- r t ;^ ! ' , t c,; , I�{A 1t ;`',:\_� ,"` i�i�:;ta+� -�`''' ./.. STATEMENT OF INTENT •:j i .— , ,',.;;- �_.z.- '""-- THE WATER SUPPLY AND SEWAGE DISPO, �_ ____..._� SYSTEMS FOR THIS RESIDENCE W `' • ' ? j f r-, ,n r.-1r")\. CONFORM TO THE STANDARDS OF 1 -,..4 i µ .. il� 1 1 t 1 t f? �_ � >__ L� ,, '1 :�..+1 ':, ;f i S f �.•. ►. 1.......:;. i� k SUFFOL O. DEPT OF H ' LTH SERVIC ....i .----- •- :..7---- - __. '' (S APPLICANT PECON f C SUFFOLK COUNTY DEPT. •F HEAL 4N-"0 -50 UI { :..f;tP,l`i! - SERVICES -- FOR APP OVAL•_ Q o CONSTRUCTION ONLY i +.‘:', 1 7 !C"1 t 7. F.A. ;7 ''.f r-I V F) ! '�! : ){ N t 011 0 �U � -' 1�E.J TA.u ... ; , f ' O _ DATE: i::d�•: Jt0 Fi':� r:�1 UA I'E Oh Ai` PROVA�. HSNOD- -c 0' (� H. S. REF. .. �' \1 APPROVED: / Wt ' --7 , / Y SUFFOLK CO. TAX MAP DESIGNATION - / \ V i DIST. SECT. BLOCK PC r1000 c6 4 Pfd 1,: OWNERS ADDRESS: RO,E :C {57 . ' 121VL;CI'-iE-AD, C.:. '. I IgG1 DEED: L. P. ,' • TEST HOLE STAMP c A:e.-_r--k_ OCi (',C.-, r _.. .len rr�. r. ,•nlat;on nr Ea_.F.i�...t'L M Eki i W I:rlry r :'r'.e Now York + �'`i. L�_ • C`.! ,'\`r ,,f, -i..- c?bi-.swims,mt�✓art t- -.. _ .—____ ___________ 2• r;Ir.,ror'a inked veal c ";.,.o seal shall net be Cor' _- .�hri r•t.':usIid tri copy, t,. . --•'-'?,'2. _'a>t:.,,tees Indicated d he eon et' .-'1.•to in*:+4rsen for OHnO'n th' —A—uttered,end,an his behalf V '.s c -nr:any.governmental as !r.Inctnuuon listed horeon • >o:;,i;asstgnees of the loading •.n.Guarantees ore not tran . a,r•(•.Tonal institutions or SUS. NL) SEAL GuAi2A,A-1TEEG17) - - 'FFOLi< COUNTY NATIONAL a' tJk`; OFNFiy '-t;&:AGQ MIL1 i5U2 NCc KJ . •cv- 1CK t,� io y RODERICK VAN TUYL, C. r- r� f { ,„--,a.. ..,„/„.. �"_.a...-to ;r� o a•,�,I► `_ - 0 LICENSED LAND SURVEYORS 17' `Fp >//O rr, ' GREENPORT NEW YORK ����,%