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HomeMy WebLinkAboutSmith (10) • OFFICE OF THE TOWN CLERK K cOFOU Town of Southold Judith T. Terry, Town Clerk • Town Hall, 53095 Mainall, • P. O. Box 1179 v' y` Southold, New York 11971 0o�-�,• Telephone (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 221 Residential X Non-Residential Fee $ 10.00- Septic Cesspool X PERMIT ISSUED TO: NAME: - Diane Alec Smith ADDRESS: RFD 193F, Main Road Cutchoque, New York 11935 DESCRIPTION OF PROPOSED- CONSTRUCTION or ALTERATION New Single Family .dwelling with cesspool system APPROVED as per Suffolk County Health Dept. approval. --LOCATION OF PROPOSED CONSTRUCTION or ALTERATION: OWNER OF PROPERTY: Randy and Diane Alec Smith OWNER MAILING ADDRESS: RFD 193F, Main Road Cutchoque, New York 11935 OWNER PROPERTY ADDRESS : Bridge Lane Cutchoque, New York TAX MAP NO. : Section 84 Block 1 Lot 6.11 CROSS STREET: Route 48 BUILDING PERMIT NUMBER CROSS REFERENCE: Judith T. Terry/ Southold Town Clerk DATE : September 2, 1987 (TOWN SEAL) �,. � 1 c\\ Fp(/,4 , • � � k�"del* ,n4,,'%� ,�=ems ��' ;�-�e �� s Town Hall, 53095 Main Road 4 ) � P.O. Box 1179 C� e `�01► Southold, New York 11971 '•JUDITH T. TERRY +''"' "i - TELEPHONE TOWN CLERIC i! - - (516)765-1801 REGISTRAR OF VITAL.STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD September 2,- 1987 • Randy and Diane Alec Smith — RFD 193F, Main Road - Cutchogue, New York 11935 Re: Bridge Lane-- Cutchogue, 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, Judith T. Terry - Southold Town Clerk - ' Enclosures. (3) JTT/Ijc - - - r,0III// II,,(,, \ .44#",-0,, .s•'�rj�.1 a if Town Hall, 53095 Mom Road I ` �so, P.O. Box 728 �ii�� � Southold, New York 11971 Il ll)li I I 1 1I REV TELEPHONE 1 rrnr\( i RE (516)765-1801 REGIS I FAR OF VII Al,tiIArl5ucs - OFFICE OF THE TOWN CLERK _ • - TOWN OF SOUTHOLD August 31, 1987 To: - Victor Lessard, Southold Town Building Department From: Judith T. Terry, Southold Town Clerk Transmitted herewith is a copy of application No. 224 for a • CONSTRUCTION or ALTERATION Permit for a cesspool or septic system submitted by- Diane Alec Smith and Randy Smith • 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 - DISAPPROVE - COMMENTS: e Stie.)}gCQ . ' 14 Qh 1 • \\ Z.S. Signature S1 SIO)31 Date i •r OFFICE OF THE TOWN CLERK ci\VF Town of Southold '�''" ,rte ' Application No.Q 9 Judith T. Terry, Town Clerk +� t -4 Town Hall, 53095 Main Road • ..< a Construction •v P. O. Box 1179 cr3 "•' k ' M� 4 Fi Southold, New York 11971 0 - �- Alteration Telephone _®1 t �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 .$ JO — - DATE %i,c7 • APPLICANT NAME: ya A/ c Oni11-4 APPLICANT ADDRESS: J /T�/Q3/ ftt/V RD U 0.e Ly SEPTIC , CESSPOOL x DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION kr c() 51T6 — LOCATION MAP: Must be attached hereto before permit may be issued. • LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: 76N-11-)17\./ ► )4k-e OWNER MAILING ADDRESS: 7' 77 )93 lUr-tyv ccfth Q jc)-e ►t-e( it s" OWNER PROPERTY ADDRESS: jn dse I y. (°cc-k kk ko Icy TELEPHONE NUMBER OF CONTACT PERSON : 771_(0LfC(J TAX MAP NO. : Section &4 Block / Lot 6. 11 CROSS STREET: 4. za BUILDING PERMIT NUMBER CROSS REFERENCE: ptond,us iJ Signature of Applicant RECEIVED BY: G am- & Town Ierk's fice DATE: cP-,?/—L ) _ SUF FOLK CO. HEALTH .0 E 1:I. APPROV, i• ..-7 I. H. S NO _ siur '/,,11 ; /i, •PYOZ:p i v LI/.a.. , , • I ;, i.-;:..r.p,4_,,, tv,,, _1:1 .I 1 v iy4.-"iligt,If,t : ,..„. , • .... I . - ii ,) ! cc-, -. i. Rot)/ 4-1... - • Qi r! i-4-.--. .14c--)..17 ------t-! -Z-• ; • •Pi r4_-ri 0 jy131- . 1 ,, . (..,• i., ,,,:)-,•.., sTATEmErillbrep--r ------ -1‘Ppd, r_ .. , 1 ,:, • - u t - . ‘....1 , .• • ! •/ : t , . THE WATER SUPPLY AND SE.INA -11742.P0 , ,, , , •. l' ' : SYSTEMS ' FOR THIS RESIDENCE V, -,,• , l, CONFORM TO THE STANDARDS OF 1 , , 1 ; i .• SUFFOLK CO. DEPT. OF HEALTH SERVI• (s)...._1),f_nesa-1--f, C --...1,51 I Ot APPLICANT Isti 1 „.-- - s, I ..---„. SUFFOLK COUNTY DEPT. OF HEA sr, ---i. SERVICES - FOR APPROVAL CONSTRUCTION ONLY 11)7 /3'1 DATE: . c'.'i H. S. REF. NO.. '0 1 - anor51,1 — ,:!t: 1 "••,) .1 ,• tI) APPROVED: .% _______ .... ....1, - ‘...N ' ........._ 1 SUFFOLK CO. TAX MAP DESIGNATION i I /.1.- DIST. SECT. BLOCK PC . . O'i. ,. , I 1 ,0 •!'- -5- / I 1 / / ..,, OWNERS ADDRESS: I ,/,-/ / / •..• Cf'\ 1 ,...-•'' / ,;:/ ,,•-....s.---2. /.-.---, c,. /e.---;...,•=r E., ,1.,:.,-.,-, /pi /..--(-:7,,-).:,•! ,•,.1 /..., - I . /, , ...i. 1 i / ,i'./- (- </(-1(i..".:.4';,-,.1/i•:-- /,./-1„,... '_--"'„.",,i. „,.... ,/r..... ,.... f / — . (11" ,,‘ f 0 /: / / 1 — /7 i DEED: L. 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