HomeMy WebLinkAboutStaples i/'�'!/ ppb/,'/,%ii���'`i
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Town Hall, 53095 Main Road
P.O. Box 1179
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vu ri• Southold, New York 11971
.��i!�� FAX(516)765 1823
JUDITH T.TERRY „m„„
TOWN CLERK TELEPHONE(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. 511 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : STAPLES, ROBERT
Address 1 : 44 WILMARTH AVENUE
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 6/9/89 (SUBJECT TO REVIEW).
Name Of Owner STAPLES, ROBERT
Mailing Address 1 44 WILMARTH AVENUE
City St Zip GREENPORT NY 11944
Property Address 1 40 WILLMARTH AVENUE
City St Zip GREENPORT NY 11944
Tax Map No. section 41 .00 block 1 lot 7.000
Cross Street BOOTH PLACE
Building Permit Number Cross Reference:
Issue Date: 7/20/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
571 (
= _ x ,-r, `��' Town Hall, 53095 Main Road
4 •� P.O. Box 1179
y/�� L
� Southold, New York 11971
JUDITH T.TERRY TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Victor Lessard, Southold Town Building Departm: y • 11W11
From: Linda Cooper, Southold Town Clerk's Office 2V'
Dated: June 29, 1989 '' ~ t
Transmitted herewith is a copy of application No. 524 a ri ,ir+�� pmkj ,.
Septic Tank Construction Permit submitted by:
Robert Staples •
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.
4.7Y-Ce a---
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments: o �-�c �c 8. � e ()) GL:th,c. 9„ ,1N4--
Liv.� � .�• G,,•, bct\cg9 (CsluAL3)
1,"F Signature
�L9�Q ' 1 ?
Dated
Bies Qtr Southold
,:\
4.;93•;ri. `.:7:,,: .; . Town Hall, 53095 Main Road
'� P.O. Box 1179
At
.. / a1 � �e Southold, New York 11971
JUDITH T.TERRY —..�.�o. 1 TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Victor Lessard, Southold Town Building Department
From: Linda Cooper, Southold Town Clerk's Office
Dated: June 29, 1989 ,
Transmitted herewith is a copy of application No. 524 for a Cesspool/
Septic Tank Construction Permit submitted by:
Robert Staples - •
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
DISAPPROVE
Comments:
' Signature
Dated
OFFICE OF THE TOWN CLERK COFJ(I
Town of Southold 0��-� `" COGL
Judith T. Terry, Town Clerk Application No. ��
in
Town Hall, 53095 Main Road xY'�°? -- '� Construction
P. O Box 1179 Alteration
Southold, New York 11971
Telephone 1611 * /‘ Residential
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 749 .• •
Fee $ /0 . I
DATE (,, ( 3 9
APPLICANT NAME: 'Robert St-711 es
APPLICANT ADDRESS: 14)16n p.tJ Ave.
Geeinpo f iV/ //9y'l
SEPTIC ✓ CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
S'eii' c. Sygtenit regu ;re d by COuPity Beard eF )-leafid-Ii
LOCATION MAP: Must beaittached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: RObef^r Sf f p /e ,S
OWNER MAILING ADDRESS: iitt Lv/ f gen r f Ii Agee
Greer pov't /V` //?(y
OWNER PROPERTY ADDRESS: L® t2;f .1 2# 1 Av-e
Err ,e Ya � 'v 1 /V7 /(99/ /
TELEPHONE NUMBER OF CONTACT PERSON: Li 77 - 2 q 9
TAX MAP NO. : Section ! 1 Block f Lot 7
CROSS STREET: goof k Pla c e
BUILDING PERMIT NUMBER CROSS REFERENCE:_
ger(-eA47J1
Signature of A. .Iicant
RECEIVED BY: W\
own Clerk's Office
DATE: Ul, 9
! _ _ _ .
1
' GnADIr1G PLA1,1 r SUFFOLK CO HEALTH DEPT.APPROVAL
R.EL_t�.O s 1 ,FINISHH13 60AD6
2G_i" ' ,� { u.l +te D '/ +_ tt-J� �) _ y! H.S. NO } 751?-.--. 3
20.'
FMDa. L ERt S-r.6¢OnE �-`_ 1` 't•r 1�+ MA Q ..f ROPE RT
SWAMP RE_Z'1AL.-_ -------2- .'Ii+al. +na•u.++c4, u.t yr Poo-11+ ---- ---- —
�' U r"J Y':0�-'q Q�`�
GgD1_IND WATER r _- —1^4'r ./ C` � �L.l. FOR.,
rJ�t�_'AFE{.0 ff OBER-F _ STA PLF--)"'s
STATEMENT OF INTENT
(VACANT) _AT THE WATER SUPPLY AND SEWAGE DISPOSAL
f;f2ENpc-J:?T SYSTEMS FOR THIS RESIDENCE WILL
N•8-7' :-.3O E CONFORM TO THE STANDARDS OF THE
100,0 • _ TUWPN GP (...Yrf-f',LC),.NAY, SUFFOLK CO. DEPT OF HEALTH SERVICES
• - (S)
_ APPLICANT
lf154P� • SUFFOLK COUNTY DEPT. OF HEALTH
SER VICES - FOR APPROVAL OF
•32' 3I. / �� CONSTRUCTION ONLY
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CAP+ES (33 �t� APPROVED:
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r1.1 `' pruEt,jv� _ SUFFOLK CO.TAX MAP DESIGNATION:
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\ HQ. •a ea ram- 1jj
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• x.87-?6 ' 0"W 1 . `�.160.J _376,6.3_{'O_ A{_ht_$_l` l+ --
-_ �' O° {20N PIPE
I `� TEST HOLE STAMP
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SEAL
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LICENSED LAND SURV ORS l8 t; s t `- ��%
F GREENPORT NEW YORK �==:�