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Town Hall, 53095 Main Road
,`` P.O. Box 1179
Ves I4 ` o Southold,New York 11971
JUDITH T.TERRY "tso' TELEPHONE
TOWN CLERK � (S16)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. 377 R Residential X Non-Residential
Fee $ 10. 00 Septic Cesspool X
PERMIT ISSUED TO:
Name : WINDS WAY BUILDING CORP.
Address 1: 1020 GLENN ROAD
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND SUBJECT TO SUFFOLK COUNTY HEALTH DEPARTMENT
APPROVAL.
Name Of Owner TINER, FAITH M.
Mailing Address 1 COX LANE
City St Zip CUTCHOGUE NY 11935
Property Address 1 SILVER COLT ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 95. 00 block 4 lot 18. 004
Cross Street MIDDLE ROAD
Building Permit Number Cross Reference:
Issue Date: 7/20/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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��, P.O. Box 1179
i ��1000 Southold, New York 11971
JUDITH T.TERRY
414� 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: July 19, 1988
Transmitted herewith is a copy of application No. 382 for a Cesspool/
Septic Tank Construction Permit submitted by:
Winds Way Building Corp for Faith Tiner
•
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
IIS
OFFICE—OF THE TOWN CLERK - y I���FO
S
Town of Southold .
Application No. o
Judith T. Terry, Town Clerk � _ � ,fit', pp
Town Hall, 53095 Main Road ` cn � ` Construction
P. O. Box 1179 y`� $ Alteration
Southold, New York 11971 _
Telephone 44e' Residential L
(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 '
DATE-
APPLICANT NAME: //(I% fb,:4,a6 '
APPLICANT ADDRESS: / 62-0 C/ /ei. _
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SEPTIC CESSPOOL Pe -
DESCRIPTION OF PROPOSED CONSTRUCTION OR AL ERATIO_ N
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LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: %'ic4" . /4,64—stJ
OWNER MAILING ADDRESS: £k I' - J'tr `d 1 ,A�
OWNER PROPERTY ADDRESS: /i1/./r 46/f .4)41-j - c(.s' L% Le`
( Lellit �j eleea au> 6.0.04474/z...-
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TELEPHONE NUMBER OF CONTACT PERSON: /33
TAX MAP NO. : Section ('qf Block U$4 Lot /4 j
CROSS STREET: A /4y-cf
BUILDING PERMIT NUMBER CROSS REFERENCE:
i de/to-2
Signatu Applicant
RECEIVED B146-11-0-1."---
Town C erk's Offi e
DATE: - _
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SURVEY FOR
LEANDER B. GLOVER JR. 8 FAITH M.TINER
LOT NO. 4, OREGON VIEW ESTATES" '
- - AT CUTCHOGUE _ DATE: AUG.9 , 1986
TOWN OF SOUTHOLD SCALE' In = 50'
SUFFOLK COUNTY, NEW YORK NO. 86-808
i{I N UNAUTHORIZED ALTERATION OR ADDITION TO THIS GUARANTEED TO=
7 �•�i L . `7 I c 4 a- t.„ ../1 ` J SURVEY ISA VIOLATION OF SECTION 7209 OF THE TICOR TITLE GUARAN o-F i
(�)_ \ J NEW YORK STATE EDUCATION LAW et.
N COPIES OF THIS SURVEY NOT BEARING THE LAND ( ?� hP-
1t) ..j Li �Jt L1 ��_.�`I SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL gtiD Ny �{)
NOT BE CONSIDERED TO BE A VALID TRUE COPY i „?� k 4;
NGUARANTEES INDICATED HEREON SHALL RUN ONLY TO 4? '0
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY IS PREPARED �t 9"EC"
AND ON HIS'BEHALF TO THE TITLE COMPANY,GOVERN— (a?, 1�
N NEAREST WATER WAIN MI.. N SOURCE OF WATER: PRIMITE_PUBLIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED rr � '
N PUFF CO. TAX MAP DIST�000 SECTION 095 BLACK QL LOT 1L4 HEREON,AND TO THE ASSIGNEES OF THE LENDING I u�y�.:':.:11
NTHERE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE '` 1
OTHER THAM THOSE SHOWN HEREON. TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT / �`N THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCEOWNERS � � uWILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT TDISTANCES SHOWN HEREON FROM PROPERTY LINES 4*�tvTO EXISTING STRUCTURES ARE FOh A SPECIFIC
OF HEALTH iERVIC[f, r r4APPLICANTS PURPOSE AND ARE NOT TO BE USED TO ESTABLISH ' �� M,i) SS
,U�,/;._I , PROPERTY LINES OR FOR THE ERECTION OF FENCES _�_
ADDRESS
I
TEL A YOUNG YOUNG RIIV _VERHEADN EW YORKDER
NOTE: O=PIPE A=STAKE ■=MONUMENT 4 �I s`
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF ,•ar'3n, ,3c ALDEN W.YOUNG,PROFESSIONAL ENGINEER
• -4!"r,r. -'7V AND LAND SURVEYOR N.Y-S.UCENSE NO,12845i
SUFFOLK CO.ON APRIL 4,1975 AS FILE N0.6241 . .-v;'•
. s', HOWARD W.YOUNG, LAND SURVEYOR
*TIC LOCATION OF WELL(W),SEPTIC TANK(STII CESSPOOLS(CP)MOWN H[R[ON ` N.Y.S.LICENSE NO.45893
ARE FROM FIELD OSSERWTIONS AND OR DATA OBTAINED FROM OTHERS