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HomeMy WebLinkAboutTuthill (9) !e .n .11,1 ' sst our 6®® ®���� JUDITH T. TERRY Town Hall, 53095 Main Road TOWN CLERK T P.O. Box 1179 REGISTRAR OF VITAL STATISTICS tri Southold, New York 11971 MARRIAGE OFFICER t. 00 Fax (516) 765-1823 Telephone (516) 765-1801 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 695 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : JOHN C. TUTHILL Address 1 : 3910 ELIJAH LANE City St Zip MATTITUCK NY 11952 Descripton of Proposed Construction or Alteration ADDITION OF CESSPOOL: 2 RINGS, 4' EACH APPROVED AS SUBMITTED. Name Of Owner TUTHILL, JOHN C. Mailing Address 1 3910 ELIJAH LANE City St Zip MATTITUCK NY 11952 Property Address 1 3910 ELIJAH LANE City St Zip MATTITUCK NY 11952 Tax Map No. section 108.00 block 3 lot 1 .000 Cross Street COUNTY RTE. 48 Building Permit Number Cross Reference: Issue Date: 4/01/91 Judith T. Terry Southold Town Clerk (TOWN SEAL) :, , ,„ .D . .,„,. :,...._::___,,.,...., , ._ • _• _ ,.., to ? ___, ,-,.,- ,7,,,-,,,—/z,„ ,‘ " - . . . .. . _ _. ._ \ I rEE©mov7 moR 1 .„, ,,,,,. :, ,,,, -_ — „, 199! _. ....... . ; 7 '1 B G a PT""d'�` .,..cic ... , .....„.. ,s., - Town Hall, 53095 Main Road TOWN OF SO1J a - '' P.O. Box 1179 C90LCa 'i t ''s/ ' '� r�1 r _=''; Southold, New York 11971 JUDITH T.TERRY -'y TELEPHONE TMCLERK (516) 765-1801 REGISTRAR Ot VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Southold Town Code Enforcement Officer From: Linda Cooper, Southold Town Clerk's Office Dated: March 18, 1991 Transmitted herewith is a copy of application No.713 for a Cesspool/ Septic Tank Construction Permit submitted by: John C. Tuthill . 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 K DISAPPROVE _ Comments: q„ y,�,r$a, i) ce.r, carwmasuR /01.1-ca- . Signature Z ,..b./0\Ck.‘ Dated •# OFFICE OF THE TOWN CLERK , g'""", ' Town of Southold .�' � IFULK Judith T. Terry, Town Clerk Application No. /7/•--/ Town Hall, 53095 Main Road _� ' s • Construction P. 0. Box 1179 Alteration Southold, New York 11971 �� y�'��' Telephone �Q���• $10.00 - Residential (516) 765-1801 l � S' $25.00 -Non-Residential • ~0011' TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit' No. • - • Fee $, DATE 711.4R.dhl ) T- ' ?f APPLICANT NAME: CC3 tf /. •Tth/ 1- 2-- APPLICANT ADDRESS: 3 q j p � /Y)/j... r, 7-c--1A A1,'. 1/9 J^ SEPTIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION C2Z6.5 Pe cis ,, R! "6 ,4ut• LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: J010,/ 6. I u OWNER MAILING MAILING ADDRESS: ,016, i�;<l 4i� OWNER PROPERTY ADDRESS: TELEPHONE NUMBER OF CONTACT PERSON: 5- - TAX MAP NO. : Section id,rr Block 3 Lot CROSS STREET: BUILDING PERMIT NUMBER CROSS REFERENCE:• ( /),d•://t - Sigr 'ture of Applicant RECEIVED BY: (- � '�•� Town Clerk's Office DATE: SHI/ j • 5. Size of lot: Front Rear Depth 6. Date of purchase or lease of land 7. Zone or use district in which premises are situated 8. Does proposed use violate any zoning law, ordinance or regulation? 9. a. Method of Sewerage disposal b. Source of Water Supply c. Source of Electricity PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimen- sions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. Indicate clearly location of proposed trailer on prem- ises, showing distances from all buildings and property lines. } ,T'�SSPtCV QJ )e-/ 5r(A}6- p 2N sSPcoo - 11� • STATE OF NEW YORK 1 COUNTY OF SUFFOLK J ss. - being duly sworn, deposes and says that he is the applicant named above. He is the (owner or lessee or agent) of said owner or owners, and is duly authorized to make and file this application; and that all statements contained in this application are true to the best of his knowledge and belief; and that the trailer will be located in the manner set forth in the application filed herewith. Sworn to before me this day of , 19 . e '' (Signature) (Notary Public)