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OFFICE OF THE TOWN CLERK
F
Town of Southold ;gd.
� CSJudith T. Terry, Town Clerk . 5k
Town Hail, 53095 Main Road . 8 itx,
P. O. Box 1179
Southold, New York 11971 O *.&-•�•�
Telephone Ol
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 87 Residential X
Fee $ 10.00 Non-Residential
Septic Cesspool X
PERMIT ISSUED TO:
NAME: Winds Way Building Corp.
ADDRESS: 1020 Glen Road
Southold, New York 11971
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Roger Vorce
OWNER MAILING ADDRESS: 405 East 54th Street
New York, New York 10022
OWNER PROPERTY ADDRESS : R/O/W off Oregon Road
Cutchoque, New York
TAX MAP .NO. : Section 72 Block 1 Lot p/o 1-4
CROSS STREET: Bridge Lane
BUILDING PERMIT NUMBER CROSS REFERENCE: Pending
•
Judith T. Terry l/
Southold Town Clerk
DATE: December 30, 1986
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(TOWN SEAL)
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JUDITH T.TERRY TELEPHONE
TOWN CLI RK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
December 30, 1986
Winds Way Building Corp. • - _.
1020 Glen Road
Southold, New York 11971
RE: Roger Vorce
ROW off Oregon Road
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 ours,
010.14(4Qemoles 6.044frodorommft
Judith T. Terry
Southold Town Clerk
Enclosures (3)
JTT/Ijc -
—soi
( ----,- -
to C\\MU(e(el-
Jam. ta� ba
;tb' f �`� Town Hall, 53095 Main Road
A, %, . P.O. Box 728
�����4 ��,, 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
December 3, 1986
To: Victor Lessard, Southold Town Building Department .
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 82 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by Winds Way Building Corp. for Roger Vorce •
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.
er0
eeasee
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:
4
Signature
Date
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•
OFFICE' OF THE TOWN CLERK „CS FOa'eToD
Judith T�n of Southold Terry, Town Clerk Application No. �a
n• r .cam
Town Hall, 53095 Main Road ;�<~ � Construction
P. 0. Box 1179 e:5 *'� � Alteration
Southold, New York 11971 ..
Telephone ®�-��
, 1:° ' 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 $ o-G
• DATE
APPLICANT NAME: � 5, /164:11
APPLICANT ADDRESS: 44., .
SEPTIC CESSPOOL Y
DESCRIPTION OF PROPOSED C.pt STRUCTIAJk#OW R ALTERATION
d4/1/ .'4 G
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONS "'rCTION O�� ALTERATION:
OWNER OF PROPERTY: L/®4464'
OWNER MAILING ADDRESS: y® , y ®F .
/ 003,,L
OWNER PROPERTY ADDRESS: 19/0 7' )- 44414.44. ®44)4, At 40 4
yjr, 4140,40Imo'. TaolJg..-
TELEPHONE NUMBER OF CONTACT PERSON: ',Cs . $. 316,1
'
TAX MAP NO. : Section 7 Block I Lot p/b /0'41
CROSS STREET: OA .
BUILDING PERMIT NUMBER CROSS REFERENCE:
pp
Signature of Applicant
J
RECEIVED BY: 6
Town CJk's Off ce
DATE: /a-- 3 - 0 fr
r ' , , SUFFOLK CO. HEALTH DEPT. APPROVAL 1; \.;
i....)r. ^)' —s^ `' �✓ H. S. NO. • -,i1 1 ri
' ) vor21- E: . (..)
11
STATEMENT OF INTENT ' ''
•
----- THE WATER SUPPLY AND SEWAGE DISPOSAL
.;_4.,'LJ ir-.i C'L..f!-;axl,'.1 SYSTEMS FOR THIS RESIDENCE WILL
CONFORM TO THE STANDARDS OF THE
SUFFOLK CO. DEPT. OF HEALTH SERVICES,
(S). .� _s
•
APPLICANT
' SUFFOLK COUNTY DEPT. OF HEALTH
SERVICES -- FOR APPROVAL OF
CONSTRUCTION ONLY
DATE _____ , „__
H. S. REF. NO.:
!!++ APPROVED:
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SUFFOLK CO. TAX MAP DESIGNATION:
\KZ)\ DIST. SECT. BLOCK 1;
\ \ . 1000 72 { , • ,'� 1'::
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