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HomeMy WebLinkAboutWard e,, JUDITH T.TERRY Town Hall,53095 Main Road TOWN CLERK car s g P.O.Box 1179 O ��� REGISTRAR OF VITAL STATISTICS Southold,New York 11971 � 1 Fax(516)765-1823 MARRIAGE OFFICER �_r® ,z"ego Telephone(516)765-1800 RECORDS MANAGEMENT OFFICER c FREEDOM OF INFORMATION OFFICER ,s" OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1197 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : EDWIN J. WARD Address 1 : SENATE HOMES City St Zip CENTEREACH NY 11720 Descripton of Proposed Construction or Alteration SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING. APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES. SCHD REF. #R10-94-0081 Name Of Owner WARD, EDWIN J. (AGENT) Mailing Address 1 SENATE HOMES 6 MALIBU LANE City St Zip CENTEREACH NY 11720 Property Address 1 AKERLY POND LANE City St Zip SOUTHOLD NY 11971 Tax Map No. section 69.00 block 5 lot 7.000 Cross Street LOWER ROAD Building Permit Number Cross Reference: Issue Date: 9/15/94 Judith T. Terry Southold Town Clerk (TOWN SEAL) 4., JUDITH T. TERRY Town Hall, 53095 Main Road TOWN CLERK c v P.O. Box 1179 ,� Southold, New York 11971 ,.,,. . 0„,„„...,,,,, ,..0,Ifobrt, // ? 7 ,oc, , i,,,,,., REGISTRAR OF VITAL STATISTICS ® ,' � .1 Fax (516) 765-1823 MARRIAGE OFFICER �' ia®I�1i Telephone (516) 765-1801 RECORDS MANAGEMENT OFFICER =_�®1 i FREEDOM OF INFORMATION OFFICER �;�,�o/o/k/ii'l, OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD ID TO: Southold Town Building Department Cr_� — 1 1994 FROM: Linda J. Cooper, Southold Town Clerk's Office I --o-B of ------ f p BLDG.DEPT DATED: August 31, 1994 SOUTH®L® Transmitted herewith is a copy of application No. 1242 for a Cesspool/ Septic Tank Construction Permit submitted by: Edwin J. Ward (Senate Homes) • 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: J2,44,d -��-i �� i) Ay/ A ®9s-may ........._ ,PP. i, 4.,_____.� Signatur-. / /� Dated , OFFICE OF THE TOWN- CLERK �S�FF01 Town of Southold �, Dli Judith T. Terry, Town Clerk ; : Application No. /� �/� Town Hall, 53095 Main Road Y'to i. �. a• � Construction P.- O. Box 1179 {-'`:, Southold, New York 11971 Alteration • Telephone 1 st •, 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 $ /D. i • QQ�f DATE (A.J 3c9l APPLICANT NAME: . ?,.j CRJ a¢trp \ at.4e f 1ouRes) APPLICANT ADDRESS: - /r i Li I/ Oa SEPTIC I CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION PR90ose p it),9"... C�a�-s 0 0:1i csw o•--c u g • S 14c e s ,4 � - O 7osiL( gYs wt C'dws;s1-1A-3 04N f 5f 1c4-4P(< 9. 1 CIt?5S?CC)I wig t(000 cti{((o CfRr,fet' I rNt q4 e R 4i, 4c• ARS Ctis4 45 CAR •C(k &ARO eC (4, LOCATION MAP: Must be attached hereto before permit may be issued. , l • LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: 1.,SD(�4-4M �, caGi-nki+ ) OWNER MAILING ADDRESS: C tr n ( ; eu 1a14.€ 0,20 OWNER PROPERTY ADDRESS: ,. Peop©Se0 gou._'ee y L e, C4c keg!y P5vf L e TELEPHONE NUMBER OF CONTACT PERSON: S , '4 k ( c (e — &R('xp TAX MAP NO. : Section Block 05- Lot 1% 0 CROSS STREET: Locea gOAO - BUILDING PERMIT NUMBER CROSS REFERENCE: 7v�7 t L Cit=' Signature of Applicant RECEIVED BY: e3/ //Town Clerk's Office .e •DATE: ( 5- • lam familiar with the STANDARDS FOR APPROVAL r SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES w AND CONSTRUCTION OF SUBSURFACE SEWAGE �• ' s' FOR APPROVAL OF CONSTRUCTION ONLY . DISPOSAL SYSTEMS FOR SI E FAMILY RESIDENCES �� � �p� p . and will abide by the condi •ns • to I rein'and on the <5,6›- DATE s'6 "'!!!j. DATE<la M� /ti/d-g41'0D 81 permit to construct. - I • ` o. HS. REF. NO. * • •� '. _ /esi 6or/n9 1 �� �G� a�� ' APPROVED ��i'= 1 0 e ® V ��6 '?`�r AIM _ scs.dy/oc.,-, �` �N SINGLE FAMILY II r'y.�QiNLY'- a� z' %. - k A ' �% iXPIRG.7 THREE YEARS i RO"• {G OF HI'i'RoVN1. co o.rs Q ° 2 ' �/ y �a .4• to /�f� I Sand 1QOIs W;t(( Aoy4 �/y ? %:„R,61-1 P:Y- - 43 � (`�, %z / y 111777 ,�3 6 ZOt 44' ‘- ��0 ®� �o ,S ,,a.O Q9 CP. S' h2 et ��r ti r'S 4� aJ t `#a! /' sow e'.. yG r G J mss•- yJ. c J 8 se t' !i O or 0 Lc , :43t� C SURVEY FOR / . ,„?, - • EDWIN WARD k •k, FF Aa°dy J A AT SOUTHOLD -1:- 2' I° x.52 TOWN OF SOUTHOLD SUFFOLK COUNTY, N Y. • VV. \ L A1000-69- 05P1007 yr• �C'-.• \ 1 Quo c'c V Scale: 1"= 60' •+ L ti oP .•''i. June 15, 1994 O�.c� p�rq< L�,d� O �J��G�'P • • 8, 1994 (B.O.K -.4144k di' /28 .\,z-,.. o' 01) • r ply "�S \,.., cQ{e o ti O� izr� Oec �� � 5 51 �" AREA - 2t. .5386 Acres c) tiQ„�! f-: '° C .ti ,•r. : �'r ,� y �� „k CERTIFIED TO' ka or `- ',�F49sta�OP�170 \ 0•i vat.v EDWIN WARD NDN ti0% 00e , C1� \ g2•vPrepared In accordance with the minimum �1 N.Y.S. LIC. NO. 4961 -9, 7�, c,. _ LOT NUMBERS ARE REFERENCED TO standards for /ills surveys as established Dci-neUr' r _Iirvnnn