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HomeMy WebLinkAboutThe Way Back JUDITH T. TERRY Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS :; :' Southold, New York 11971 MARRIAGE OFFICER �G M� Fax (516) 765-1823 .l 4,w 4$, 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. 785 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : THE WAY BACK, INC. Address 1 : 1401 MAIN STREET City St Zip PORT JEFFERSON NY 11777 Descripton of Proposed Construction or Alteration TWO STORY FRAME HOUSE WITH NEW, EXPANDED CESSPOOL SYSTEM. APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES. Name Of Owner THE WAY BACK, INC. Mailing Address 1 1401 MAIN STREET City St Zip PORT JEFFERSON NY 11777 Property Address 1 25675 MAIN ROAD City St Zip CUTCHOGUE NY 11935 Tax Map No. section 109.00 block 2 lot 7.000 Cross Street ALVAH'S LANE Building Permit Number Cross Reference: Issue Date: 12/17/91 Judith T. Terry Southold Town Clerk f Tr1WN I,51 1 8 w Y5 JUDITH T. TERRY % < Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER ` `y ' '' l Fax (516) 765-1823 ,..-=a.zta,-.-=_---u--R,-,, ,-fn:1i ,. m .. iso Telephone (516) 765-1801 DNI©1.7-7A Iri V]ILL-12111 —_41421 2, X091 t 1 '!" OFFICE OF THE TOWN CLERK 1 i TOWN OF SOUTHOLD BLDG. 15EPT. ' TOWN OF SOUTHOLD.. �... To: Southold Town Code Enforcement 'Officer From: Linda J. Cooper, Southold Town Clerk's Office Transmitted herewith is a copy of application No. x803 for an ALTERATION PERMIT for a cesspool or septic system "submitted by The Way Back, Inc. . Please review the application and location map and advise if this office may issue the permit. Please complete the form below and return it to this office. Thank you. , Linda J. Cooper * * * * * * * * * * * * * I have reviewed the application and location map of the project listed above and make the following recommendation: APPROVE - DISAPPROVE - COMMENTS: 1,w�t.e.. R, . fly 4. &, i),....644.-.....6,, 1.i...slik. ‘ iti . .i i-of ;Lt. fip - :I_ Signature .4-1k .. ,7, I Ll a_. 01\ DEC 1 71991 Date Town (nth SOVUfO d - 1 OFFICE"-'OF THE TOWN CLERK %S\YFOL nO Town of Southold Application No. Yr63 Judith T. Terry, Town Clerk Town Hall, 53095 Main Road =1 1' � = Construction c P. O. Box 1179 �. Southold, New York 11971 Alteration Telephone 7°l x i )\)?) Residential (516) 765-1801 11 Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit ,No. 20292Z Fee $ 10.00 - DATE • 11/25/91 APPLICANT NAME: The Way Back, Inc. APPLICANT ADDRESS: 1401 Main Street • Port Jefferson, N.Y. 11777 SEPTIC X CESSPOOL X DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION See P1ans given to Building Department LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION : OWNER OF PROPERTY: The Way Back, Inc. OWNER MAILING ADDRESS: 1401 Main Street Port Jefferson, N.Y. 11777 OWNER PROPERTY ADDRESS: 25675 Main Road • Cutchogue, N.Y. 11935 TELEPHONE NUMBER OF CONTACT PERSON : Francis X. Burke TAX MAP NO. : Section 109 Block 2 Lot 7 • CROSS STREET: . Alvah 's Lane BUILDING PERMIT NUMBER CROSS REFERENCE:_ r Signature of App-rcant Francis X. Burke - Executive Director RECEIVED BY: e. Town Clerk's Office DATE: RECEIVE® NOV 2 :1 Town Clerk Soutlfold a .r U _� Ly/ C9\° ��\ 00 E V5, �lJ�iTOWIV OF.SEUTHOI D I is ' \-1:11' t..4--1/4.:6 , t`I(SN G�Ik 0,0 OK;_ dyN SILT Wim ..;• 2.o' of MED, At w/mark • aN T SI` MeP, G YEL. 7 fleoJec-r-y 6,•°' _ - --- - _�r -r-A4-4 Sib.S `/,�/T of G> e1, \ �`, s\ �\\.: . 1-1•a - ----- L1: rAN-SPANl7 wtrg�.E rs - PINIONED OR/ADE .— SMPd.L gepcveL ' ' TArd +.►p W/T�Pc-e �—or c11-1- >1111111111' \� - FRE-GAcoT Iz.EINFORGED ZO •S le.pUND Wim' =,•.� ��; CONCRETE COVER �\\ --- ---* pAc k-fAly I� WIL'ITTL 1 \ ,1 •\\• \' �°cr'e slur M A — IAN a"b INLET ojp p1 SND or. {-loL->✓ OGHED'U'-E bO r/G ?In. I \ , MIu.PI1CFi 1/4•• , 0' i f}OL- 61 y(2r1(cD1ki f_-, t;\'' )1 1•Cp5 1<eS 2 / — b/+CKFILL MATERIAL TO K EY ?)E CLEAN "AND 4+0F2 VEL / (ALL AROUND) .. HOT TC 1 / O ryri ‘?„„1 \ B7.._c:_r? OOL rxl `I'IN� TREcs o �)r o 100 ROM L. 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