HomeMy WebLinkAboutFoster, Arthur (2) �# iiii
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JUDITH T.TERRY t o Town Hall, 53095 Main Road
%TOWN CLERK t cm Z ; P.O.Box 1179
1k Southold,New York 11971
REGISTRAR OF VITAL STATISTICS '. 1
MARRIAGE OFFICER 4* O�11 Fax(516)765-1823
:
RECORDS MANAGEMENT OFFICER 5l * `14,00 Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER „. ,,I''
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1367 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : ARTHUR P. FOSTER
Address 1 : P. O. BOX 1132
City St Zip MATTITUCK NY 11952
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. #90-SO-137
Name Of Owner FOSTER, ARTHUR P.
Mailing Address 1 P.O. BOX 1132
City St Zip MATTITUCK NY 11952
Property Address 1 HUNTINGTON BLVD.
City St Zip PECONIC NY 11958
Tax Map No. section 67.00 block 4 lot 10.000
Cross Street FASBENDER AVENUE
Building Permit Number Cross Reference:
Issue Date: 8/14/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
•16 FOl./re- - 614 OW
7
JUDITH T. TERRY Z Town Hall, 53095 Main Road
TOWN CLERK p r= P.O. Box 1179
ifs �� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = �. et Fax Fax (516) 765-1823
MARRIAGE OFFICER Q
RECORDS MANAGEMENT OFFICER =� 1 � ri�r Telephone (516) 765 1801
FREEDOM OF INFORMATION OFFICER "•Nwr,,,i,r'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department — 2 IQQr
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: August 2, 1995
Transmitted herewith is a copy of application No. 1418 for a Cesspool/
Septic Tank Construction Permit submitted by:
Arthur P. Foster
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: cw sC /'� �/4o -/3 0
-� r l�
Signatu e
37
7///13-
Date.
I
OFFICE OF THE TOWN CLERK "",, •
Town of Southold ".... c0Faiti`+D Application No. ��
Judith T. Terry, Town Clerk G
Town Hall, 53095 Main Road ° Construction
P. 0. Box 1179
Southold, New York 11971 ; ,...... t.... x :=
Telephone Q ;., Alteration
$10.00 - Residential -
(516) 765-1801 -- wir ,�' $25.00 -Non-Residential
• -• - , ,,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$ / -
APPLICANT
DATE F//NAME: -4(-F- tC -e Pod--ems
APPLICANT ADDRESS: 4)0 P3•01.. 1132
• mom-ktt I--e1/__ I'1:�1. ills-2_
SEPTIC CESSPOOL v U
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION n,t o Sv
edAkeka.ed, c./;417,e4;-?
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ±-kit c •Q 54•2 (Z,
OWNER MAILING ADDRESS: 78 IS-0, _ \ t'3 Z
•
9r `0 V-_t `Ylka__ 1Ic1 .5-2_
OWNER PROPERTY ADDRESS: //cf.uTI,VG..T`v,c,,) ,aLv 6
TELEPHONE NUMBER OF CONTACT PERSON: 1/45-11:2 -2-RF O g 'S-
TAX MAP NO. : Section/,7- 116 ock 44 Lot -. /
CROSS STREET: r ?fie ç V -t) 4,1)ecti-vu CI
BUILDING PERMIT NUMBER CROSS REFERENCE:
k
Signature of Applicant
RECEIVED BY: • (Aioe/e/kl-•---;
Town Clerk's Office
QQl`
DATE: _'C2 �'s •
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DARK MOWN LOAM 8" . t `tom of ,i-,.
SAM LOAMY SAas. Q P;OLCO SE SAID '' W 41 "�, f 9.
04‘)IR'
MOWN N.SANDY L'LAY /�
u.AYw WA1-617 lx .
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qi _$ r1p�iAREA = 9,871 sq. ft. ,.a,, ,Ne e
, . ,
SINGLE FAMILY DWELUIG O 1LV 9 - �i� .
WIRES FROM DATE 01F APPROVAL y S�
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES r
FOR APPROVAL OF CONSTRUCTION ONLY
DATE 61-l—41 t, H B.REF.NO. '10' —13 g "' SURVEY OF
APPROVICAV404 5414:1 L O-TS 91 & 92 .
MAP NO. 2 '
The locations of wells and cesspools shown hereon are from field "PECONIC SHORES,
observations and or from data obtained from others. FILED SEPTEMBER1l,. ,1890 FILE NO. 654
AT PECONIC
The water supply and sewage disposal TOWN OF SO�JTHOLD
systems far tWa residence �conform r
to the stsndy& of The Suffolk County SUFFOLK COUNTY, N Y.
Department of Health Services. 1000 - 67 04 - 10
CERTIFIED TO ; Scale 1" = 20'
JACK P. CHRYST NOV: �, 1990
MARIE R. CHRYST'
ELEVATIONS ARE REFERENCED TO ASSUMED DATUM .
,i `,°4, 0 `AND S
1. MFT ���..
/' /'; tf ' . NO. 49818
'le , 01 ',tOpared in accordance with then MUM
-ECO -U' T i *RS ':'.0. star r& for title surveys as eatablshed
by the / 1 iA 1 q enrl annrrwasd....4 e4,...044a•/