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JUDITH T.TERRY •
` Town Hall,53095 Main Road
TOWN CLERK t ,g0 P.O.Box 1179
REGISTRAR OF VITAL STATISTICS Southold,New York 11971
MARRIAGE OFFICER 4 �� Fax(516)765-1823
RECORDS MANAGEMENT OFFICER jet ED �i���0.' Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1306 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : KEVIN J. WRYNN
Address 1 : 38 ROSELLA COURT
City St Zip WEST BABYLON NY 11704
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. #R-95-0039
Name Of Owner WRYNN, KEVIN AND JOAN
Mailing Address 1 38 ROSELLA COURT
City St Zip WEST BABYLON NY 11704
Property Address 1 LLOYDS LANE
HONEYSUCKLE HILLS
City St Zip MATTITUCK NY 11952
Tax Map No. section 99.00 block 3 lot 4.012
Cross Street SOUND AVE. & REEVE RD.
Building Permit Number Cross Reference:
Issue Date: 4/07195 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
/ 3 66
„..,cof pure; _
4.14.%JUDITH T. TERRY t� Town Hall, 53095 Main Road
TOWN CLERIi; P.O. Box 1179
th Southold, New York 11971
REGISTRAR OF VITAL STATISTICS � ,' Fax (516) 765-1823
MARRIAGE OFFICER __40'b 40, to Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER : ®,l j
FREEDOM OF INFORMATION OFFICER ����
17
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD ,1 / CS 'z
7/1/
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office • 4
DATED: March 24, 1995
Transmitted herewith is a copy of application No. 1354 for a Cesspool/
Septic Tank Construction Permit submitted by:
Kevin Wrynn •
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: Cj c�� /47,7Z.-Ar-d---0 3 r
dl Aer
Signature
1//6, f
Dated
OFFICE OF THE TOWN CLERK ,,,,""""'%,
Town of Southold .s'"� �FFD(� _
Town Clerk •'• �� , -��1/ Application No. / �
Judith T. Terry, i• O� <. . . �'`
Town Hall, 53095 Main Road ; Z .G
Construction
P. 0. Box 1179 . = '- = mm :
v ^' • Alteration
Southold, New York 11971 to �.`
Telephone ‘ �iy `����i', $10.00 - Residential L
(516) 765-1801 = 01 �; ' $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE_ Y2*
APPLICANT NAME: , 11 t7 2/ . 1/VieY
APPLICANT ADDRESS: 3r.JeOJ5LGk' '
)i/', dfdq-A yU.,v, >V/ )176 /
/
SEPTIC CESSPOOL
I Lfz,�e
DESCRIPT ON- OF PROPOSED CONSTRUCTION OR ALTERATION
5 vo-1 SV`D,/ .6 ,I2-0s.X'1104.
LOCATION MAP: ' Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: /"Gt'%,c/ -i- Or4.-70 Wily
OWNER MAILING ADDRESS: SnMe as 444o�
OWNER PROPERTY ADDRESS: JT-0/2- G1-4 AS 4t
TELEPHONE NUMBER OF CONTACT PERSON: 57t - W-/80
TAX MAP NO. : Section 091, do Block ®3 ,A0 Lot O ) < p/ 2-
CROSS
CROSS STREET: 5®off , -/- ,e,/, /A-
BUILDING PERMIT NUMBER CROSS REFERENCE:
t
Si n ure opplicant
RECEIVED BY: R ®
Taq of t % Office .
DATE:
9��I9PP
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Young & Young, Land Surveyors �'
6 1995 400 Ostrander Avenue, Riverhead, New York 11901
r :% . 516-727-2303
S,�wt.OF \' /-VI-SERVICE% — f-
J
�1 �j t.. Alden
A Ytnsng, Prot®satonal Eng{neer Land Surveyor
• \ A \O v�E4 Howard W Young. Land Surveyor
O\ �•ll A �O O V Thomas C. Volpart, Professional Engineer
L-JPLp g� j Kenneth F. Abruzzo, Land Surveyor
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y'� % o-► F( ~ aUFFOLK COUNTY DEPARTMENT OF HEALTH SERvu.
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6Ao2300 O p0� �� OO. 9'9 4,0 ���� n F APPROVAL OF CONSTRUCTIOi1 ONLY
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° q °ya L� Qoy`� ' SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES CERTIFICATI(
// P �.'C // �,,,le' •I AM FAMILIAR WITH THE STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURF/
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S� I, •o• 7,;:.,�e - .,1 4 SEWAGE DISPOSAL SYSTEMS FOR FAMILY CES AND WILL ABIDE BY THE CONDITI(
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�y � SET FORTH THEREIN AND ON 7HE PERMIT TO CON�/SjI,//A�U_(C/,FTy'/_mY�'
c% Zi APPIJCANYS 9GNATURE•� ' O
V. A F
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. �� v \�OTELEPHONE NUMBER S/`�``,-ip Q 2 •
L5 • + °� \
5'o * °� \2 \f'5`rk ; SURVEY FOR:
0 O o \� \ °�\'0t, ,�a\ N ? KEVIN J. WRYNN a JOAN E.WRYNN
c o• �£ o o �/ P1 ea \\ o ��W' Y•t LOT NO 12, HONEYSUCKLE HILLS°
f O^ o \ ZrO,p1. N O \ 1* 2 r.1::27,'7'
's6 c, o N m �� \\ t'-l''' II At: MATTITUCK Town of:, SOUTHOLD
-, �3� �;, t \\ \ =' _` O Suffolk County, New York
o% o 1t+ 45893
c % 1 ^e u. LAND 1000 99 3 4 12
tri 0 1• a`' 0 Suff. Co. Tax Map: I I I I
S t0 00 DIWIrt Section Block Lot
\0 a
I moo•' 330 "8 NOTE =MONUMENT FOUND 'STAKE SET CERTIFIED TO:
e\.'' 2 I.SUBDIVISION MAP FILED INTHE OFFICE KEVIN J.WRYNN
S•=1° �g0 OF THE CLERK OF SUFFOLK COUNTY ON JOAN E.WRYNN
/ P OCT 16, 1981 AS FILE NO 7019 NORTH FORK BANK
I�/ ed .2 ELEVATIONS SHOWN HEREON ARE FROM ACTUAL CHICAGO TITLE INSURANCE COMPANY
/
ReS `1 N6 V.D.(MSLVEY AND AI929)ERENCED TO
/
1'l1wa4f
/ DATE FEB.6,199:
SCALE :1'.= 50
• JOB NO. :95-0034
• SHEET NO.:1 OF 1