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N %,._ :: Town Hall, 53095 Main Road
4 P.O. Box 1179
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JUDITH T.TERRY _ >•.x,,,,,o o FAX(516)765-1823
TOWN CLERK TELEPHONE(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 613 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : DOUGLAS STANDLEY
Address 1 : P. O. BOX 500
City St Zip JAMESPORT NY 11947
Descripton of Proposed Construction or Alteration
AADDITION OF NEW CESSPOOLS TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. EXCAVATION INSPECTION REQUIRED. CALL SOUTHOLD
TOWN BUILDING DEPARTMENT (765-1802) FOR AN APPOINTMENT.
Name Of Owner YOUNG, HERBERT AND SUSAN
Mailing Address 1
City St Zip 0000
Property Address 1 WEST ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 110.00 block 7 lot 8.000
Cross Street PEQUASH AVENUE
Building Permit Number Cross Reference:
Issue Date: 5/17/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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BIOG. DEPT .. ;ma;r.,...„ ....,,nfrn� r7
TOWN OF SOUTHOLD e,i rra Town Hall, 53095 Main Road
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• P.O. Box 1 179
k f Southold, New York 11971
.JUDITH T. TERRY �'-•""ir Ili '/
TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
May 17, 1990
To: Southold Town Code Enforcement 'Officer
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A628 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Douglas Standley for Herbert and Susan Young
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 - x
DISAPPROVE -
COMMENTS: ca.... ,i... cook. pr, c.'cQc1
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a® Signature
Sj / 7/ 90
Date
se
OFFICE OF THE TOWN CLERK ' ' c\S�FFO(K`o
Town of Southold Y �N. .; •
Judith T. Terry, Town -Clerk' tAG Application No.
Town Hall, 53095 Main Road Construction
P. 0. Box 1179 1. _ ; 't'?: i
Southold, New York 11971 ® .._ Alteration
Telephone *l Itvi
•.' 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 $
DATE ' 6,
Dom CceS S .
APPLICANT NAME: -=-�*i� - ,�i ,_�__ _ _ •
APPLICANT ADDRESS: 8 O S--d 0 /
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SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION� OR ALTERATION:
OWNER OF PROPERTY: 11,/,-, s
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS: 1�2 (' der , _
TELEPHONE NUMBER OF CONTACT PERSON: f2( 0675
TAX MAP NO. : Section 1 O00 Block / / 0 - 7 Lot --
CROSS STREET: - - � ,
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of plicant
RECEIVED BY:
MAY jwtg�lerk's Offic_ �
.DATE: �A! w :t ')►
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TAX ;_i;.
' OWNER: HERBERT A. & SUSAN C. YOUNG :, zl. .:-.1,,,,f.,-' .r
. C/O UNION TEXAS PETROLEUM - • �° -r;"L '
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P.O. BOX 2120
, HOUSTON, TX 77252 • . . -
ZONING: R-40 - RESIDENTIAL LOW DENSITY
ONE ACRE
• LOT AREA: 17,550 SQ. FT.
. BUILDING AREA: 2,345 SQ. FT. . - -
SITE PLAN: TAKEN FROM SURVEY BY:
• - RODERICK VAN TUYL •
_ GREENPORT, N.Y.
DATED. 07/23/84
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. DATUM: NATIONAL GEODETIC VERTICAL - . .
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