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JUDITH T. TERRY '" Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
C� �; Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ‘IiP
' ;,� Ni- s'. Fax (516) 765-1823
MARRIAGE OFFICER - �' � ' Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER --- ®i �0
FREEDOM OF INFORMATION OFFICER ""�..�.riviwiii1
OFFICE OF THE TOWN CLERK r n.� Y `�=�r;-; ; :-.
TOWN OF SOUTHOLD < Pr 1 .-Y- _,! ' "
1
1 \y JAN 131994
TO: Southold Town Building Department j ; mbi.p
FROM: Linda J. Cooper, Southold Town Clerk's Office L 1'®V1/Pa 01"SourHO r1
DATED: January 13, 1994
Transmitted herewith is a copy of application No. 1124 for a Cesspool/
Septic Tank Construction Permit submitted by:
Michael Zuhoski for William Beebe •
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: €5-a A -P,-, ce f 0 bcD
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3 ` 3G Dated
OFFICE OF THE TOWN CLERK cj1FFO11
Town of Southold . ��"-'
Judith T. Terry, Town Clerk 0� „ri` .� �� Application No. ��
Town Hall, 53095 Main Road o "pf
Construction
P. O. Box 1179 v ' • J
O •• � Alteration
Southold, New York 11971
Tele hone Ol [ lt, , Residential
p
(516) 765-1801 "'
Non-Residential
•
TOWN OF SOUTHOLD
•
SOUTHOLD WASTEWATER DISPOSAL DISTIICT
•
APPLICATION •
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL` '
Permit No.
Fee $
DATE /// 3 9 c/
APPLICANT NAME: a ijd9j/ 9C ciicZ T`/
APPLICANT ADDRESS: 47 /fr 2 o2 afaor,s,
SEPTIC /CESSPOOL V-
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
• (PO GQ o ��.r J i ES /P// S 6 P, ' 4.5-7/4_ Ar.
' mss"
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: /a// 4►p8e
OWNER MAILING ADDRESS: Pew, Zit' Xicti,
meq, $. e7/4 /v
OWNER PROPERTY ADDRESS: _ •
1
TELEPHONE NUMBER OF CONTACT PERSON : 95'/ ag
l
TAX MAP NO. : Section /,if Block Lot '' 7
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Si. • ure of Applicant
RECEIVED BY: (%
Cle k's Office
DATE: /,,/ 3 9 y
coP � r .
et
R = 25.00' rkniribN
L = 39.27'
pn l ;r.
SA
O��A 3o DEC N8 1993
s9,
�iL���` cT°DUI.
°cis .
e/2T 0 J — — — — ,
,y - a
•
e` e`� S 40`
E.
• - y°53 �► / SURVEY OF.
R ", 5 9283 .I
L Allg:
2 / LOT 7 �'�' �t'` „
5L, e''' "THE WOODS AT SOUTHOLD" , T('.,/,l/ 't
cd,�°oFP �}
FLED MARCH 23,1989 AS MAP NO.8717 ,J
C4.7,_____
yk , AT CUTCHOGUE /y-: •
r5o e, o TOWN OF SOUTHOLD
of-Pi.
03. AD ..-_,PTD 'r+� - �o kr 3h0� SUFFOLK1 O N 01-4 i' N. Y.
-6., e• Scale: 1"= 50'
Dec. 12, 1993
0 .
\e '<C). Mari rprmy Lir,4 rn. mit'v
0 r: r.
,� x GR rr AREA 49,063 sq.ft.
•.'O or �O oa The water supply and sewage disposal
4 a v J 0'
totems for this thestandards of residenceThe
Suffolk County NEW V0
Department of Health Services. Ste. , c.
MET
y
;;:�
The locations of wells and cesspools '4 �� o ,: �� is
shown hereon are from field observations m t$ :„?'•y
and or from data obtained from others. .q,� \14J'
co • a\ • SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES ti( �
FOR APPROVAL OF CONSTRUCTION ONLY li ,0 ,'•.\--'
Prepared in accordance with the minimum 3'I - 'JAN 1 0 1°9S c•
/' ��i? .� ' LIC. NO. 49618
P DATE_ HS. REF. NO. R1O ]� OOa .,."
standards for title surveys as established T 51PE6) 7656 `SII- • •ORS, P.C.
0
by the L.I.A.L.S. and approved and adopted P. 0. - 50 9
for such use by The New York Slate Land P. BOX 909
Title Association. / ELEVATIONS ARE REFERENCED APPROVED n /% V MAIN ROAD
SOUTHOLD, N.Y. 11971 •
TO AN ASSUMED DATUM. -
•
• 93 - 306
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