HomeMy WebLinkAboutGordon, Leon OFFICE OF THE TOWN CLERK S�FFOLKC'
Town of Southold
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road
P. 0. Box 1179 •�•
Southold, New York 11971 O�y� �4C-•.•,
Telephone I * •
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
•
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 219 Residential X
Fee $ 10.00 Non-Residential
Septic Cesspool X
PERMIT ISSUED TO:
NAME: Bennett Orlowski
ADDRESS: P.O. Box 297
Cutchogue, New York 11935
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family-Dwelling
APPROVED as per Suffolk County Health Dept. approval.
--LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Leon Gordon
OWNER MAILING ADDRESS: 320 Bunny Lane
New Suffolk, New York 11956
OWNER PROPERTY ADDRESS: Silver Colt Road
Cutchogue, New York 11935 _
TAX MAP NO. : Section 95 Block 4 Lot 118.39
CROSS STREET: County Rt. 48
BUILDING PERMIT NUMBER CROSS REFERENCE:
Judith T. Terr
Southold Town Clerk
DATE: September 2_ 1987
(TOWN SEAL)
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'Town Hall, 53095 Main Road
.* .4P.O. Box 728
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Southold, New York 11971
II 1)ITII I II RRY TELEPIIONI:
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(516) 765-18(11
FkGIS7 NAI?OF VO Al.STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLI)
August 31, 1987
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 222 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by Bennett Orlowski for Leon Gordon
Please review the application and location map and advise if the
project has received Suffolk County Health Department approval
and if we may issue the permit.
Please complete the form below and return it to my office.
•
Thank you.
egoeejzeas,,.........;00w+"°
• Judith T. Terry
Southold Town Clerk
I have reviewed the application and location map of the project
cited above and make the following recommendation:
APPROVE -
DISAPPROVE -
COMMENTS: al JA,%.dLtca 9.4.‘\1,14.1 Lb . ittuacAck,
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\\16:f01..,‘ —512.-voLti
Signature
cA ‘1, 1
Date
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OFFICE OF THE TOWN CLERK c.OFDL4
Town of Southold *C*► ; Application
Judith T. Terry, Town Cl er k .4
Town Hall, 53095 Main Road gConstruction
P. O. Box 1179 � � Alteration
Southold, New York 11971 ��
Telephone �_0l [ ��; i. Residential
Tele
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(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 $ Q
DATE 4 ,.Z 7
APPLICANT NAME: ` - J,„ ,..
APPLICANT ADDRESS: A „,y 7 e_.".44�
SEPTIC CESSPOOL L.-
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION 444) 460s
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
,
OWNER OF PROPERTY: 4�o0iv �OroLi�
OWNER MAILING ADDRESS: ,/�/.orrf ,J
OWNER PROPERTY ADDRESS: S4'4),Or
71-9
TELEPHONE NUMBER OF CONTACT PERSON: 71 5,--3`'i 7
TAX MAP NO. : Section 93"- Block 7 Lot 1('. 1 r
CROSS STREET : /�7zieZr/t ,d2/ 49
BUILDING PERMIT NUMBER CROSS REFERENCE:
de .44
Signature of Appl cant
RECEIVED BY:
Town Clerk's Office
DATE:
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O C.� ST .4 -[ cP.• o FILED APR. 4 , 1975 FILE NO. 6241
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r TOWN OF SOUTHOLD
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U �—� X o - SUFFOL K COUNTY,N.Y.
c.P !n ° 14 c.e 1000 - 095 - 04 - 18. 39
CrrTh tiWELL SCALE 111 = 40'
W ° � 9D _____00 �> ra• -MI •5: MAY 12 , I987
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48.98 MIDDLE ( WESTBOUND ) ROAD ( ( BARBARA J. GGRDo/4 q
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( VACANT ) 49.96
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LAN h a lit
SINGLE FAMILY DWELLtN 0191-7 +Sir
40 ens t e water supc CRSS IWO YEARS FROM DATE Gt- APPROVAL1
5' N �/ tams for this re t
y 5�Q 4 NCF 'QL standards of at
a disposal toys-
s- -� cyot".c meat of HeaitF conformto Ow
Tr i tig, . S. LIC. NO. 4966 8 j;�,�,, ,unty Dowort. • ,
.:.` � ����, l SUFFOLK COUNTY DEPARTMENT OF HE.�LTH SERVICES
PES y IC =' E (7" S 8 ENGINEERS , P. C.
Prepared in accordance with the minimum FOR APF!?C�Vt'�l OF COFIST�fI,CTyON Ota?LY
( 51 a9 �"• • 496y.0 ad ELEVATIONS ARE REFERENCED r ( �
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' standards for title surveys as established by N / TO AN ASSUMED DATUM. 7/���' HSE O• O LI --
DATE
P. 0 . NO the L.I.A.L.S. and approved and adopted /-/q�I`
MAIN RO A I for such use by The New York State Land +I c
L-I< NY-
SOUTH O L D , N . Y. 119 71 Title Association. APPROVED j�
THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD (_
OBSERVATIONS AND OR FROM DMA ODTAINED FROM OTHERS- I CI
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