HomeMy WebLinkAboutGuild, Jack OFFICE OF THE TOWN CLERK c31FO(Kp,lj;
Town of Southold
Judith T. Terry, Town Clerk ` '
Town Hall, 53095 Main Road
P. O. Box 1179 yc �•`
Southold, New York 11971 O
Telephone Oi
(516) 765-1801 '
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 224 Residential X
Fee $ 10.00 Non-Residential
Septic Cesspool X
PERMIT ISSUED TO:
NAME: Jack. Guild
ADDRESS: P.O. Box 331
Cutchogue, New York 11935
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling with Cesspool System �.
APPROVED as per Suffolk County Health Dept. approval. •
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Jack and Mary Guild
OWNER MAILING ADDRESS: P.O. Box 331, Main Road
Cutchogue, New York 11935
OWNER PROPERTY ADDRESS: 1420 North Bayview Road
Southold, New York
TAX MAP NO. : Section 78 Block 9 Lot 76
CROSS STREET: Victoria Drive
BUILDING PERMIT NUMBER CROSS REFERENCE:
Judith `T. Terry
Southold Town Clerk
DATE : September 3, 1987
(TOWN SEAL)
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T• i SOUTHOLD
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,►`� Town Hall, 53095 Main Road
►► P.O. Box 728
Ol�T,,,, ►. Southold, New York 11971
.1UUITI I I-TERRY TELEPHONIC;
TOWN('I I R K
(516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
September 3, 1987
To: Victor Lessard, Southold Town Building Department
•
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 227 for a
• CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by Jack Guild .
•
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.
tore404;;efsigg'.."1".
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 - ` 1
COMMENTS: � . % (�1. 1; `.t�. ftxdsMti t-.
Signature
Date
OFFICE OF THE TOWN CLERK c.3VFFU1K
Town of Southold Town Clerk �r CO�`' Application No.�R 7
Judith T. Terry, ,G ;
Town Hall, 53095 Main Road Construction
un
P. O. Box 1179 Alteration
Southold, New York 11971 ,yt D�
Telephone _�.� 41 �� ,.y 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 9/3/97
APPLICANT NAME: Gid
APPLICANT ADDRESS: ` (Dix 331 CcticLnupe
SEPTIC CESSPOOL/
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION I1e( ) lwe�
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: -+ VAoor Gwl�
OWNER MAILING ADDRESS: 'To" 0A01 _ C- o e,
OWNER PROPERTY ADDRESS: /`f:20 /12 2 Ucj
TELEPHONE NUMBER OF CONTACT PERSON: ?3y - C0OD9
TAX MAP NO. : Section 7$ Block °) Lot 7(u
CROSS STREET: _� V/G7-0 //3-
BUILDING PERMIT NUMBER CROSS REFERENCE:
Sigo ke1kw:
atur oApplicant
RECEIVED BY: ¢
wn 21erk's ffice
DATE: SEP 0 3 1987
Town Click Southold
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The water au I & sewn a dis l a IHF E V ATON Or WELLS AND CESSPOOLS SHORN HEREON pRE EROIMf1EtD
supply 0 P� Ys" OBSERVATIONS AND OR FROM DATA OBTAINED ROM OTHERS.
,semi for this residence will conform to the A/0/9
:standards of the Suffolk County Depaht.64 33 �� r "4
CA N r
anent of Health Services.
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SURVEY FOR
M N —JACK
A . GUILD
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CERTIFIED TO : MARY E . GUI LD
COMMONWEALTH LAND TITLE � V AT BAY VIEW
INSURANCE COMPANY V
JACK A. GUILD TOWN OF SOUTHOLD
MARY E . GUILD
SUFFOLK COUNTY , N. Y .
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
I000 - 078 - 09 - 076
FOR APP' ' VAL OF CONSTRUCTION ONLY
SCALE la = 601
DATE O lef9 (if� -S M
REF. . •. - - �
1 JULY 1 4 , 19 8 6
•.3s--� A R R. 17 , 19 8 7
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APPROVED.
���° A , sG SI L FAMILY DWELLING ONLY
44, c,,P� ' "tF�L N .4I• : ►i O ' ""'1i :S FROMeDATEoOF APtPROVAL .
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P : G',►NI '':'`'h';'1)'' . tl RS a ENGIN EE R SP. C . standards for title surveys as established b)
( + � r the L.I.A.L.S. and approved and adoptec
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for such use by The New York State Land
P. ,N . ' •*. 9 0 99s Qdt- Title Association.
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