HomeMy WebLinkAboutGunder, Hugh ,,,111$4VOLAIC,
JUDITH T. TERRY L Town Hall, 53095 Main Road
TOWN CLERK , ,r, P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �•��trl Southold, New York 11971
Fax (516) 765-182365-1
MARRIAGE OFFICER 0•
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1 11�rr��� Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1012 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : HUGH AND LAURA GUNDER
Address 1 : 192 NINA STREET
City St Zip HOLBROOK NY 11741
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH SANITARY SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES.
Name Of Owner GUNDER, HUGH AND LAURA
Mailing Address 1 192 NINA STREET
City St Zip HOLBROOK NY 11741
Property Address 1 LAURELWOOD DRIVE
City St Zip LAUREL NY 11948
Tax Map No. section 127.00 block 7 lot 4.000
Cross Street PECONIC BAY BLVD:
Building Permit Number Cross Reference:
-p(44"44d
Issue Date: 6/11/93 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
1,,,,o��FFOIktOGy
JUDITH T. TERRY .G Town Hall, 53095 Main Road
TOWN CLERK ` C71T P.O. BOX 1179
REGISTRAR OF VITAL STATISTICS •
Southold, New York 11971
MARRIAGE OFFICER -- -Q O.- t Fax (516) 765-1823
.40 �1D Telephone (516) 765-1801
1 41. rr
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD I' ti t''.1 +i
11
TO: Southold Town Building Department l; l'
FROM: Linda J. Cooper, Southold Town Clerk's Office
3'-'
DATED: June 10, 1993
Transmitted herewith is a copy of application No. 1041 for a Cesspool/
Septic Tank Construction Permit submitted by:
Hugh and Laura Gunder .
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 recomm ndations:
APPROVE
DISAPPROVE
Comments: 4.411,4a , —at/ �` ,`�
, ..0
J
._a ri ,/i
Signature
Dated/ 1"` 9 3
•
OFFICE OF THE TOWN CLERK c�V"rf3(,`'�;�
Town of Southold �
Judith T. Terry, Town Clerk Application No. ( 0'7��
Town Hall, 53095 Main Road
P. O. Box 1179 v' t'� ,1 � l in Construction
Southold, New York 11971 �` r'• � r-
•
.r�O � Alteration
•Telephone •
1 r 1 Residential
(516) 765- 1301 �aft°
Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
• for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
•
Fee .$
DATE 47 /67
APPLICANT NAME: HUGH
Ar-.
APPLICANT ADDRESS: t 9Q NINA $TREES'
SEPTIC CESSPOOL -
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: HUGH & LAURA GUNDER
• OWNER MAILING ADDRESS: '192 NINA STREET
HOLBROOK N.Y. 11741
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT. PERSON: $/b
VI, 7 - e.�gl
TAX MAP NO. : Section 11,-) Block 1
Lot
•
CROSS STREET: L/-Eveio,00-0,0Pei V pp QQ
� 9- �� GaNi C. -PA- .1:�1•rVt�..
BUILDING PERMIT NUMBER CROSS REFERENCE:-:
j
S •
• / j'cdn tu'-e of Applicant
•
RECEIVED BY: , • 7Z .L (
Town Cleric's Office
•
DATE: 4- • �c� - •
CES5PO0 LS
SUFFOLK CO.HEALTH DEPT.APPROVAL
•
`
LH.S. NO.
23 _
(7 (2E5IPENCE) r J
CESSPOOL (7 i '\JELL
.
WELL) 5 STATEMENT OF INTENT
ir
IkV
/ V THE WATER SUPPLY AND SEWAGE DISPOSAL ,
SYSTEMS FOR •i HIS RESIDENCE WILL
3 N.€6•50IO�E, 288.08 { CONFORM TO THE TANDARDS OF THE
+� I___15-__ - 1 =1+ _ 0.-1-b � ��/ SUFFOLK . D P"" F H LTH SERVICES.
. ._ o Q is't �
p¢oP ti LA Y F - :, , P IC
SUFFOLK COUNTY DEPT. OF HEALTH
W I 1 O•'�•. CV SERVICES - FCR APPROVAL FOR
2 F-i- • � CONSTRUCTION ONLY
3 Z ;6�, 1-- ii DATE:
Q - I a L___.- H.S. REF.NO..
kr‘
; - 50 Pao P. _ NROP I 44is.5 F- APPROVED:
LL �. 3 SEPTIC ; •1-E- --- PROP.' So" W N
8 L I,; 8 ,LL SCALE- 50'.i'
'O •, O 3 _ / AREA' Z,776 S.F(0.48 AC SUFFOLK CO.TAX MAP DESIGNATION:
BUILY4NG to() ENVELOPE U1 W / 4 2 •) DIST. SECT. BLOCK PCL.
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