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ELIZABETH A.NEVILLE �� �� Town Hall, 53095 Main Road
TOWN CLERKk �{ P.O. Box 1179
REGISTRAR OF VITAL
k ea P.O.tao il °• Southold, New York 11971
MARRIAGE OFFICER ® ''` '4%• Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER _4®J -001.1 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
SOUTHOLD INASIVIWASCIEIRPHOIEDSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2597 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : COLIN CROWLEY
Address 1 : 1735 GRANDVIEW DRIVE
City St Zip ORIENT NY 11957
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-01-0001
Name Of Owner CROWLEY, COLIN
Mailing Address 1 PO BOX 343
City St Zip EAST MARION NY 11939
Property Address 1 320 PRIVATE ROAD #7
City St Zip EAST MARION NY 11939
Tax Map No. section 38.00 block 1 lot 26.000
Cross Street SHIPYARD LANE
Building Permit Number Cross Reference:
Issue Date: 6/27/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
,S9
ELIZABETH A.NEVILLE ����� �d • Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �� Southold, New York 11971
MARRIAGE OFFICER c ��� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ®� ,.ss2-2, �ii� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER `-S Vo
i.
OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: May 30, 2001
Transmitted herewith is a copy of application No. 2685 for a Cesspool/Septic Tank Construction
Permit submitted by:
Colin Crowley
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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments:
ignature
C/3oh) i
Dated
/+r
/', oG
ELIZABETH A.NEVILLE d � d; Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. Box 1179
REGISTRAR OF VITAL STATISTICS � Southold, New York 11971
MARRIAGE OFFICER ?i _ ` ��� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER .Ql iii° Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ��„
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: May 30, 2001
Transmitted herewith is a copy of application No. 2685 for a Cesspool/Septic Tank Construction
Permit submitted by:
Colin Crowley
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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments:
Signature
•
Dated
OFFICE OF THE TOWN CLERK sAV OLI' -
TOWN OFSOUTHOLD � Q _ Application No.(3 (0o67—
ELIZABETH A.NEVILLE,TOWN CLERK 0 ✓
P.O.BOX 1179 . Construction
SOUTHOLD,NEW YORK 11971 •
T
W . Alteration Ly
Telephone ,y Q��'� $10.00 - Residential-
(631) 765-1800 l 10'0.
000 $25.00 -Non-Residential
TOWN OF SOUTHOLD •
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION •
ECE ! VED
for pp��
CONSTRUCTION or ALTERATION PERMIPAY 29 2001
SEPTIC TANK or CESSPOOL uthuaa lawn Clerk
Permit No.
Fee •$
DATE 51 lel/�
• APPLICANT NAME: Co Crawley
APPLICANT ADDRESS: 11 3c bra , QLj ew (Jr • C P_ f w7'
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION /✓•o,,_ ,'�
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: CA, Croo,tr/
OWNER MAILING ADDRESS: 9.0 bo ,c 3`t3 O.x,;,� tvy /Hi('
OWNER PROPERTY ADDRESS: (`nt^t Ro,,A •f4-7 5 Aip��ti.�
TELEPHONE NUMBER OF CONTACT PERSON:
air
TAX MAP NO. : Section iggp..7 Block C 0// Lot L.1-
CROSS STREET: 3L;P (_,qrOL.
BUILDING PERMIT NUMBER CROSS REFERENCE:
Mgt
Si nature f App icant
RECEIVED BY: •
Town Clerk's Office
DATE:
•
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3' PERMIT FOR APPROVAL OF CONST UCTIQN FOR A --
2001 F~p, 2 2 AH 9: 52 0 GL FAMILY RESIDENCE ONLY
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1EPT F F1EALTI1 SEF', '
8�0/W' IC U STEWATER M�,M
cb,Ae ,vo Mata • /-. //.� .
• FOR MAX[MUM OF 4BEDROOMS
, EXPIRES THREE YEARS FROM DATEOF APPROVAL.
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