HomeMy WebLinkAboutMGH • ,, ,,® �uFFO`� e
ELIZABETH A.NEVILLE ��� .V: Town Hall, 53095 Main Road
TOWN CLERK ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS 'fit Southold, New York 11971
MARRIAGE OFFICER s`• .4
.�✓ �� Fax(631) 765-6145
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RECORDS MANAGEMENT OFFICER �;�,� l'e't Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER
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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. 2561 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : ORIENT BY THE SEA
Address 1 : PO BOX 333
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 #C10-1-0004
Name Of Owner M.C.H. ENTERPRISES INC
Mailing Address 1 PO BOX 333
City St Zip ORIENT NY 11957
Property Address 1 MAIN ROAD
City St Zip ORIENT NY 11957
Tax Map No. section 15.00 block 9 lot 8.000
Cross Street PLUM ISLAND LANE
Building Permit Number Cross Reference:
Issue Date: 5/01/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
vnl low".
Offet51E9 (
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ELIZABETH A.NEVILLE ,� °A�;. Town Hall, 53095 Main Road
TOWN CLERK a P.O. Box 1179
REGISTRAR OF VITAL STATISTICSv, �t Southold, New York 11971
•
MARRIAGE OFFICER : � °V.
0 Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER � se 2, J I
��� II Telephone (631) 765-1800
s
FREEDOM OF INFORMATION OFFICER ` 133 S °
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: April 23, 2001
Transmitted herewith is a copy of application No. 2651 for a Cesspool/Septic Tank Construction
Permit submitted by:
Orient by the Sea
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 farm below and return it to me.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and cation map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments:
Signa e
Dated
OFFICE OF THE TOWN CLERK :'"c��FFOLkc--
TOWNOFSOUTHOLD •• �� Application No. 5 I
ELIZABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 `y Construction
SOUTHOLD,NEW YORK 11971 v • rn
Alteration
Telephone ts.v.
,�� sO••••, $10.00 - Residential
(631) 765-1800 = �l', ' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION RECEIVED
for APR 23 20W
CONSTRUCTION or ALTERATION PERMIT
univo'ci /own Oak
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$ l`
DATE 7�
APPLICANT NAME: ?7AktjFP2y' 7X e $4 cL gl'tk-a
APPLICANT ADDRESS: 19,01, O-70333/1Q,'v p(7
(os- ) •
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: f-t• l`v'+ t-
OWNER MAILING AOQRESS: !.d i • ' 333
OWNER PROPERTY ADDRESS; a41 6L)'.
0 k,,�V, � f (9 5-7
TELEPHONE NUMBER OF CONTACT PERSON: (,3/ 3-2:2)
TAX MAP NO. : Section <- Block 9 Lot •
CROSS STREET: ��^^ 5-(0.„jQ La e_
BUILDING PERMIT NUMBER CROSS REFERENCE:61
l
• /
lgnature of Applicant
RECEIVED BY: Agr
2� own erk s 0 fice
DATE: <1
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