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HomeMy WebLinkAboutWilliamson o',�®�®guFFOB,�-�®� ELIZABETH A. NEVILLE �� O. \ � �d Town Hall, 53095 Main Road TOWN CLERK ; - P.O. Box 1179 ca REGISTRAR OF VITAL STATISTICS ,i Southold, New York 11971 MARRIAGE OFFICER :� �i ���1� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER �_�Ql ��®�i� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER - .. ��� OFFICE OF THE TOWN CLERK SOUTHOLD iftlAIRTEMAREIRTIMI@SAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 2681 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : RUSSELL WILLIAMSON Address 1 : 71 POPLAR STREET City St Zip GARDEN CITY NY 11530 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 #R10-01-0208 Name Of Owner WILLIAMSON, RUSSELL Mailing Address 1 71 POPLAR STREET City St Zip GARDEN CITY NY 11530 Property Address 1 10885 PECONIC BAY BLVD City St Zip MATTITUCK NY 11952 Tax Map No. section 114.00 block 3 lot 19.000 Cross Street BAY AVENUE Building Permit Number Cross Reference: Issue Date: 11/01/01 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) _ - ,,,,,, ,,, CC, a ea ELIZABETH A.NEVILLE _0 � Town Hall, 53095 Main Road TOWN CLERK ` ® - P.O. Box 1179 h REGISTRAR OF VITAL STATISTICS �' � Southold, New York 11971 MARRIAGE OFFICER `�®?s ���1�, Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER ��®��� 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: October 22, 2001 Transmitted herewith is a copy of application No. 2773 for a Cesspool/Septic Tank Construction Permit submitted by: Russell Williamson Please review the application and location map and advise if the project has received Suffolk County Health Depailulent 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: ►" _. i` -- �� Signature /OA—0/ Dated Jte -•'" OFFICE OF THE TOWN CLERK ��' ,, FFg ..:, ( 7, TOWN OF SOUTHOLD ��� �� �'QG Application No. ELIZABETH A.NEVILLE,TOWN CLERK • P.O.BOX 1179 }� Construct14/ •on SOUTHOLD,NEW YORK 11971" v T Alteration . $10.00 -Residential • 0 ire" Telephone 631) 765-1800 --461 ( -_ 'r ��' � $25.00 -Non-Residential TOWN OF SOUTHOLD • SOUTHOLD WASTEWATER DISPOSAL DISTRICT • APPLICATION for RECEIVED CONSTRUCTION or ALTERATION PERMIT ' OCT 2 2 2611 SEPTIC TANK or CESSPOOL Southold Town Clerk Permit No. • Fee .$ DATE /072 /6 / r* APPLICANT NAME: 0� S e- 0v1 SG 44) APPLICANT ADDRESS: J 0 s-R, IS f o&hC �j c_y 13,0 0 I e i,o.j P / ok--- IT"r tic-IC Ki{1 SEPTIC 47CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION IVC(A) c31''USc 1' , 1.7 l40114 • LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION' OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: KO-n-I( //J '` “ i a•,vY1 ,SaA) OWNER MAILING ADDRESS: 7/ fq Flag Gos“i t.J Q.+7 kj& 3a OWNER PROPERTY ADDRESS: 77 I /o..tt % + C7 a v(teiu N '( ! /556 TELEPHONE NUMBER OF CONTACT PERSON/` 74f 7 /0 y �, /ow TAX MAP NO. : Section / g90)0 Block 03. 06 Lot c9 l el • CO©© CROSS STREET: 130/ PVV�, BUILDING PERMIT NUMBER CROSS REFERENCE: kx,t) N1-il kLt/e'ai"'/-4- Signature of Applicant '4 RECEIVED Nov • Town Clerk's Office DATE: '!O �-o I, ---Oa -i3 p . .. ''r• , - -- - - - ---- N ED Corc�R. Tp (3(Zo.ge, © Peak' rcl_lai Lf r,i;e�t`1 e 4/ 1 ' Bio°`� aU�R : lJ�.-I' e,9 ®t 0,1 v.9 We°42 ro sz .d (...1)j • Alk I�Pe, ,f „ Fri c� ,see ksgin e-ilcGs'is-i 1 12-.0o • ,0,� Poop evor/G ✓ ,.. W -- c4-Ez•/3.3 9, -9,J .7;--1:5:...T.- 61. L,!' ---.3",Ets'o 1. I . �ov3� ,owiceic n/„rr�,c • �,� AJ 75'oa ooyam' /v '0,G" • --- --• - 1 • -- � � .000,o, system �.�,�d� Tor hee Abandonment o 1 xisting sanitary y Q h ��Q ��,c•�u- -9���, til be wits Heaith Department. .b 4 c'o 0 rte•SYPTer,•--/ P,v�. �+�,/v.,.d J b• �` YG� ToMeaiu4edvvo tk. .,,,, • e Ci I .06-cx. I \ 1•- W.0/2xkogildA4tw,•, -- J P,ees,�,.1w I z.5f�ay// 4 i a i 'r3 1.148o ei ,err w...re,E..1641 ,,„ , , . , . _ A 7) ,NN ,3, o Y' , � 5nv - - , is 7G°,(�Oq"S/ %03.68 l "�- , rearso R ..„z ).---77—/a �G -"7-,-4,/,V..-- -f-,,i.V - _ . /��«//C+10-o 0/9y 9,/ � �:eY/s'r�'lU 4 g • / T).VA/ /.;9 •.^• -- Afl-¢vFY,era2 - /eU! P/L4//A32°, fit/ /41/411143-e-/YW-dC",1;4,vvod>':,c; 2:e 417;141-11, fY1.0rJc;rw •------- - ,�; M _ -vLry�,P —_, �P RTMENT OF HEALTEL.. . :)"'>a„l .-4‘d, /,,577/ //p7/ PERMIT FOR APPROVALiOF CONSTRUCTION PGO A"6--2"" SINGLE FAMILY RES!DENCS ONLY DATED (Aro t.H.a. EF 0. A ...._ ©l- b.�©k fo Eis! E�/s/2oc APPROv D ()A '� Ter s l .G / Ny Ga '�-/ -C/a FAR MAXIMUM O r3E _ DI~!OOMr xri!.7460-/e/c/-43-/9 -- - -- - EXP S-TIiRc4�.' .7,-A1:9- RO :•A.--er ':7: A "/. 01/ii I