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Home My WebLink AboutMuir, Jill OF S®�jy®� i ELIZABETH A.NEVILLE,RMC,CMC O Town Hall, 53095 Main Road TOWN CLERK l l P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER • �� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICERl Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER CUM southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 3868 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : COASTLINE CESSPOOL & DRAIN SER Address 1: 4225 BRIDGE LANE City St Zip CUTCHOGUE NY 11935 Descripton of Proposed Construction or Alteration ADDITION TO EXISTING SYSTEM. APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES EXCAVATION INSPECTION REQUIRED. Name Of Owner JILL MUIR ------------------------------ Mailing Address 1 P 0 BOX 241 ------------------------------ ------------------------------ City St Zip ORIENT NY 11957 -------------------- -- ---------- Property Address 1 RACKETT'S COURT (PRIVATE) ------------------------------ ------------------------------ City St Zip ORIENT NY 11957 -------------------- -- ---------- Tax Map No. section 17.00 block 6 lot 9.001 ------ --- ------ Cross Street OYSTER PONDS LANE ------------------------------ Building Permit Number Cross Reference: ---------------------------------- Issue Date: 4/22/09 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) V Town Hall, 53095 Main Road ELIZABETH A.NEVILLE P.O.Box 1179 TOWN CLERK :y Z Southold,New York 11971 REGISTRAR OF VITAL STATISTICS ` - • Fax(631) 765-6145 MARRIAGE OFFICER Telephone(631) 765-1800 RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net - t t OFFICE OF THE TOWN-CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK ` Residential @ $10-1 or Noh.Residential @$25 Application No. Permit No. Applicant Name CCXS'\\^fV Applicant Mailing Address &g-2k cue Lo<--k Septic Tank ✓ or Cesspool ✓ Brief Description of Proposed Construction or Alteration _CNSN `x\\ Own N)CC e r'A%C_ r�\��' Ca ac <--)a ov��-��,�� O\S• Location of Proposed Construction/Alteration: Owner of Property: \ Owner Mailing Address: 'PO ?--)oX OC�e n 4\D�=A Owner Property Address: Name and phone number of'contact person �x k Tax Map No: 1t000 Section C)\—j Block Oln Lot C( . Cross Street Acs- �n)M s La c:)Q� NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES VEY WITH HEALTH DEPARTMENT APPROVAL C. =IBJ- -Signature of Applicant Date Received by: J OF SOUT�o ELIZABETH A.NEVILLE,RMC, CMC �� l0 Town Hall, 53095 Main Road TOWN CLERK l P.O.Box 1179 REGISTRAR OF VITAL STATISTICS ua Ac Southold, New York 11971 MARRIAGE OFFICER • �� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER �l Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER �C�UIY �,� southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department D FROM: Carol Hydell, Southold Town Clerk's Office APR 16 2009 BLDG DEPT. DATED: April 15, 2009 TOWN OF SOUTHOLD Transmitted herewith is a copy of application No. 3868 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Coastline Cesspool for Jill Muir 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. Carol Hydell I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE DISAPPROVE Comments: Maintain required setbacks from adjacent wells,buildings,property lines and water Bodies. EXCAVATION INSPECTION REQUIRED. Signature e O /7 o f Dated _ .� .. +.. 7 1 n IT VST V". I c A, F Pp-opER 7- X75. fa Q j,��i2r f'ass� L'*��t6 ------—'- __ X\ \ - CUP?f�� Tax acv V- 15.577 a'..r1 AZO"cF. rZ46.74 f.� U `� - ' p• L l:. .5. .1� T"i�1� /1ti v cer�wBNPt�� GCy. 3 -1-5-171d— .JE// j Z-1111 _Y t- Ile I �6 J i m V .� r1'r.•re ; r'f'',� - �OG',E.�`l�::c: ;.Jr��,l 7"t.t AL, �:` �". /Z.- 5�iesr•S ( �� •.. - �r�t3w'=J„`�ta�r'�', til. `�', - OPWORRPD ALMNATIL)N ua ADDITION / e k I Ll M THIS SURVEY IS A VIOLATION OF 7 t rfGyc” t i l t:.,�31J�•r�sro p7 SXl Qe eFo ��iL"a/s � O O 7209 F THE NEW YORK STATE V3. W. POPIES OF THIS SURVEY MAP NOT dEARING �l t tN LAND SURVEYOR'S INKED SEAL OR WSOSSED SEAL SHALL NOT BE CONSIDERED IO BE A VALID TRUE COPY. �/ C i GUARANTEES INDICATED HEREON SHALL RUIa QNLY TO THE PERSON FOR WHOM THE SU"t p`g i IS PREPARED,AND ON HIS BEHALF TO THF q Q f1TLE COMPANY,GOVERNMENTAL AGENCY P?j/� i Qf�jQ j- ly LENDING INSTITUTION LISTED HEREON, rt 11 TO THE ASSIGNEES OF THE LENDING It-y TUTIObI,GUARANTEES ARE NOT TRAR19'F' EO ADDTHONAI INRT"" �,a•r o��OF SO!/j�ol ELIZABETH A.NEVILLE,RMC,CMC O Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold,New York 11971 MARRIAGE OFFICER Fax(631) 765-6145 RECORDS MANAGEMENT OFFICERTelephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER 100umi i southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 4402-R Residential X Non-Residential Fee $ 10.00 New Existing X Name Of Owner JILL MUIR ------------------------------ Mailing Address 1 P O BOX 241 ------------------------------ Mailing Address 2 -- ------------------------------ ��---_ City St Zip ORIENT NY 11957-0F -------------------- -- -------� WU�c��N Property Address 1 RACKETT'S COURT ------------------------------ Property Address 2 �� City St Zip ORIENT NY 11957-0N `\ o oc� �. Owner Telephone No. 631-323-2784 ------------ Tax Map No. section 17.00 block 6 lot 9.100 ------ --- ------ Cross Street OYSTER PONDS LANE ------------------------------ ---------------------------------- Issue Date: 10/07/09 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) L� ELIZABETH A.NEVILLE Cz C Town Hall, 53095 Main Road TOWN CLERK = P.O. Box 1179 REGISTRAR OF VITAL STATISTICSO Southold, New York 11971 MARRIAGE OFFICER y • �� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER ��l ( �a Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION OPERATION PERMIT CESSPOOL or SEPTIC TANK Residential @$10 or Non-Residential @$25 Application No. Permit No. Owner Name' Owner Mailing Address �;h L3s�l 0 \ons--, MON \ q5-7 Owner Property Address chQ_4"5 �- Owner Telephone No. Tax Map No: Section Block— — Lot Q , Cross Street 1;�_Apr W-Y-113 Lane Please check each that applies: New Construction Alteration to Existing System Residential Non-Residential NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. (Locate building and system; give north arrow and approximate distance in feet from system to building and closest road. New construction may submit copy of survey with SCHD approval.) laq i_g_tlature of Applicant Date Received by: Coastline Cess�iool;&-Drain Service ; 4225-Bhdge�,Lane, = Cutchogue, LI,-NY 11935. { : - (631-734-6585-, SCCA Lic,Nd:134-W'- -. DEC No.,AA-600' , _ ,y ,. _. 's , , .. _ - - .• -. -'- - , •, 1'r1, - � , .' '. _ ,. , - Ili t ' • 1 - - a�' ` l 1' �, -• • .L I - 'moi. Y -' � 1 I �^ � L I , I