The URL can be used to link to this page

Home My WebLink AboutMaxwell, Gina SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 3633 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : GINA MAXWELL Address 1: P 0 BOX 553 City St Zip ORIENT NY 11957 Descripton of Proposed Construction or Alteration INSTALL 8 X 8 OVERFLOW APPROVED - MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS PROPERTY LINES AND WATER. **EXCAVATION INSPECTION REQUIRED** Name Of Owner MAXWELL, GINA ------------------------------ Mailing Address 1 P 0 BOX 553 ------------------------------ ------------------------------ City St Zip ORIENT NY 11957 -------------------- -- ---------- Property Address 1 170 ORCHARD ST ------------------------------ ------------------------------ City St Zip ORIENT NY 11957 -------------------- -- ---------- Tax Map No. section 25.00 block 3 lot 3.000 ------ --- ------ Cross Street VILLAGE LANE ------------------------------ Building Permit Number Cross Reference: ---------------------------------- Issue Date: 5/07/08Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) S0U�'7 ELIZABETH A.NEVILLE h�� Ol0 Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR,OF VITAL STATISTICS Southold,Ngw York 11971 MARRIAGE OFFICER G Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER �lij'MU� southoldtown.n�orthfork.net MUM I'� 3 ?-- OFFICE OF THE TOWN CLERK �1 LkN N � TTOWN OF SOUTHOLD ` �j I ajjj 1 APR 4 cU 3 3 TO: Southold Town Building Department - -- -- -� FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: April 11, 2008 Transmitted herewith is a copy of application No. 3794 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Coastline Cesspool & Drain for Gina Maxwell Please review the application and location map and advise if this office may issue the permit. Please complete the form below and return it to me. 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 Dated SOF SO(/Ty ELI7 ,J3ETFi A.NEVILLE �0� Ol0 Town Hall, 53095 Main Road TOWN CLERK J� P.O. Box 1179 REGISTRAR OF VITAL STATISTICS °' Southold,New York 11971 MARRIAGE OFFICER G Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICERCOUpM'� southoldtown.northfork.net '�11 h OFFICE OF THE TOWN CLERK TOWN OF SOIUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: April 11, 2008 Transmitted herewith is a copy of application No. 3794 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Coastline Cesspool & Drain for Gina Maxwell Please review the application and location map and advise if this office may issue the permit. Please complete the form below and return it to me. 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 Dated ELIZABETH A.NEVILLE �`L` �G•y Town Hall, 53095 Main Road 'TOWN CLERK p P.O. Box 1179 W 2 Southold, New York 11971 REGISTRAR,OF VITAL STATISTICS Fax(631) 765-6145 MARRIAGE OFFICER y RECORDS MANAGEMENT OFFICER �fQl �a� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @ $10__V,' or Non-Residential @$25 Application No.,� 79 y n Permit No. Applicant Name Applicant Mailing Address k � O_NC1qCJ-1 Septic Tank or Cesspool v,-- Brief Description of Proposed Construction or Alteration Location of Proposed Construction/Alteration: Owner of Property: Q n a `M0'X U_"g_' 1 Owner Mailing Address: PO S�( T�r-NP rr CLQ 1�q�`1 Owner Property Address: \`1 O C3,( S� Name and phone number of contact person W�\\- C Tax Map No: \OuLD Section o Block_ 73 Lot CD__3 Cross Street_ 'h\N nk �_Q NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL le 4P !`t )-69 Signature of Applicant Date Received by: SURVEY OF PROPERTY A T ORIENT TO WN OF S O UTHOLD SUFFOLK COUNTY, NEW YORK 1000-25-03-03 SCALE: 1 "=20' .l 15 � APRIL 6, 2001 30, S 74 o S' L��7 rTE S AS Ff ,6 os�vow E 25e 00 / 8913e / STpN fS l 04's COAlc 4pJ /OO V fill uX�1 � / p 08 / ti8 / rc'3• kttF ti 0 WIRE c DfCk_ J OU� 1 ^'V 6 y 0,8E RfT GgLL ? LJ . WpOD RET, �,,q / LL - --- -- �6'S7'30. WSCI�eeNED LR Ff� � p� PARCH/03S CL f' 90,33, o fAl 03, 5-4 S. L IC. ND. 4 9618 ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION o /E$YD � OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. (631c' —4FAX;(631) 765-1797 EXCEPT AS PER SECTION-7209—SUBDIVISION B. ALL CERTIFICATIONS P. ❑, � D HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF 1230 TRA STREET SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR ■ =MDNUMENT AREA- 8401 S. F. N.Y. 11971 A SDUTHDLD, 0 1 — 0 9 WHOSE SIGNATURE APPEARS HEREON. h 0 ti0