The URL can be used to link to this page

Home My WebLink AboutDickerson ��QF S®(/ry®l ELIZABETH A. NEVILLE � Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS �' Southold, New York 11971 MARRIAGE OFFICER �Q Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER �lyTelephone (631) 765-1800 C FREEDOM OF INFORMATION OFFICER OU01 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. 3566 R Residential X Non-Residential 0 Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : COASTLINE Address 1: 4225 BRIDGE LANE City St Zip CUTCHOGUE NY 11935 Descripton of Proposed Construction or Alteration -ALTERATION TO EXISTING SYSTEM -MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS,BUILDINGS,PROPERTY LINE AND WATER BODIES Name Of Owner ROB DICKERSON ------------------------------ Mailing Address 1 1600 ALVAH'S LANE ------------------------------ ------------------------------ City St Zip CUTCHOGUE NY 11935 -------------------- -- ---------- Property Address 1 SAME AS ABOVE ------------------------------ ------------------------------ City St Zip 0000 -------------------- -- ---------- Tax Map No. section 102.00 block 4 lot 810 ------ --- ------ Cross Street ROUTE 25 ------------------------------ Building Permit Number Cross Reference: ---------------------------------- Issue Date: 7/10/07 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) SOUTy® ELIZABETH A. NEVILLE �® �O Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS N Southold, New York 11971 MARRIAGE OFFICER Q Fax (631) 765-6145 RECORDS MANAGEMENT QFFICERholy Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER C®UNsoutholdtown.northfork.net ' •__ -''` �fir, i:_ ice, OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD O--- Soutihal own Building Department - FROM: Michelle L. Martocchia, Southold Town Clerk's Office DATED: July 3, 2007 RE: Cesspool Construction/Alteration Application Transmitted herewith is a copy of application No. 3725 for a Cesspool/Septic Tank Construction/Alteration Permit submitted by: Rob Dickerson 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. Thank you. I have reviewed the application and location map of the project cited above and make the following recommendations: l APPROVE " DISAPPROVE Comments: c i Signature ®7 O O Dated EL77Ai3ETH A. NEVILLF. Town Hall, 53095 Main Road P.O. Box 1179 TOWN CLERK %`3 '' Southold, New York 17971 ItEGTS'.'RAR OF VITAL S'.'A'['IST[CS � �:-s�° 5.. '� t ;vTARRIAGE OFFICER '1 �'� Fax (631) 765-6145 RECORDS-NLNNAGEMENT OFFICER �� a Telephone (631) 765-1800 FRE,EDONT OF INFORMATTON OFFTCER sot itholdtown.northfork.net OFFICE OF THE TOWNI CLERK TOWN OF SOUTHOLD SOUTHOLD IVASTEWATER DISTRICT APPLICATION �C ,Sc- nm��lie sj J \ • 4 T � J CESSPOOL or SEPTIC TANK 3� " Residential @ $10 ✓ oI Non-Residential @ $25 Application NTo. _ Permit No. � Owner Name _ 2 O\O rc) k Ck e c Sack _ Owner Mailing Address \La 00 Owner Property Address 5 CQCDP Owner Telephone No Tax Map No: Section� Cao Block C)a -( Lot— , Cross Street 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 ith SCHD approval.) Signature of Applicant Date Received by:re�—/�- 0 SO�Tyol ELIZABETH A.NEVILLE Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS N Southold, New York 11971 MARRIAGE OFFICER �Q Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER �l� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER C�U�� southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 4338-R Residential X Non- sidential Fee $ 10.00 New xisting X Name Of Owner ROB D CKERSON ----- ------------- --------- Mailing Address 1 1600 AL AHS LANE -------- ------- ------------ Mailing Address 2 ---------- - ---------------- City St Zip CUTCHOGUE NY 11935-0000 ---------- -- ------ -- ---------- Property Address 1 SAME AS VE ------- ------- -------------- Property Address 2 ---- ------------- ----------- City St Zip 00000-0000 Owner Telephone No. 6 -734-2485 ------------ Tax Map No. section 102.00 block 4 lot 81 Cross Street ROUTE 25 ------------------------------ ---------------------------------- Issue Date: 6/14/07 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) L N 0 �x, s 00 '9 P x 0 ° L'° ed - �e, op 03 G°�`P ��°• Pe• 4 Q�e 0 ®1� �N; #,0 . 0. a a6 • �h \ �'e, 2 F ` h tr• 2h\2 ®� e �q a�� 5 0i 00 v oo. 1,00 o <00'� roc, goo_ �6 SURVEY FOR AREA- 42,976 sq.ft. WILLIAM J. KERRIGAN AT CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y 1000 - 102 - 04 - 8.1 Scale: 1"- = 50' CERTIFIED TO: Mal'. 25, 1996 WILLIAM J. KERRIGAN Dec. 17, 2003 (SET PROPERTY MARKERS) CHASE BANK July 2d, 2004 (cerli(icalions) FIDELITY NA TIONAL TITLE INSURANCE COMPANY OF NEW YORK 20/ 57/4 OF NER,r C1' j ' •�69„rte ,P� ANY AL TERA TION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW, N.Y.S. LIC. N0. 496/8 EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONL Y IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR ECONI RVEYORS, P.C. WHOSE SIGNA TURF APPEARS HEREON. (516) 765 - 5020 ADDITIONALLY TO COMPLY WITH SAID LAW THE TERM "ALTERED BY' P. 0. BOX 909 MUST BE USED BY ANY AND ALL SURVEYORS UTILIZING A COPY 1230 TRAVELER STREET OF ANOTHER SURVEYORS MAP. TERMS SUCH AS 'INSPECTED' AND SOUTHOLD? N.Y. 11971 BROUGHT-TO-DATE'ARE NOT IN COMPLIANCE WITH THE LAW. ADD CERT. 04125196 4 OF SO(/r�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 • COQ Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER �rN Tele hone (631) 765-1800 FREEDOM OF INFORMATION OFFICER I�COU�y 1�,� southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 4400-R Residential X Non-Residential Fee $ 10.00 New Existing X Name Of Owner ROBERT DICKERSON ------------------------------ Mailing Address 1 1600 ALVAHS LANE _ ------------------------------ Mailing Address 2 ------------------------------ I �'►\-� �r\ 2°°-T City St Zip CUTCHOGUE NY 11935-0000 -------------------- -- ---------- Property Address 1 1600 ALVAHS LANE `� L IC Zr- S O Y-\ ------------------------------ Property Address 2 ------------------------------ City St Zip CUTCHOGUE NY 11935-0000 -------------------- -- ---------- Owner Telephone No. 631-734-2485 ------------ Tax Map No. section 102.00 block 4 lot 8.100 ------ --- ------ Cross Street ROUTE 25 ------------------------------ ---------------------------------- Issue Date: 10/02/09 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) ELIZABETH A.NEVILLE �`�` Gy Town Hall, 53095 Main Road TOWN CLERK o P.O.Box 1179 ti 2 Southold, New York 11971 REGISTRAR OF VITAL STATISTICS Fax(631) 765-6145 MARRIAGE OFFICER 0 RECORDS MANAGEMENT OFFICER y��l �� 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 �O\Oerk 0\ tcrwc) Owner Mailing Address )Ugon M\) y)s �Q cy_ 'C�c�aa� 1'y� t X435 Owner Property AddressQ Owner Telephone No. -t Tax Map No: Section ,Ua.CSb Block Lot b Cross Street &Ote a7 S Please check each that applies: New Construction Alteration to Existing System Iv- Residential /Residential 1/ 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.) Cighature of Applicant Date Received by: Coastl"ine:Cesspo®1 & Drain-Service;" 4225 Bridge`Lane Cutchogue, L-I, N-Y,, 11935 (631-734-6585 r Ir SCCA:Lit.,No. 134=W' c„ _ _D k No.1A-600`--