HomeMy WebLinkAboutAdel, Werner (4) ��,l"c FFOL4
JUDITH T.TERRY t� y1 Town Hall, 53095 Main Road
TOWN CLERK ; y Z t P.O. Box 1179
ivt
REGISTRAR OF VITAL STATISTICS ‘‘.?/
t Southold,New York 11971
MARRIAGE OFFICER 15 (516)Fax
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RECORDS MANAGEMENT OFFICER 1 '1►
FREEDOM OF INFORMATION OFFICER '•v„� 0'9,,I,'�� Telephoe (5 6) 765 1800
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1536 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PETER SCHEMBRI
Address 1 : P. O. BOX 163
City St Zip WADING RIVER NY 11792
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #R10-96-0038
Name Of Owner ADEL, WERNER AND CRON, DICK
Mailing Address 1 C/O PETER SCHEMBRI
City St Zip 0000
Property Address 1 ROW OFF SOUND AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 121 .00 block 5 lot 1 .009
Cross Street LAUREL LAKE ROAD
Building Permit Number Cross Reference:
Issue Date: 9/16/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY �,_, G1:11 Town Hall, 53095 Main Road
TOWN CLERK ; N 2 P.O. Box 1179
n7 t Southold,New York 11971
REGISTRAR OF VITAL STATISTICS ;Oy ����1, Fax(516) 765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER 0.( *►a 1o, Telephone(516) 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: Sept. 5, 1996
Transmitted herewith is a copy of application No. 1602 for a Cesspool/
Septic Tank Construction Permit submitted by:
Peter Schembri for Adel/Cron
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.
Thank you.
,: t--)cc e.---
Linda J . Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments:
Afr
Signa ur-
Dated 9,./A‘
1.` tOFFICE OF THE TOWN CLERK '""—
Town of Southold A Application No./ 0
4 Judith T. Terry, Town Clerk
Town Hall, 5A195 Main Road Construction
P. 0. Sox 1179 .fsy, Alteration
Southold, New York 11971 ,' t
1 $10.00 -Residential
Tel 4,, t10 r
(516) 765-1861 $25.00 -Non-Residential
44111-
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
,
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ /D — /
DATE ?/(-/,
APPLICANT NAME: f2E-4-cc S'C,LI, A-&
APPLICANT ADDRESS: /0 A /6#3 L2 r T.,`"' i ('74Y0.2-
SEPTIC CESSPOOL t/
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION /G
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRU TION OR AL E TA/
OWNER OF PROPERTY:
OWNER MAILING ADDRESS: /0- 1 /(0 '5 W - i/W----, r-7
OWNER PROPERTY ADDRESS: j ) sir,..„,
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TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section /) / Block ( Lot /, ?
/ I i0
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFEREN
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�Si•nature of Applicant
RECEIVED BY: Idb.n:,,.r.I
'' erk s Office
DATE: �I �`'b
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1WATER.SUPPLY,-40,7"D ,r�
SETVA ,D E,-T rcn y 3 ?STEMS../VII
T
I CONF,..,RM WITH NEW STANDARDS D: 2D NOVEMBER 13,1995. c^°
I OF PROPERTY
1TUATED AT �$
ATTITUCK
OF SOUTHOLD
COUNTY, NEW YORK
'o. 1000- 121 -05- 1 .9
•
SCALE 1" =40' •
.PRIL 23, 1996
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
= 121 ,460.44 sq. ft. 01. '. .. CONSTRUCTION
R APPROVAL Y_sF O IS U ®N 1L A
2.788 cc.
G�TI.T..q•y �@ 9 3`.6��r��-+�
►►771111(ItaY,;'.Y'AIKI.;�i :.{ .15 r i°3LY
DATE 5---e-9 :173 Rid -96"Oa3?
IED TO: APPROVED_ tooG<:
THUR KRETCHMER FOR MAXIMUM OF 4L BEDROOMS
DOMES TSE YEARS FROM DATE OF APPROVAL
S SHOWN THUS: LOT® ARE REFERENCED TO
)IVISION MAP KNOWN AS RUSSET ACRES
SHOWN THUS: ..34./2 ARE REFERENCED TO TO AN ASSUMED ELEVETIONS.
DISTRICT: R-80
ATA TAKEN FROM MINOR SUBDIVISION MAP.
CHING SYSTEM FOR A 1 TO 4 BEDROOM HOUSE IS 300 sq ft SIDEWALL AREA.
DEEP, 8' dia.
rIC TANK CAPACITIES FOR A 1 TO 4 BEDROOM HOUSE IS 1,000 GALLONS.
ONG, 4'-3" WIDE, 6'-7" DEEP
TEST HOLE DATA