HomeMy WebLinkAboutAdell, Werner OFfO4ee
JUDITH T.TERRY ��_ t% Town Hall, 53095 Main Road
TOWN CLERK y i P.O. Box 1179
T �� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER ‘
0� ��� Fax (516) 765-1823
?'� � �
RECORDS MANAGEMENT OFFICER O.( `" ,,, Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER - �
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1459 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PETER SCHEMBRI
Address 1 : 76 OVERLOOD DRIVE
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. #R10-96-0021
Name Of Owner ADELL, WERNER
Mailing Address 1
City St Zip 0000
Property Address 1 OLD FIELD COURT
City St Zip MATTITUCK NY 11952
Tax Map No. section 120.00 block 3 lot 8.022
Cross Street FARMVUE ROAD
Building Permit Number Cross Reference:
Issue Date: 4/18/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
or ilii�� 54-1 .-'
4. 0$,oN,St�FFOl�-GA
11,'i y
JUDITH T.TERRY 4 = < % Town Hall, 53095 Main Road
TOWN CLERK i H Z P.O.Box 1179
r fly i/� Southold,New York 11971
REGISTRAR OF VITAL STATISTICS 1 Fax(516)765-1823
MARRIAGE OFFICER ` •4, 0.
RECORDS MANAGEMENT OFFICER : Ol `t►�ls1 Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER o�.,,•, dr 1
OFFICE OF THE TOWN CLERK 6pi@uow G . ,
TOWN OF SOUTHOLD �
APR 1019eJLjTO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office Toweei-DO'DEPT.
DATED: April 9, 1996
Transmitted herewith is a copy of application No.,,,isiow for a Cesspool/
Septic Tank Construction Permit submitted by:
Peter Schembri for Werner Adel! .
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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE e------
DISAPPROVE
DISAPPROVE
/moi ,��
Comments: L„/' ,J SC?%), 1/� -� /� /o- ,�,s110;Z/
DAir-
-77:177. 4-- ' .
l
•
OFFICE OF THE TOWN CLERK ,„ ""
Town 0f Southold Application No./5'ae
Judith T. Terry, Town ClerktNo -
%
Town Hall, 53095 Main Road .. Irv. Construction �
P. O. Box 1179
Alteration
Southold, New York 11971
+, s- pz` $10.00
-Residential
Telephone .. f
(516) 765-1801 ` 1,6 r $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE YA/F.0
APPLICANT NAME: Vrzyk c.,k0,44ii, •
APPLICANT ADDRESS: 7 Ce O Aek
cJJ 3 /VV. (r -761
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRICTION OR ALTERATION
1 14'1-3). CIA'14L0
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ii41/4-)w✓1.4,- ae,e4
OWNER MAILING ADDRESS: 7 4 _, felAK , .
OWNER PROPS TY ADDRESS: 10 Ct-ln- (052,4 1" t i
aY
1-1 0 (1' 7c a �✓ ./ „Ai_
TELEPHONE NUMBER OF CONTACT PERSON: 57G — ?)-9-- M//
TAX MAP NO. : Section /)--45 Block d 3 Lot g . r40-
CRO-SrS STREET: c .,W6
ala
BUILDING PERMIT NUMBER OSS REFERENCE:
/
f e ,
gnature o Applicant
RECEIVED BY: III- )
Town Clerk
DATE: ll9 9
`L '-1QM4- 2-0 -
. wE4-.-
d. -1'1 f —
I 1--.,-r- 10 Lt.TGI
S7o - 19- 30‘.../
Zo.oa ..
1c.3 .FC�A 1 n d ics(7 Iv1.1
k...141 L ) is2�- .
Al �hit , , -ct �-) L''' 4.1114t .
0 ...'t on
0MS MU13ST
WATFORT LY AND AGE DISPOSAL SY ,F.R ,1995.
CONM NEW gFANpARDSSEWDATED t4
wrt,v V• I ,
.n oVI:
iv)
Q-
� .>,i w ,
Q 4 Pk> xrnn 0 `V _
n` -25�- FF lo(. oo A ,/,_pI lrhl.lo4.So /0
Q .' V
ii,
^ �1O�M.v Q.. .
14.7 0
6-Lek/ATI 0'0'7
j I000GAY ,
' __/:
7 1\ p I •r iUW1ed* -vtA
ti:
A 4�,.F
4`
\
_\,_4
12 .lSo.o yi G b7. a
_ L:2gS.1t 0 OIOUNTY DEPARTMENT'OP HEALTH SERVICES
-iik 4SD.o 104 1Y 00..—_. ,
1 "1i 1 3' w Nk'POR APPROVAL OF CONSTRUCTION FOR A
ORIOLE FAMILY RESIDENCE ONLY
r
T,G DATE' 6 4:4' 0 ` 40 --Cto.1- r'
Ibq.li
OI,T7�f�� 'T C o ] APPROV:� ,_ . �,.r .' .L.,..4 l t, fil
FOR MAXIMUM OF BEDR••MS
! TRPS THREE YEARS FROM DATE p'
OF NEW yot re„• . s, .
yqP q� \\\„,_
DESTIN 0.GRAF I a NQ 1996
MK
LICENSE N ik.11, JAS S•C:�S 61
CES
'• '''''-'4-:'
=�;
N h , e,1!>09,,
IN.eetimlud ettrrtlrs w ddrow M MIe Irrrnwt.Y o MMA.M Siloam 730.
of tSURVEY OF: 1 0...rtheNe Yost limb W�.lu ton. .. - V'
GAMatlw 1e4ebd lana no 4•y b M poem for than It Y prepared
on/.n MM MMI to Mr AN Comporyt llo monis M'honey MI IsndMf InsNbudn /A}� ..,I �J
Helot how%o d b Mn:.glow*of M.*At M AMw or MAhrWnl.rwn. ,we O d .lq/A T4fi�+flt ' 01- ;..
Polio of ties doo wowt not/tettfM pwfonlw+:.MMI or r.mb.rood red .�+Ti1 y ..� �,����,,�
Au e1Mb(inaMooe)them Avow his ebvAeoe b IN Moody Iger w MACT11 1 �1'-1"-1 I�WPJ O� �/"vt 14OL.-41
far a wrdMe pwpwr w1 vas end Ihwo we.re not Aloud d is PA Ne emotion of I— I
temp. raft pods.pop*.pMMmf ins..I Teo M boNna r wy owe �.pV`G.�VN 1 . p N. 1
IN.Atone of rl, oar ad/e...anal«M need.N wy,not chem ere r r
net learnt... ht of SURVEY DATE: 3IS He., SCALE: i = So
CERTIFIED ONLY ro :h A421 4 op DESTIN G. GRAF 71\
LAND SURvF 0R
By '
DESTIN GCIIleo`, 7 ROOKY
wooa�rrH ROAD
'
OOK POINT.NEW YORK 11771 `-
TAY Lf1 Nn 1 �.... - i 2_,"=` i'Xi R 2.7-- PHONE(ale)e21-344E, N.Y.e,U N1E No.NOPf