HomeMy WebLinkAboutAlbrecht, Scott FFO( cor,_
ELIZABETH A. NEVILLE �,``Z` Gy Town Hall, 53095 Main Road
TOWN CLERK p .� P.U. Box 1179
ti 2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS OFax (516) 765-1823
MARRIAGE OFFICER y
RECORDS MANAGEMENT OFFICER Q �0, Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER �'d4
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1896 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : SCOTT R. ALBRECHT
Address 1 : 3621 SOUND AVENUE
City St Zip RIVERHEAD NY 11901
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-97-0187
Name Of Owner ALBRECHT, SCOTT R.
Mailing Address 1 3621 SOUND AVENUE
City St Zip RIVERHEAD NY 11901
Property Address 1 325 HYATT ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 125.00 block 1 lot 15.001
Cross Street MAIN ROAD/BRAY AVENUE
Building Permit Number Cross Reference:
Issue Date: 7/10/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
CC
E. ' Co
.gUf FO(� _ l d- C/6
ELIZABETH A.NEVILLe� 4 h yam►� Town Hal], 53095 Main Road
TOWN CLERK
% 4=1
P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER1� Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER '*(i Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER = 1 Sig `1►,',�
q //sI •
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 25, 1998
Transmitted herewith is a copy of application No. 1970 for a Cesspool/
Septic Tank Construction Permit submitted by:
Scott R. Albrecht •
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
DISAPPROVE
Comments:
ignatu e
fq
Dated
1
',I
OFFICE OF THE TOWN CLERK �.....��,���'OFFICETOWN OF SOUTHOLD ,•'°' �l l��k
O
Ft.i7ABETHA.NEVILLE,TOWN CLERK ;`O�� CO'l/ '` Application No. l Q 7d
P.O.BOX1179 �`; Construction L/
SOUTHOLD,NEW YORK 11971 . = Z •
IP Alteration
Telephone -Diy �����', $10.00 - Residential t�
(516) 765-1801 -... 'Z * 1 ,�' $25.00 -Non-Residential
• .,/,O,,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee '$ `
DATE �P/ . 6 /78--
APPLICANT
NAME: S�prr jZ. 4L,B 2c_L WY--
APPLICANT
jAPPLICANT ADDRESS: 3(p2I gov/V 4-v_
..iiiveLh N* i (40 i
SEPTIC 7 CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
A
00 V.I. �� itI C. p,,v1--€444-419;v,
k- .4- 12' 'c �3' Poo)
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CO TRUCTION OR ALTERATION:
OWNER OF PROPERTY: eotT 2, (LAG jt'j—
OWNER MAILING ADDRESS: 2(y2/ Sov,riA Al*.
RiV4li + N-Y, ' Vivi
OWNER PROPERTY ADDRESS: 5 .6-- H(jf.rr P-t
(b I*1-n rvl-)1- N Y1 ,
TELEPHONE NUMBER OF CONTACT PERSON: 5-1 ip- 3 (05- LI ci 1 tp
TAX MAP NO. : Section JJZ6-0 0 Block o I Da Lot b 19 ov 1
CROSS STREET: MA I N
BUILDING PERMIT NUMBER CROSS REFERENCE:
,e-7 /
Sig ture o Applicant
-/
RECEIVED BY: C AZ-A--
Town Clerk's Office .
DATE: GA/ /,'
i
no Wo-ter MCLirl_) W1"fhm /50't _ { bw,^9
ANYA�.7ERA70N ,Op�1 �7o 15A 1MQLAT SUFFOLK COUNTY DP.PARTMENTOOFREALM SEnviCES• olbms
SEC s 72109 OF TFE ;7dat srAST 71oN c
Nit,
7 AssrcFEoirreAALD F s7 Oi�L SEAL OF THE SLINVEYOR PER11tf POaAPPI3DYki 1hF(J(Xt3fTiti�LTiOri r2i326y Few- MNC 7 Lubtax iirgs Te ONLY ��
_Ao,v ' y 'f- LLY T+" a ALL w me AL er As A A No DATE/24679 0'97 O(d r ��
N � w. �ry.T 43 7r AEs NOT N wnl LA IK APPROVED :e-ver
b5Za� 'P `�i�yj- eo- FOR MAXIMUM OF y BEDROOMS 9 s,'
4" r 4' 4 o r\ EXPIRES TREE YEARS FROM DATE OF APPROVAL,r
92. rA
PCJ • �' F 4� t
0 �a`10 4.`.. \• '9 �'r J 1O
I
,o" , i Vii, \C h\ T.
a I 9
a`��Z �\ �' ti� i• ��7- SURVEY OF PROPERTY
�6K "� \ �, / Faa / AT LAUREL
d`'� y9: 3, ;4 , .4' 'fir o TOWN OF SOUTHOLD
ti ' r� arc\,e ' oP ��''` �0w � �`' s� .y SUFFOLK COUNTY, NY.
f' ,� A e Na 49. ' 94.,9,Q 1000 11'5 01 15.1& 17
,�� .�. / a , � 5 �, -.�. g SCALE r = 40'
SEPT.a 199.7
tis— ?` + `gym• Qq N.
, Nov. 19, 1997(stakes)
F // F
O—ice �� t@ /� �Op�y.?. �I'�a. 3` � Dec /G/9971B.4 Nin,l
A.
I 101'
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.t.31‘ I am /amldar with the STANDARDS FOR APPROVAL
y aP�j \ AM) CONSTRUCTION OF S( GI'/FACE SEWAGE
t��, / \ l DISPOSAL SYSTEMS FOR&NBLE FAMILY RESIDENCES
"IA 1 ti9 / \\55.
. and.1 a61 i by !M ccnd91au se/forth there n and on fMZ� `'o., / .sj9 / / - $ pern+A to'eonshuet.
v�p / hp / // * ,77 ,4<-.
1•
V / leg 10, %:-.\ g, .1).5:
�0' / °"L• S.
2�J 0b.01 QFC I J@a
ce .
A R e, S,
N.,
�� 5 roc
( AlYS/RR°AD '.� \•� 1q5 l �1 ���`t��.M Ew�o �d "
\`rcQ�%• \r ?p5 PO $.1i ..:. a, it
The hcolions of we/Is and cesspools tis'.10 S'? A1`, = i 40 ��� o . LICNO. 49619
shown hereon ore from field obsother ons / �r 1_ PE 71.:3"1,,,J1:17 -.C.
f and or from data obtained from others. 13161 ''"^
i CONTOUR LAKES ARE REFERENCED TO 771 0 B' •Y
FIVE EASTERN TOWNS TOPOGRAPHIC MAPS / TRAVELER STREET
AND OFFICE NFORMA 7IDW S , N.Y. 11971
.97" 91A