HomeMy WebLinkAboutChryst, Jack /e"
41F FOL
O\.
JUDITH T.TERRY �1 _(,‘\. .
G'y� Town Hall, 53095 Main Road
TOWN CLERK
c/3 P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS O � Fax (516) 765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER �WO
1 * ������ Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ,,s°���
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1611 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : CHRISTOPHER E. KENT
Address 1 : 737 ROANOKE 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. SCHD REF. #R10-96-0077
Name Of Owner CHRYST, JACK P.
Mailing Address 1 2700 RAEFORD COURT
City St Zip ORLANDO FL 32806
Property Address 1 125 BURTIS PLACE
City St Zip PECONIC NY 11958
Tax Map No. section 67.00 block 4 lot 14.000
Cross Street FASBENDER AVENUE
Building Permit Number Cross Reference:
Issue Date: 3/20/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
. � 1 /
••_oN)OF F014-•
JUDITH T.TERRYy004 1 Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. Box 1179
4",?
�� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS G
44,
�1� Fax(516) 765-1823
MARRIAGE OFFICER P
RECORDS MANAGEMENT OFFICER 0��.0� Telephone(516) 765-1800
1
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: February 14, 1997
Transmitted herewith is a copy of application No. 1668 for a Cesspool/
Septic Tank Construction Permit submitted by:
Jack P. Chryst by C. Kent .
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 recomme dations:
APPROVE
DISAPPROVE
Comments:
RECEWE®
MAR 21 1997 Signatur%
3 4,/,7
Dated
Southold Town Clerk
OFFICE OF THE TOWN CLERK Oc,VFFOL'CO
Town of Southold ,W" Application
Judith T. Terry, Town Clerk �. -
Town Hall, 53095 Main Road CIS Construction
P. O. Box 1179
Southold, New York 11971 ,y� � Alteration
Telephone _i, * ' , " Residential
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE cg- g.7
APPLICANT NAME: ThcK Y t 0.61/97-C7- 6/ ' 07-a,7&
APPLICANT ADDRESS: LT 706 k/9/tfORI) Coc
47 4.-711171)1
SEPTIC CESSPOOL
DESCRIPTION OFPROPOSED CONSTRUCTION OR ALTERATION
Paiify /V stiAi C-615 A � 2
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY : r4:C .12—OWNER MAILING ADDRESS: _2700 Ceic, /
OWNER PROPERTY ADDRESS/
;'4
TELEPHONE NUMBER OF CONTACT PERSON: 7._/ 3 /
TAX MAP NO. : Section 7 Block Lot Ni-/ _c-
CROSS STREET : 41 / r
-.
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signa'ure of Applicant
RECEIVED BY : ---�-c '� _
o Clerk's Office
DATE:
N
1 1 V
111)013
t,
000 sr,
(-- •
---.., —0•1)
V —
36-1 0
0, 4 , , .„, ......
C4 0, tl _ ,•-•— 00 s i - " .,-
- - ' V -4=
3
:9 --,1tb' ..t.
I P 7 0
1 ,
Ste "'„\l
_
.- -- ----- -.
\ th. : „
0:11.*\N"-saIN E
0 0 W
/ ,
___________ - --- •55), 1.)J kll
eft
y 5/4t// 7 c Y-5 0
%A
Z ...41.4
f-, -4
4, ..,-,-,. ....t5' S
- 0014
7
..— 1..... N
0 7 '5%
- 0 ct
, 41 0 t5-)
-tp —
7 U.
I
s'%)
\ '98) i)
S°
I
,
- v
-7::- '.
(6) V -o
..... '3% v•-•
0
, s t:1)
W W crl k C. . -
tn
V „--
77
-5 ti o 9.)1 1c1, SI
• e‘' \---
No
t4 VICJe CC
(i ) ...D
-0 N
I ri til
V
°TA OWEIVIVG)
,JARk BROWN 0_0Am 6• C!....1) .1.• Pg 1 f/ e'/7-..,/t.,
B ,ROWN _0ANY SAND 2.5.
7: (\ l'"...., / ,
Y .
o ,
t PALE BROWN NEDOIM ••,, ,, A.----X) ,)
0 COARSE SAND Itr c K(/91/z-WL, S/? "\/7>t.-F S5 i, 'N. (-? GI.
I k)SANDY CLAY /4-,(1,) 0 ,,-, ,er/ -/) vi-\ 5-4,t.-i 2 -
). ,....
Nc
-cc,
pp &\J 14
. ,d,e7-//47e6 x
'' '' --__-..
SAW:3Y CGAly /*4 , , 0
. IwAre it tI 1 1 7---4 G( V 3 ell , 1 0
' (92)
•0
AREA = 10, 137 sq. ft. 11/4/1 4 7' D-i
'f
ORIOLE FAMILY mum% coax r1/ 7"41')' P4/2:-"/"--i X NO
ExPoies THREE YEARS mow awe OF AFPOQC" .1-4 "F I') ? 7) f 1
I ff,
I
I
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES .7-4/ 5 .5 .-51., r)=--- xr-r--- .s e c)e-s ei 9 ,,
FOR APP1tOVALpF CONSTRUCTION ONLY c/C Ty d,,,i _s 7-.).S /, ,s-, -,c Ce-7- cp\ 7:, 93
1 FA 1
DATE —7?4-,4 S.REF.NO ,q m- 96 -- dA 77 SUR VE Y OF
LOTS 98 & 99
;„ „„„„„„,,,, ,
APPROVED _ ,
MAP NO. 2 - - •
1
The locations of wells and cesspools shown hereon are from field IIPECONIC SHORES"
, observations and or from data obtained from others. FILED SEPTEMBER 15, 1930 FILE NO. 654 le
The water supply and sewage disposal A T PEGONIC
systems for this residence will conform
, to the standards of The Suffolk County TOWN OF SOUTHOLD
Department of Health Services. CERTIFIED TO, SUFFOLK COUNTY, N. Y.
JACK P. CHRYST 1000 - 67 - 04 - 14 & 15
Scale 1" = 20'
4) E REFERENCED TO ASSUMED DATUM. Nov. 1, 1990
-,
:, > ,.....
'=-:--,-,g,
/2- ,,,,,,. . ii.t...
' tip ,k
icy ., v:;-• N.Y.S. LIC. NO. 49618
640 ''Or .-/ --' Prepared in accordance with the min
'E • z URVEYORS, P.C. , --
, standards for title surveys as established
. ,
516) 765 - 5020 by the LLALS and approved and adopted
'. 0. BOX 909 , l_ for such use by The New York State Land
, klAIN ROAD r . ') rro. A,....,.,•11,• *i
' •......./"Ir vri felt 1-1 0,r 1,,
',-