HomeMy WebLinkAboutCockerill, Robert O '
el Of FOL
ELIZABETH A.NEVILLE I,`Z� 4 = Town Hall, 53095 Main Road
TOWN CLERKp %:"*- P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS 1 Fax (516) 765-1823
MARRIAGE OFFICER y
RECORDS MANAGEMENT OFFICER 0! ����'1� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER
•¢rrr
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1804 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : ROBERT AND MARIA COCKERILL
Address 1 : P. O. BOX 1835
City St Zip SOUTHOLD NY 11971
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 #R10-97-0134
Name Of Owner COCKERILL, ROBERT AND MARIA
Mailing Address 1 P. O. BOX 1835
City St Zip SOUTHOLD NY 11971
Property Address 1 540 RAMBLER ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 88.00 block 5 lot 22.000
Cross Street MAIN BAYVEIW ROAD
Building Permit Number Cross Reference:
Issue Date: 2/04/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
eo,JO%S /a
„,,swat,
ELIZABETH A.NEVILLE /',tom Town Hall,53095 Main Road
TOWN CLERK c _ P.O. Box 1179
to 2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS �' # Fax (516) 765-1823
MARRIAGE OFFICER �Ow � Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER ��0P
FREEDOM OF INFORMATION OFFICER
, v,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD ,
BLDG. DEPT.
TO: Southold Town Building Department T�?4P� ?F 'n�3TNc��D --Y
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: February 2, 1998
Transmitted herewith is a copy of application No. 1878 for a Cesspool/
Septic Tank Construction Permit submitted by:
Robert & Maria Cockerill
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 applicati n and location map of the project cited above
and make the following rec mendations:
APPROVE
DISAPPROVE
Comments:
Signature
Dated
loviolvact
0111ICE1V TIIIE TOWN CLERK cOf
Town of Southold Clerk e/e4
Application 1.10. 18"
Judith T. Terry, Town
Towit Ilall, 53095 Main Road . t Construction
tn
P. O. Box 1179
Altertion
Southold, New York 11971 a 1/7 •
Telephone . • Residential
117711firif
( 510 765-1801 Non Resid(?ntial _
•
TOWN OF SO o-F1101_11)
SOUTH(1)LD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
1 01.
CONSTRUCT ION or ALTER/VI'ION PERMIT
SEPT IC TANK or CESSP001.
Permit No.
Fee $ „.;
. - DATE
APPLICANT NAME:jaaeL4_41±1.14figcKefill ......
APPLICANT ADDRESS: PO o()Y _LOS
....
_
SEPTIC CESSPOOL V
•
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
el
.... ......_.
. - ... ---
LOCAT ION MAP: Must be attached hereto before permil may be Issued.
• LOCAT ION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY : ko.bezi Ha:C.0(
OWNER MAILING ADDRESS:_____Sanje... ..__CI,$ .ccio.ove ...
OWNER PROPERTY ADDRESS :..5.q.o _ _
.S..o.u411
ELEPHONE NUMBER 01: CONTACI• PERSON : -7105- 23(01
-
*1•A X MAP NO. : SectionBlock C Lot 2 2_
. . .
CROSS. STREET vie _ .Pdt•
BUILDING PERMIT NUMBER CROSS REFERENCE :
•
.11/a/leka:
Si 1jnature of
RECEIVED1n Clerk's BY :_ r
o • •—
Dm 1::
•
•
_ . _
Lq. DEPL OF - ,-,:i
RIYf RN ?_ ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION
�e�0 `�. - �O EXCEPTASSECTION E1�SLYe STATE
VJ�Z.EDUCATION
037 Alb 20 P12. �' HE7EON ARE V.4W FOR THIS MAP AAV COPES THEREOF ONLY F
SAID MAP OR COPES BEAR THE IMPRESSED SEAL OF THE SURVEYOR
C) WHOSE SIPHATt I APPEARS EREOIL
ADDITIONALLY TO COMPLY WITH SAID LAW THE TERM 'ALTERED BY'
• 9 oN GQ MUST BE USED BY ANY AND ALL SURVEYORS U77UZIVG A COPY
\') c\ID • Ss.5`.
OF ANOTHER SURVEYOR'S MAP. TERMS SUCH AS 74SPECTED'AND
\� � /��� "BROUGHT-TO-DATE"ARE NOT M COMWITH TH TIDE LAW.
FO- c� •
- qy
61
1 `"4 bJ, The locations of wells and cesspools
'PO shown hereon ore from field observations
e� and or from data obtained from others.
.- N . ,'
0 0
0 �\ 0
i
10 fly ft, 1'x'2 -�q'
6l
fie.
O ,
1
r� rt1P'If 6
r ss�2_ _ aQ �`` ��� � ° SURVEY OF
FO. �� D $O Y
\h ,a' LOT 31
?c• •�_� 00 ` "MAP OF TERRY WATERS"
<10 ( Q�, FILE MAP NO. 2901 FLED DEC. 29, 1958
T HOLE tih rq i¢.,l QN AT SOUTHOLD
? TOWN OF SOUTHOLD
®
2.
6a.- • SUFFOLK COUNTY, N Y.
Of o� P '�,. `z's. ,, 1' �to 1000 - 88- 05 -22
\ �° �� N° Ir,° SCALE 1"=30'
` <iA
SW `‘�� c\y �CONC.. c.,. P Ile��y C4 JULY 14, 1997
CND
rs• StPFOLK COU1ttY DlA&T1 4 P 0!RRAZ.TH 1s®tYICBi
EN moi, d f 8'/ fr"b
moor FOR APPROVAL OF C NETRUCI/ON A
C / om familiar with the STANDARDS FOR APPROVAL NG FAMILY ONLY AZE Of e,i 1,
AND CONSTRUCTION OF SUBSURFACE SEWAGE a DATE l40 Z, 9� G.
N t Mer c,�
i7' DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES �+` Z. .p
• and will abide by /he conditions set forth /herein and on the ��. 7 D/ F>Tr Fp
permit to conslruc/. � � .k ' ;r.•
.A = 17,513 sq. ft. J MAXIMUM OF
•
S LIC. NO. 49618
THREE YEARS FROM DATE OP AlrIRpyAj, ;,�+ . 1717:-57',77.,. P.C.