HomeMy WebLinkAboutGorman, Lawrence ,p
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ELIZABETH A.NEVILLE •
�'c ?fit ' Town Hall, 53095 Main Road
TOWN CLERK vs Z P.O. Box 1179
Q Southold, New York 11971
REGISTRAR OF VITAL STATISTICS1
yijJ 0��/ Fax(516) 765-1823
MARRIAGE OFFICER ` O� %00,01Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER °
FREEDOM OF INFORMATION OFFICER
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1912 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : LAWRENCE P. GORMAN
Address 1 : P. O. BOX 1041
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 #R10-97-0079
Name Of Owner GORMAN, LAWRENCE & DALIA
Mailing Address 1 P. O. BOX 1041
City St Zip SOUTHOLD NY 11971
Property Address 1 2105 VANSTON ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 111 .00 block 6 lot 2.001
Cross Street HAYWATERS ROAD
Building Permit Number Cross Reference:
Issue Date: 8/13/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
".stoo4c (
ELIZABETH A.NEVILLE $ �0 Town Hall, 53095 Main Road
TOWN CLERK p 1 P.O. Box 1179
y Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS O
MARRIAGE OFFICER •� Fax (516) 765-1823
: 4.
RECORDS MANAGEMENT OFFICER %N.� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ,si�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: August 6, 1998
Transmitted herewith is a copy of application No. 1988 for a Cesspool/
Septic Tank Construction Permit submitted by:
Lawrence P. Gorman
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:
natur
411 iq
Dated
OFFICE OF THE TOWN CLERK O.cOFULk' D
Town of
Terryouthold Town Clerk ��' ''✓ G Application No./ 4
°f' p
Town Hall, 53095 Main Road : ' Construction
P. O. Box 1179
Southold, New York 11971 ,�,I LL O�> Alteration
Telephone 0l se �. 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. HP
Fee $
DATE elle,
APPLICANT NAME: Liji,k/"...,e — P 67C,4(444. 1
APPLICANT ADDRESS: `' , � (19L//
(4) (/977
SEPTIC CESSPOOL
DESCRIPTION OF P OPOSED CONSTRUCTION OR ALTERATION A/C, Z-
54/L L
y
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONST UCTION OR ALTS ATION:
OWNER OF PROPERTY: (--;:r�,
OWNER MAILING ADDRESS: , 60), /6 T�
L
OuT 0 0
OWNER PROPERTY ADDRESS: 2- 0 " 67-* A-/
TELEPHONE NUMBER OF CONTACT PERSON: 7 L65/
TAX MAP NO. : Section /// Block � Lot 2 , C7/
•
CROSS STREET:
//moi
BUILDING PERMIT NUMBER CROSS REFERENCE:.. 2-412i/(.
g -ture of Applicant
RECEIVEDc6)BY:
own Clerk's Office
DATE: ���
in
1
. • . SUFFOLK COUNTY HEALTH SERVICES
(RESIDENCE) APPROVAL OF PROPERTY APPROV RS. NO
— SURVEYED FOR
- - _ __ -F-
_ ____ MRJ3ERNARD J. GO
CESSPOOL 17
AT
OF INTENT
Q NASSAU POINT Y THE WATER YsvPPLA TEMENT AND SEWAGE DISPOSAL
TOWN OF SOUTHOLD,N.Y. SYSTEM FOR THIS RESIDENCE WILL C.DIST
ORM
\ , - OLE TO THE STANDARDS OF THE .` O-
TFSTH viosi
- /HOUSE ell
APR 1 1A07 /v' .OF HEALTH y�•�,�� i
/ / (5) i '. .- 1J/''.�
1
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Suffolk Co.Dept of Health Se
•
/ ft / - 0 �j-/ Environmental Protection
i O S 52 19 E Li
,- 200.0' SUFFOLK COUNTY HEALTH SERVICES
WELL • _- - — - APPROVAL REFERENCE#9250-73 8/19/92 SUFFOLK COUNTY DEVF OF HEALTH SERVICES
i11 _
1( ' ,/ f \ ' ;-:- . 1
FOR APPROVAL OF CONSTRUCTION ONLY
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sT O(X CO.TAX MAP DESIGNATION
(RESIDENCE) •
`� I' .� I ! ( � ^- /JO T l R/F.Ij, ';�Q DISI SECTION BW PARCEL
v; BUI DING ENVELOPE
C� _ _ ��'� L l Dao �� �� /
0 i _ j,
N 55 04 W — — _ -— 217.0'
OWNER'S ADDRESS:
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107 TUTS LANE
• JAMESPORT.N.Y.11947
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\ i e 64- ) .,
516-722-8056
AC r`� DEED P.
__.------ --- i i
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STAMP
/ S� tiO I \ TEST HOLE
I — SUFE NN. ARTMEN'1�t)F ALTH SERVICES NUM 4 5 1
X04 --
— PERMIT FOR APPROVAL OF CONSTRUCTION FOR A - !X43. 0
GI,E FAl 1V i r"MEK ONLY Co
�� DA E V;://
F3". s. ICU, 7 (,O 7 g0 �'
"/ 1 /, SCALE: 50'=1"
APPROVED._ ,! zair- ' AREA:20.772 SF(TO TIE LINE) I
(RESIDENCE)• FOR MAXIMUM OF C ` '
�CKS MONUMENT
O IRON PIPE N J ?'
EXPIRES THREE YEARS FROM DA YE, APPROVAL.
OVAL
_ SURVEYED FEB.25.1985 5A411204
NOTES: REVISED OCT.24.1985 (,� A; (, (/- -
p� ` ` y
REVISED JULY 22.1992 ��FD �' GO7:1-
A•
1. LOT NO.S REFER TO MAP OF SECT. D NASSAU POINT CLUB REVISED AUG. 18.1992 ° 4:1;'‘'''1-1::::::':,::.;'11
;' `
PROPERTIES,INC._FILED IN THE SUFFOLK CLERK'S OFFICE
AS MAP NO. 806 ` t o s
2. CONTOURS REFRER TO MEAN SEA LEVEL
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