HomeMy WebLinkAboutGreenbriar Homes Inc (2) I�0,
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ELIZABETH A.NEVILLE h`t co
�` Town Hall, 53095 Main Road
TOWN CLERK i o :'� P.O. Box 1179
CO 2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax r")# Fax(516) 765-1823
MARRIAGE OFFICER ‘‘:#
,�� Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER Ql �a
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. 1906 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : GREENBRIAR HOMES INC.
Address 1 : 59 MAWXHURST ROAD
City St Zip COLD SPRING HARBOR NY 11724
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 #R10-09-0101
Name Of Owner GREENBRIAR HOMES INC.
Mailing Address 1 59 HAWXHURST ROAD
City St Zip COLD SPRING HARBOR NY 11724
Property Address 1 OLDFIELD COURT
City St Zip MATTITUCK NY 11952
Tax Map No. section 120.00 block 3 lot 8.025
Cross Street FARMVEU ROAD
Building Permit Number Cross Reference:
Issue Date: 7/30/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
SN/II .��,o, FFO( cIOo ?o
G Town Hall 53095 Main Road
ELIZABETH A.NEVILLE i `Z` yam►
TOWN CLERK % p -4 % P.O. Box 1179
• ti Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS • Fax��� Fax (516) 765-1823
MARRIAGE OFFICER : y /1
RECORDS MANAGEMENT OFFICER • ��l ��� 11 Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD 4 1998I_, 11
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TO: Southold Town Building Department TS'W" Or . '2?D
•
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: July 22, 1998
Transmitted herewith is a copy of application No. 1981 for a Cesspool/
Septic Tank Construction Permit submitted by:
Greenbriar Homes Inc. .
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.
cw
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:/
APPROVE �/
DISAPPROVE
Comments:
Si ature
7p -7 /(
Dated
• tees.
OFFICE OF THE TOWN CLERK cj�FFULk -
Town of Southold
Town Clerk ��O D
Application No. /nt
Judith T. Terry, r4
Town Hall, 55095 Main Road ,- '
Construction L-
P. O. Box 11791. ' 1 • Alteration
Southold, New York 11971
Telephone 01 ''� •• Residential t
•
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 7/a-a/9'd
APPLICANT NAME: C% - i'',e/ m,Es /A/c_
APPLICANT ADDRESS: s9 /1/944!f/iiesP ,€,425
G'l i z .CP•,.✓L- /01/9/20492- / ,it ?! //-7.2
SEPTIC CESSPOOL w
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
0.0,51K4/6-72a4) t:9 _.c /42--) - ' C SS6'a OCA
,'1)4- n/1 i- ,.
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: GT0e6404,402-- Alemes /4f
OWNER MAILING ADDRESS: :S-79 /-, / / z/ T" ,e'b
elv ��/ :�i�iA/C.-- j ,0OR—, AI Y //7,a- L'
OWNER PROPERTY ADDRESS: l/`/S' &_.6P/6-21) ‘"_10,40.....77,
4,5-7, / ' •S/G' t'9g1,7 efEIJ izero_ /17.g7-7-i 7"v�X
TELEPHONE NUMBER OF CONTACT PERSON: . 4,2/--/z/e_.3,-/
TAX MAP NO. : Section / Block Lot f , .
CROSS STREET: c/4 ( ', -b
BUILDING PERMIT NUMBER CROSS REFERS CE:_.
ij7.1472,14.-- , - .Z.'( .
Signature of Applicant
RECEIVED BY: _ b."(..IA--'
// own Clerk's Office
DATE: l �Z
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Received t t �: I.
(� / Suffc�i'K roup Y p ' } O
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Ot health yeNtC$S -
o pt. star M9 ._.
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Of W2stew �----
K_ 0,O 104.3 ;f!ce THE WATER SUPPLY&SEWAGE
I,-.38.8e2 _re_ 41... I , DISPOSAL FOR THIS RESIDENCE
WILL CONFROM TO THE STAND-
ARDS OF THE SUFFOLK COUNTY
/e1.D ,e..: 0.0 i DEPT.OF HEALTH SERVICES.
' -e.-44/C7-- L=78.5 .
�io • r of v►n 1,116(4 Pu4712.1s(1-1
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Unauthorized alteration or addition to this document is a violation of Section 7209 SURVEY OF: V5 1 Z�
of the New York State Education Law.
Certifications ehs f to thted hereonCshallarun onlyrto the persongenfor whom it is prepared L^ ,A� 0 /1 e
and on his behalf to the Title Company,Governmental Agency and Lending '"` C.VT
quetoInstitution listed hereon,and to the assignees of the lending institutions or subse- r
quem owners. � ' I YIN_ TawN
Copies of this document not bearing the professional's inked seal or embossed I
seal shall not ts considered on ) hvalid true copy. ' I ,ff0 60141/1D-(1
� I 1 QI,
The offsets(or dimensions)shown hereon from structures to the property lines are _/�/V t/ivwya� /J ' F
for a specific purpose and use and therefore are not intended to guide the erection of
fences,retaining walls,pools,patios,planting areas,addition to buildings or any other
construction,
The existence of right of ways and/or easements of record,if any,not shown are ,r .1,not guaranteed. 4.• NKI DATE: (�I q 8 SCALE: - jp
CERTIFIED ONLY TO:
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pE31VN O. :,. �.�\
&- , DESTIN G. GRAF
'j a LAND SURVEYOR
By A i '/ + 't, 73 WOODLAWN ROAD
DESTIN G.GRAF N.Y.S.LIC No.50067 _'— 4o ROCKY POINT,NEW YORK 11778 C
TAX I.D.No. s14A��'P PHONE(516)821.3442
1000- 120-03 -x.25 `' '