HomeMy WebLinkAboutGreenbriar Homes Inc (3) ego<oFFO( c
ELIZABETH A.NEVILLE I h`Z` �t%; Town Hall, 53095 Main Road
TOWN CLERK c 4 P.O. Box 1179
ti 2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax 1% Fax (516) 765-1823
MARRIAGE OFFICER %%45*
4, 0�'0� Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER : �Q �a
FREEDOM OF INFORMATION OFFICER W8.0
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1835 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : GREENBRIAR HOMES INC.
Address 1 : 59 HAWXHURST 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 #R10-98-0030
Name Of Owner GREENBRIAR HOMES INC.
Mailing Address 1 59 HAWXHURST ROAD •
City St Zip COLD SPRING HARBOR NY 11724
Property Address 1 FARMVEU ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 121 .00 block 7 lot 10.000
Cross Street HARVEST LANE
Building Permit Number Cross Reference:
Issue Date: 4/10/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE . I ` 4, Town Hall, 53095 Main Road
TOWN CLF) r � _ P.O. Box 1179
a r` a' Z Southold, New York 11971
REGISTRAR OF VITAL rA' rc`�`"'m Fax Fax(516) 765-1823
MARRIAGE OFFICER � /fi �l/� Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER Ql ill
FREEDOM OF INFORMATION OFFICER �'W �
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: March 31 , 1998
Transmitted herewith is a copy of application No. 1909 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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments:
/Signa _ e
I %t
Dated
1
OFFICE-OF THE TOWN CLERK .cwFFOL '
JudithTTW own Terry,of TOWN Clerk thold
A. :- :. G
y Application No. /
Town Hall, 53095 Main Road :; �: ,`:': . jz Construction k/-
P.
"
P. 0. Box 1179 , .. •.
Southold, New York 11971 Y p. -c' Alteration
Telephone -4_1Ni t SAO `* Residential `�
(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 3/3/1/4.4,
APPLICANT NAME: C2�F�✓.g,e//JP /-/-29,776-5 /NG,
APPLICANT ADDRESS: v�9 /444,41X/04e--)S-"r gei9ib
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THE WATER SUPPLY&SEWAGE rI
DISPOSAL FOR TSI=S RESIDENCE
WILL CON FROM TO THE STAND- 1Ww
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ARDS OF THE SUFFOLK COUNTY - ` .
DEPT.OF HEALTH SERVICES. 10.7
Co I.
SUFFOLK COUNTY s ..•... `
2.00. 24 ��
PERMIT FOR APPROVAL OF CONSTRUCTION FOR A , I 2Z Oto -ookd
SINGLE FAMILY RESIDENCE ONLY i .
DATAIAR 0 5 1998 Hs REF • G. f%. :$0030
APPROVED C d I ,Ai-- T
FOR MAXIMUM OF HE► •o MS
N\f i /rv14 Kt
EXPIRES THREE YEARS FROM DATE OF APPROVAL 1 n.s .. ._- --
PLEASE NOTE
Minimum d s n ;
!;� I�1CTv..te(1 Well
and ces:pcoi is to h; ir,':,J feet.
Unauthorized alteration or addition to this document is a violation of Section 7209 SURVEY OF: 1,---del— �j c,
of the New York State Education Law.
Ce
the person for whom it is prepared
and on hips behalf to thetions indicated Companyhereon shall,Govern n onlimental Agency and Lending / A A-e. 0 FA rtA ve.L4 ALi- 0A b
Institution listed hereon,and to the assignees of the lending Institutions or subse-
quent owners. 1��1
seal Of GioniDuni
hell not this considereddocumentnot bedd true professional's inked seal 6f'9tf 588158 Received r j ��
TM offsets(or dimensions)shown hereon from structures to the roperty lin O y I-2(A w Y
for a specific purpose and use and therefore aro rat intended to guile the er,Notf tit COUP t z / 0
fences,retaining walls.pools,patios,planting areas,addition to buillings or an other
construction. ■ • d. .t.�
The existence of right of ways and/or easements of record,If any°not n ♦[f 1 Y II I
not guaranteed. ,SP - I'+ DATE: I (qt. SCALE: I
0011•
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CERTIFIED ONLY TO:. Offs 0�4� ;.4. —.", DESTIN G. GRAF
c__(ii_et4;- - .01 _e ___ F-7 •;:r€3.•' ''..-:::;% 1 !1_I_6
a, ...,,,...,:,:.c..:. ' LAND SURVEYOR
�• SE #O I/. /ci,
By •�-' / C''r` 73 WOODLAWN ROAD
DESTIN G.GRAF N.Y.S.LIC No.50067 ROCKY POINT,NEW YORK 11778 ci
TAX I.D.No. r4 PHONE(516)821-3442
1000 - ILI - 07 - lo,o