HomeMy WebLinkAboutHaag, James •
JUDITH T.TERRYGy<• Town Hall, 53095 Main Road
TOWN CLERK yi P.O. Box 1179
v- �1� Southold,New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER '. 4' 0�/111� Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER : Ol 41. *010 Telephone(516) 765-1800
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. 1489 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : ART DIRECTIONS INC.
Address 1 : P.O. BOX 310
City St Zip ORIENT NY 11957
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR A NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #R10-96-26
Name Of Owner HAAG, JAMES, JR.
Mailing Address 1 45 WEST 11TH STREET
City St Zip NEW YORK NY 10011
Property Address 1 4725 ORCHARD STREET
City St Zip ORIENT NY 11957
Tax Map No. section 27.00 block 2 lot 2.006
Cross Street NARROW RIVER ROAD
Building Permit Number Cross Reference:
Issue Date: 6/07/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY 11 y1 Town Hall, 53095 Main Road
TOWN CLERK ; y Z P.O. Box 1179
\� � ,1� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER L 'jiff 0� �1�/ Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER . 11! jog ...40
Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER •4..,,, ,••-:
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
;�;. ;t,;
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TO: Southold Town Building Department ,.tits.0tr T '
_ CiF SCUT�PO�0
FROM: Linda J. Cooper, Southold Town Clerk's Office �`"" "�' ..a
DATED: June 3, 1996
Transmitted herewith is a copy of application No. 1554 for a Cesspool/
Septic Tank Construction Permit submitted by:
Art Directors, Inc. for James Haeg. Jr. •
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 4,--/
DISAPPROVE
Comments: C -eetj ,e,471 567D ,Y//e0--49‘ '2'6
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Signature
Dated' "
OFFICE OF. THE TOWN CLERK ,,,'"'"
Town of Southold '�',, f01./(C
Judith T. Terry, Town Clerk �'��� ' Ol/ ;` Application No✓�s
Town Hall, 53095 Main Road •L • Construction
P. O. Box 11794- 1 , Alteration
Southold, New York 11971
Telephone D), se,� $10.00 - Residential
(516) 765-1801 �l '.
,, $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ ff
DATE VVI, 1 11, 6
t
APPLICANT NAME: kl2-1 -V `-W IIS , '401L-17.03 i'Z-7o33 cl-s TACE, ( 5 ,
APPLICANT DDRESS: T,,O ,, 5( 0
SEPTI CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
CS
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Jktt cl1
OWNER MAILING ADDRESS: f5-(3.), i,(-n4 It-7Noto6,0_, 1JLq, 1oTOU. u13
OWNER PROPERTY ADDRESS:
Cf--(19W-L kff-, t-vvc---/
TELEPHONE NUMBER OF CONTACT PERSON: ,15 --. 34s7
TAX MAP NO. : Section 7-1 Block 6 Z Lot �, 6
CROSS STREET: 0c(c 4- kjk (--1,R5rR_D . �-
BUILDING PERMIT NUMBER CROSS REFERENCE:
V Signature of A•plicant
RECEIVED BY: ,�,Q/V---
own Clerk's Office
DATE: � 7
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�c ON ONLYERvicEs. The locations of wells and cesspools
shown hereon are from field observations
RIO-96-0026 and or from data obtained from others.
3.
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SURVEY OF
LOT 6
SETTLERS AT OYSTERPONDS
FLED MAY 4,1984 FILE NO. 7729
AT ORIENT
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NY.
Ar.) 1000 - 27 - 02 - 2,6
Scale: 1'1=60'
May 25, 1995
FEB. 14, 1996 (SCDHS. INFO)
APRIL /9, 1996 (SCDHS REVISIONS)
ALX COUNTY D'ARTAQD1T OF HEALTH SERVICES
PEWIT POI APPROVAL OF CONSTRUCTION FOR A
SINGLE FAMILY RESIDENC2 ONLY
i
APPROV ! J . ., .,�{
EXPIRES'THREE YEARS FROM DATE OF APPROVAL
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