HomeMy WebLinkAboutKenney, Robert oolstFFOL/rc
JUDITH T.TERRY Town Hall, 53095 Main Road
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TOWN CLERK y 2 % P.O. Box 1179
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v' Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Oy ��,��, Fax (516) 765-1823
MARRIAGE OFFICER `� SIJ O
RECORDS MANAGEMENT OFFICER Ol 4ig Fax
(516) 765-1800
FREEDOM OF INFORMATION OFFICER '*so"
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1754 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : ROBERT AND LINDA KENNEY
Address 1 : P. O. BOX 18
City St Zip AQUEBOGUE NY 11931
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 #R10-97-0153
Name Of Owner KENNEY, ROBERT AND LINDA
Mailing Address 1 P. O. BOX 18
City St Zip AQUEBOGUE NY 11931
Property Address 1 WILLIS CREEK DRIVE
City St Zip MATTITUCK NY 11952
Tax Map No. section 115.00 block 17 lot 17.017
Cross Street MEADOW BEACH LANE
Building Permit Number Cross Reference:
Issue Date: 10/22/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY � _ yJ► `� Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. Box 1179
ivy �i Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ` *A,
��'�1 Fax(516) 765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER = 491 AL *N..‘,%.0 Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER - ,���o�,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: October 21, 1997
Transmitted herewith is a copy of application No. 1.828 for a Cesspool/
Septic Tank Construction Permit submitted by:
Robert and Linda Kenney •
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:
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TOWN OF SOUTHOLD
VFRICE: F .THE TOWN CLERK ~
'Towo Of SOI
Judith T . Teny, Town Clerk
Application No.
Town ||aU 53095 Main Road
. Construction
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Y. V. Box.. 1179 --- -
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Southold, New York 11971 Alteration411
Telephone Residential 4.--/
(516) 765- 1001 `�-"/rv/*''
Non ResWa`Ua|
'TOWN OF 60UT||0LD
SOUT||0LD WASTEWATER DISPOSAL DISTRICT
APPL|CAT ION
/or
CONSTRUCTION or ALTERATION PERMIT
•
SEPTIC T/\NK wu CESSPOOL
Permit No.
---- ----
Fee $
DATE
APPLICANT NAME:
APPLICANT ADDRESS: M. bo_x ______
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[----c�---~ ^-~-�-�------------------_--
6EPT|C CESSPOOL
I)ESCRI PT ION (}F PROPOSED CONSTRUCT ION OR /\LTER/\TION
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L()[NION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONST RUCT ION OR /\LTERA TION :
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OWNER OF PROPERTY : "^�' 4r p` e-
()YVNER MAILING ADDRESS: . favx
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~—Ptay.oJv°0c,Q k- k\ /1 . _____
OWNER PROPERTY ADDRESS: [�� \ {.v-e ^\- [\v-
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TELEPHONE NUMBER OF CONTACT PERSON : �] «� ? - ic\ Or-7^^~-`---------`----- -
FAX MAP NO. : Section \ � -- Block
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CROSS STREET :
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13UU|>|N6 PERMIT NUMBER CROSS REFERENCE : , ^
Signature of Applicant ---
RECEIVED UY :
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DATE:
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Lot 19
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VI V,. r 1 nf,$ 1 of m_k b inspected by the
�1l sit ` ?�iltz ► � ' ;,',t, 0 Haall i Services.
Call 6E).-2100, 24 hours in advance,
to schedule pie inspeCtiOn(S).
SURVEY FOR
i
ROBERT B. KENNEY 81 LINDA V. KENNEY
LOT 20," HARBOR VIEW AT MATTITUCKd OCT 7 1997
AT MATTITUCK DATE: AUG. 9,1988 I
TOWN OF SOUTHOLD SCALE' I" = 40' 1
SUFFOLK COUNTY, NEW YORK NO. 88- 1062 9
11 UNAUTHORIZED ALTERATION OR ADDITION TO THIS E_
SURVEY M A VIOLATION OF SECTION 7209 OF THE I
NEW YORK STATE EDUCATION LAW a
N COPIES OF THIS SURVEY NOT BEARING THE LAND =
SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL1
NOT R CONSIDERED DIC TE BE E VALID TRUE UNPYOF
N
*GUARANTEES INDICATED HEREON SHALL RUN ONLY TO
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY IS PREPARED
AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERN- (e........ • ,..,_.)
gG VV [N NEAREST W MAIN M1.! NSOURCE OF WATER' PRIVATE.._PUBLIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED �Y'P tIN SUFF CO. TAX MAP DIST1000 SECTION 115 BLOCK JLL_LOT 17.17 HEREON,AND TO THE ASSIGNEES OF THE LENDIN4*THERE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE OTHER THAN THOSE SHOWN HEREON. TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT N THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE OWNERSWILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT *DISTANCES SHOWN HEREON FROM PROPERTY UNEP
TO EXISTING STRUCTURES ARE FOR A SPECIFIC OF HEALTH SERVICES. -?APP'LICANT� IURPOSE ANO ARE NOT TO BE USED TO ESTABLISH ,,)
PROPERTY LINES OR FOR THE ERECTION OF FENCES t;\ '`"
ADDRESS t.;',..-t).."--?-L:...
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'I` YOUNG YOUNG RIVERHEAD W AVENUE
OR E
NOTE: • = MONUMENT FOUND ♦= STAKE FOUND '
SUBDIVISION MAP FILED IN THE OFFICE OF THE ALDEN W.YOUNG,PROFESSIONAL ENGINEER 1
CLERK OF SUFFOLK COUNTY ON AUG.21,1987 AND LAND SURVEYOR N.Y_S.UCENSE NO.12845
AS FILE NO. 8377. HOWARD W.YOUNG, LAND SURVEYOR
*THE LOCATION OF WELL(W),SEPTIC TANK(ST)11 CESSPOOLS(CP)SHOWN HEREON N.Y.S.LICENSE NO.45893 i
ARE FROM FIELD OBSERVATIONS ANO OR DATA OBTAINED FROM OTHERS r n F -
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BRANDIS A SONS INC.
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