HomeMy WebLinkAboutPitts, Arthur �� OgOF FOL4 ••Off' oG .
JUDITH T.TERRY t°1 ‘)-
�� Town Hall, 53095 Main Road
TOWN CLERK y P.O. Box 1179
T t Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER '.y ��) Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER = �1 * . .0OTelephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER 0°4° o
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1534 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : ARTHUR G. PITTS
Address 1 : JANE F. BRODERICK-PITTS
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #R10-96-75
Name Of Owner PITTS, ARTHUR G.
Mailing Address 1 BRODERICK-PITTS, JANE F.
P. O. BOX 637
City St Zip MATTITUCK NY 11952
Property Address 1 LLOYD'S LANE
City St Zip MATTITUCK NY 11952
Tax Map No. section 99.00 block 3 lot 4.007
Cross Street SOUND VIEW AVENUE
Building Permit Number Cross Reference:
Issue Date: 8/29/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY �i _ '11\ Town Hall, 53095 Main Road
TOWN CLERK ;
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OFFICE OF THE TOWN CLERK ••••.
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Town of Southold ��''��-�FF �� `
�� C��/ ; Application No. , OU
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road • • �s. C
P. 0. Box 1179 �• Construction
Southold, New York 11971 � •
yc : Alteration
Telephone � �c•-•r / $10.00 - Residential
(516) 765-1801 _ Ol
$25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTIIOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE SAL S/P6
APPLICANT NAME: r-f ,� � PW..s � n`
APPLICANT ADDRESS: P_ c7. a:,x ' 3 7
SEPTIC X CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: • Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY : ,4/?THw c:-,PiT eRoDh22[cL_ro,77-s
OWNER MAILING ADDRESS: 1P 0 gvx 6 37 f. CavitiYcT ✓ENp >_E.S
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OWNER PROPERTY ADDRESS: ,% •/ / �/f,�� 4/y ✓(
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ofatOriaPiAtiWW /V, /1/),
TELEPHONE NUMBER OF CONTACT PERSON: Jvl,r MAre 1A_ 7 y y —. 1J 7f
TAX MAP NO. : Section / Block 3 Lot Y. 7
CROSS STREET: .J a � (//r 44, G .
BUILDING PERMIT NUMBER CROSS REFERENCE :
;s
ignature of Applicant
RECEIVED BY :
Town Cler cis Office
DATE: a2 �e6
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APPROVED ! r`�''
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N. 89'23'00" E. 104.33' EXPIRES THR:YEARS PROM DATE OP APPRO �*'
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JANE F. BRODERICK- PI T TS o
• NORTH FORK
m FIRST AMERICANNK TITLE INSURANCE
` COMPANY OF NEW YORK
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Agiit ASP AN\\\k‘.S' \\ SURVEY OF
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AREA = 25,4 8 sq.ft. Rio OCT. *Nei_ASA 4P IV0.7019
µ AT MA T TITUCK
I om iomlHar withthe STAND RA$ FO APPROVAL TOWN OF SOUTHOLD -
AND CONSTRUCTION PON
ACE SEWAGE
DISPOSAL SYSTEMS f ON SINGLE PAMIL Y 1i'E`S'IDENCES SUFFOLK COUNTY N Y.
and will abide by the conditions set forth' therein and on the ,
permit to construct. 1000 - 99 Oa - 47
Scale: 1"= 30'
July 23,1996 '— .,
The locations of wells and cesspools ' ._ ' I a
shown hereon ore from field observe! , .
and or from data obtained from other
WATLrR gL1plLYNAND SESTEMS MUST ' ct LI 1
' ,
' tri ci
CONF01iM�►� EW STANDARDSWAGE DATEDDLSYO3AL NOSYVEMBER 13,a 495. i� �r r;
ELEVATIONS ARE REFERENCED ��Qf �/(�), - c,:
TO AN ASSUMED DATUM. o,��a; .MErzct `I \a
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ANY AL TERA TION OR ADDITION TO THIS SURVEY IS A VIOLA TION '
OF SEC770N T209 OF THE NEW YOI �$TATE EDUCATION LAW ii � ��� f
EXCEPT AS PER SECTION 7209-BUB,pInwN,2.'ALL CER IFICA�T/0NS qtr, - YtS.<<b.]C`NO. 49618
HEREON ARE VALID FAR THIS MAP AND CSS THEREf ' ONLY * Ir j • 49bi t
SAv MAP OR COPIES BEAR rNE IMPRESSED SEAL OF 1TrE SURVEYOR PECONIC S '''' '!:'4)
WHOSE SIGNATURE APPEARS HEREON. 15161 765 - 50 -.—....
ADDITIONALLY TO cOMPL Y W1774 SAID LAW THE TERM 'ALTERED By* P. O. BOX 909
MUST BE USED BY ANY AND ALL SURVEMTS UTILJAV A copy 1230 TRAVELER STREET
OF ANOT7rE7? SURVEYORS MAP. TIZVS SUCH AS ECTED•AND SOUTHOLD, N.Y. 11971
WROUGHT-TO-DATE'ARE NOT N COMPLIANCE WITH rHE' LAW.