HomeMy WebLinkAboutRackett, Grace F01at
ELIZABETH A.NEVILLE $ Town Hall, 53095 Main Road
TOWN CLERK ; p : P.O. Box 1179
N Z Southold, New York 11971
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REGISTRAR OF VITAL STATISTICS Fax (516) 765-1823
MARRIAGE OFFICER ‘‘#*
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RECORDS MANAGEMENT OFFICER : �0 .. , Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER �1
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1841 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MARIBETH MUNDELL
Address 1 : 155 STERLING STREET
City St Zip GREENPORT NY 11944
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 #R10-98-0016
Name Of Owner RACKETT, GRACE M.
Mailing Address 1 OYSTERPONDS MANOR
25-500 MAIN ROAD
City St Zip ORIENT NY 11957
Property Address 1 ROCKY POINT ROAD
City St Zip EAST MARION NY 11939
Tax Map No. section 31 .00 block 2 lot 24.000
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 4/16/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE I `10 y , Town Hall, 53095 Main Road
TOWN CLERK I p r4 % P.O. Box 1179
C4 Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax 177# Fax (516) 765-1823
MARRIAGE OFFICER :=y�O! ‘ON' � Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER ��
410 i°4�
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OFFICE OF THE TOWN CLERK U J
TOWN OF SOUTHOLD I 1998
TO: Southold Town Building Department 'j?;'' BLDG.. LITHOID
FROM: Linda J. Cooper, Southold Town Clerk's Office•
DATED: April 9, 1998
Transmitted herewith is a copy of application No. 1915 for a Cesspool/
Septic Tank Construction Permit submitted by:
Maribeth Mundell for Grace M. Rackett •
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 i
DISAPPROVE
Comments:
T
iA.
Si ature
Dated
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OFFICE OF THE TOWN CLERKS�FFour
Town of Southold AYCOQ Application No. lc"
Judith T. Terry, Town Clerk ;
Town Hall, 53095 Main Road Construction
P. O. Box 1179 �J Alteration
Southold, New York 11971
Telephone Residential
(516) 765-1801 '' Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCT ION or ALTERAT ION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE
APPLICANT NAME: 146Ytb 0004-al
APPLICANT ADDRESS: n 5 Se,rl. Sit
6/L2s2aA.,ec 1 kNi ItcrCH
SEPTIC >(_CESSPOOL)<
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION Neil
S4-0 Lk 1 i�c, 1� fc)v1 t ki Wood --cra vn e
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 61-NQ P\c\c Q - —
OWNER MAILING ADDRESS: 0 c..t Q,e R0 d V -1(avwQNr )-_`5 -coo vt VI{`L: ,
arye(A +) ley `tc(s_-7
OWNER PROPERTY ADDRESS: Kr)c C%Ylk Apadi E. V -it,NvI Gn rv\/
TELEPHONE NUMBER OF CONTACT PERSON:CSk (p) -(77
TAX MAP NO. : Section 31 Block a Lot L9 Li
CROSS STREET: Via( r1 RUzck j S,R, L
BUILDING PERMIT NUMBER CROSS REFERENCE:
?Val/14_1K- 1
Signature o A plicant
RECEIVED BY: /� ---___
Town Clerk's Office
DATE: ///9/-1?
•
•
•
• SEPTIC, DETAIL PROPOSED
not to scale DWELLING
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°ro<a is — SURVEY OF PROPERTY
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QSUFFOLK COUNTY, NY
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�PNOP OP 0����NGI p0 0 p 1000 5K 20U24 TAX MAP
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fn/ CERTIFIED TO:
S5 MARIBETH MUNDELL
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\ \ E 28 /�[\el r NOTES:
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0r - - �� O' O SEPTIC SEPARATION REQUIRES
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(h�� fz��NR. N N.0 • 40'OF WATER IN HELL O
A 20. O\,�O00 ) ELEVATIONS ARE REFERENCED TO
Z6.5 N t NAE N P t� s- SUFFOLK COUNTY TOPO MAPS
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o _/ I BROVAI LOAMY m-Coauthoing a lice. land°r °°"'or` e.i°i
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or section 7200. Sub-di:,.,on`2. or the
0.,. �• New vora"State<EYuc.t Lev. I.1
U p !SC Z'Ci,-r R 4.'" - --- 2.5 .,shall°e the original
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copies tram
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'Z,i 64-‘v,<c —}vA�i,r,,att4 <
01 i vn l iY -Certifications Kt;r"<:hereon etch the ex-
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J ►_ Rating Caand Surde of York Practice tar Land surveys
rac e.tar Land r eyPr sr adapteef
t � DEPARTMENT OF HEALTH S'rR1,1rt' L Said tert,r,c.t,.h..rep ren o,Y
$UFFD
BROWN FINE TO ar. tn. ,.prepared.
1 'r0't ,ti.aoA.ns. d nen..
T MP .h, ut,In,,.e Mean .na
COARSE SAND WITH r'r.�"t"v` ieNn<.W,ie'i.. 'ioiwr;tO" art,r,c.
tM1T FOR APPROVAL OFCONSTitU�:t!* d I 10%GRAVEL institutions
r SINGLE FAMILY RESIDENCE ON 1,/ -------
DATE 3..---5---L-2-11- HSREF.NO. `tib '• t Dal(, i A . 1
APPROVED _' lk IT \,c'
GRAPHIC SCALE 1"= 30' FOR MAXIMUM OF B ODMS / `
TEST HOLE J. N_YS. LIC',N0. 50202
=SMO��� IRES THREE YEARS FROM DATE OF APPROVAL DONALD 6EOSGIENGE 6 as ' a4,7''VEYOR
RI EAD. .Y.-1 901
369-:288 Fax 369-8287
0 30 60 90
REFERENCE 0 98-105