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HomeMy WebLinkAboutRupp, Gerald /,�,,o��S�FFO�,��o - JUDITH T.TERRY ���= y� Town Hall, 53095 Main Road TOWN CLERK ; y Z P.O. Box 1179 Southold, New York 11971 REGISTRAR OF VITAL STATISTICS O / MARRIAGE OFFICER =y* 0.° Fax(516) 765-1823 RECORDS MANAGEMENT OFFICER : .( j of. 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. 1445 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : SAMUELS & STEELMAN Address 1 : 25235 MAIN ROAD City St Zip CUTCHOGUE NY 11935 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. #R10-96-0009 Name Of Owner RUPP, GERALD E. Mailing Address 1 10 EAST 48TH STREET City St Zip NEW YORK NY 10016 Property Address 1 19455 SOUND VIEW AVENUE City St Zip SOUTHOLD NY 11971 Tax Map No. section 51 .00 block 1 lot 21 .000 Cross Street MOUNT BEULAH AVENUE Building Permit Number Cross Reference: ---- ----Issue Date: 3/21/96 Judith T. Terry Southold Town Clerk (TOWN SEAL) III • our ,„..� 1„$. /1�,O\�01FFO(/(6OG y ; JUDITH T.TERRY %% off . Town Hall, 53095 Main Road %TOWN CLERK % vs Z t P.O. Box 1179 °O 0 Southold,New York 11971 REGISTRAR OF VITAL STATISTICSFax(516)765-1823 MARRIAGE OFFICER 4,, a0* 1 RECORDS MANAGEMENT OFFICER i OlJig �,��� Telephone(516)765-1800 FREEDOM OF INFORMATION OFFICER , 0.6 1;r, e 8 �` OFFICE OF THE TOWN CLERK f' ,5' -=� TOWN OF SOUTHOLD .a / �h >f TO: Southold Town Building Department '1,, FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: March 11 , 1996 Transmitted herewith is a copy of application No. 1502 for a Cesspool/ Septic Tank Construction Permit submitted by: Gerald Rupp • 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: �,f'Ael.1 Zp/( J('17) / - / %`1 ' 'c`6 9 _-----24, -.marl--- -e7 gnature Da d Y(6-' OFFICE OF THE TOWN CLERK c��FF©�l�'''= Town of Southold ,,Q C' Application No. /S-® Judith T. Terry, Town Clerk .' $10.00 - Residential Town Hall, 53095. Main Road P. O. Box 1179 $25.00 - Non-Residential Southold, New York 11971 't vt�! S p Telephone Qj a �'. (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for ascagitiagAtSres SEPTIC TANK or CESSPOOL (� Operation Permit No. Fee $ DATE (.9/6/F6 OWNER NAME: a5€4> 6, AUPP OWNER MAILING ADDRESS: /O 6D9dT 40617 /p-t T /VIZ(/ yave , �C/� /CO! 6 OWNER PROPERTY ADDRESS: /1.171 .5.-- SOCA/00 Wei AvLvar u007-How, .y /fell/ OWNER TELEPHONE NUMBER: /a G 9 6 - 405 Q TAX MAP NO. : Section 5/ Block CD/ Lot 02/ CROSS STREET: /170vAJT of3euL,9// 41v8uF ( o 40e4.4 TYPE OF SYSTEM: Septic Tank /0.90 ejm. New ✓ Existing Leacitine 6`' )c/2New V Existing Residential / Non-Residential LOCATION MAP: Must be attached hereto before permit may be issued. (Locate building and system; give north arrow and feet of distance, approximately, to building and closest road.) Signature of A licant RECEIVED BY: lam! Town Clerk's 0 fice DATE: j ///// , , , L...............1 -----44.............L...................../ L . _ ' x W J 7 T HEI^i WL Hcol�Is . . ` - I ClC1C, SC... m-r. =gk,A0 , P. GT Kt-1 J 12..= 14/ v� v; . / 5x1sTI�1� XI 71N CEJ 14 .5:t.1, �;4 'ED 4fte i ?_- CA R,4v 1 J/ Qui 0e• 44,_. ez., 1 )- ID 60 It _ - 0 ,. ,., .4', r� 1- • 0 9 Uil dtv kiA, _��..r 1 ct1 Z if' Drawn By: ,,1, c T�� I Checked By: . T E3 (I) 4,19ttlitts0t1%01:4 Date: Z./2- /1 Cr ti;- - tAt WI !Scale: _ 201.a " . -.4‘ . WIWI le Sheet Title: ch >,• 2 �-1" a kL c.� +�* (�(��� �y Cji r -- `ET L GA c..;--1 t 1,.i Iti.ot i'Att"itN>gi t O HEWNeinty cit yam+ ` i PERMIT lit ArnOVAL OP���1M A r {_ I v S1N0t1 PAMLLY 1DENt ONLY )ATE1=EB _ . 'L' Ng , ,, -,.'7%.p.-,f6 AO oa„9 D Mgr T / . . . ilrfiPTI,��.-1� ,.., « , - Sheet No: EXPIRES�%title kOM DATE Ott A itOVAL I hi I -.." rie- C E `Com.." w / ci_ ■ I r, I Pct �ac2, :::7" r-T+.or t =U,.li 1,0Hi j�"1 C ti' 1 I b 11716::7z's 024 1 7 _ IMF I I- c*.i S :1�ir71 .e 111111111111111111/ �A �C Q` e -j " 1 JP' 4t- 4. j S Ofty �6' ��... )Q Li �N >ooD IV 0 Pro NC 2,I 'Zc , . t t'n Q Drawn By: '�," r—, c. 1 Ii OChecked E h8 �; l,®� fat* Date: 2 ay• a,C2a �.; ro T)W1Mtill scale: • Sheet Title . c G1A_ vZ=c..A. "' �sK'"'G -4�K j/i — =I' :', ?' r< t---"7" :7 11 -I--,_ 1 qI c,A.,"-7- ._ �;.. .,rr•;� COUNTY DEPARTMENT OF HEALTH SERVICES 1