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HomeMy WebLinkAboutSantora, Eileen o�w �OFFOL- O,' JUDITH T.TERRY OGy •l Town Hall, 53095 Main Road TOWN CLERK ` ti P.O. Box 1179 "p ,�� Southold, New York 11971 REGISTRAR OF VITAL STATISTICS kk%% 1 Fax(516) 765-1823 MARRIAGE OFFICER p y 1 RECORDS MANAGEMENT OFFICER = �.( `1►aOl� Telephone(516) 765-1800 FREEDOM OF INFORMATION OFFICER 0" OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1649 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : EILEEN SANTORA Address 1 : 660 TOPSAIL LANE City St Zip SOUTHOLD NY 11971 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. Name Of Owner SANTORA, EILEEN Mailing Address 1 660 TOPSAIL LANE City St Zip SOUTHOLD NY 11971 Property Address 1 650 VANSTON ROAD City St Zip CUTCHOGUE NY 11935 Tax Map No. section 104.00 block 12 lot 10.004 Cross Street BROADWATERS Building Permit Number Cross Reference: Issue Date: 4/28/97 Judith T. Terry Southold Town Clerk (TOWN SEAL) . . ;= qvFilke M14 •O .1. 0 Town Hall, 53095 Main Road tr 040 ve � P.O. Box 1179 ���' lol Southold, New York 11971 JUDITH T.TERRY "I%"0/ TELEPHONE TOWN CLERK (516) 765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: April 17, 1997 • Transmitted herewith is a copy of application No. 1719 for a Cesspool/ Septic Tank Construction Permit submitted by: Eileen Santora 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 recomm ations: APPROVE DISAPPROVE Comments: RECEIVED APR 2 5 1997 Signatur )/—) 3;ac) / " y Dated Southold Town Clerk OFFICE OF THE TOWN CLERK �jVFFULJj Town of Southold Application No. C 7 / Judith T. Terry, Town Clerk Town Hall, 53095 Main Road '� Construction L� P. O. Box 1179 Southold, New York 11971 0 ��t� Alteration Telephone 411 � , ,� Residential (/ • (516) 765-1801 Non-Residential • TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICAT ION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ �j DATE &Pill 1 / ) X16 -7 APPLICANT NAME: � L- t �14 10ept APPLICANT ADDRESS: Co CP 0 c— SEPTIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION w LOCATION MAP: Must be attached hereto before permit may be issued. • LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY : (S�2KI0c.-Q)-5 Eiz-- 1,f '34A1/7)(a , OWNER MAILING ADDRESS: �J/ jD Anl J7-A IV) Y, uE N OWNER PROPERTY ADDRESS: (p50 V A ‘,57- ,1 12.0 CA) 7-6 I0c0U- I'© 11)-)©i i � TELEPHONE NUMBER OF CONTACT PERSON: 'j(��j �-E.� w � 14 �� TAX MAP NO. : Section 104 Block /2 Lot X0 .4 CROSS STREET : 0 AD (,J jqTE BUILDING PERMIT NUMBER CROSS REFERENCE: 8i/LeAAideViALM Signature of Applicant RECEIVED RECEIVED BY : TowrAnerlis1nfifice DATE: Southold Town Clerk _�_� SUFFOLK CO.HEALTH DEPT.APPROVAL ' P�EA -------- , H.S. NC. distance between well ' tdiinim�m off ee {io„si ; I and cessp - r p d cars SINGLE FAMILY DWELLING ONLY kc .` �'aat-= t'. Expmes THREE YEARS FRou DATE OF APPROVAL 1sfl �- ' --�s(J �.t;--B7'lll7tt i i I STATEMENT OF INTENT 1 '�.,\ 1:2:.........1„......... - R I '�LEP,SE NOTE THE WATER SUPPLY AND SEWAGE DISPOSAL 1 - _ '$anitary s�Cstem is not to be Ata to ray. u� SYSTEMS FOR THIS RESIDENCE WILL +�stl S_ST'OI QO'B ;{/Z�?9 ° �. ,�� placed ddr;vewayarea. ; CONFORM TG THE STANDARDS OF THE /$ _ ___t*4 ' Y.; i* q-- _ SUFFOLK CO. DEPT. OF HEALTH SERVICES. • ?• \\ i i j51 APPLICANT 1 ,1t ,4 - .-_,..- ‘m) ,:,- SUFFOLK COUNTY DEPT. OF HEALTH 'O / D � - O -,. !r"�Y6rOf•61 'r' ;tZ \ SERVICES - FOR APPROVAL FOR _ _ CONSTRUCTION ONLY +�.'!< � ( DATE:HSREFNt :_ g , �� IAP • B f! - ` • t' - , SUFFOLK CO.TAX MAP DES GNAT{ON: I I . • ; �. P OF Lor,Na -,196 I 1000 SECT. BLOCK PCL. .,� 4 11/ASSAIJ /1t/r12 lQ r t � � -c�,��� { � ::< J�J'f -��v' i -J04 / I. .�rJrrt ,," • /! ) I 'OWNERS ADDRESS: i SUFFOLa CO. /G1�0 MAP No,1 I Roc hard Fr Gsr�, 6S9 / • f �a 49� P.o8OK y • •,..i. r. `/r: cafchLyae. ti'. Y. 0935 41 - _ Cu rcjj ,e, N. Y • i • f svaw �Eo. oe / Y /,. "�� t # �r �., r.� t� �� if DEED: L. TOOB9 P. 33$ I •i s05 J t Jos s. A- r_ a 1e"!Q NOYY 6.141.1 TEST HOLE i STAMP � :: ]r CW.-Lar-l98_ 1.,„.,.ener.e.•"e"'. Yeetgato _ d 3 ::-. x - 'S$N#y. mm'w .. -_.,...._�._ _. _ - - "-. - - __ - .I.. 4r >pfaarl-. Ease.. MbYK } t loom :....e^.-..^:eM . eio...tteivr.1 }rG4iY 6o124•tr 11. a ; 4' b. .r .1� `yam i• I cyry.gws -,_ onerfir %dii1 J;:l09id.7' SOMA o ..�._ Ra' ta � $rt'. SEAL } p . y iL 1-�L`+l�� •• pF NEIV B a trtOth•ll19ea!! { i I P•''' 4''� Surve e1,:;oc t.Z7 7905. .. RODE ICK VAN TUYL,P.0 `);;P, .1 * e i*', . 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