HomeMy WebLinkAboutSpitzenberg, Robert Jr /'/l_ilii•�-
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JUDITH T.TERRY �� y1 • Town Hall, 53095 Main Road
TOWN CLERK ; y = P.O. Box 1179
� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
�Oy ���, Fax (516) 765-1823
MARRIAGE OFFICER 0 `e. Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER z 1 l [
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. 1512 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : ROBERT E. SPITZENBERC JR.
Address 1 : 375 ELIZABETH LANE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH SANITARY SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #R10-96-0035
Name Of Owner SPITZENBERG, ROBERT F. JR.
Mailing Address 1 375 ELIZABETH LANE
City St Zip SOUTHOLD NY 11971
Property Address 1 TERRY COURT
City St Zip SOUTHOLD NY 11971
Tax Map No. section 69.00 block 3 lot 6.004
Cross Street GLOVER STREET
Building Permit Number Cross Reference:
Issue Date: 8/06/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
41 - ' ... .
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JUDITH T.TERRY i _� 4 Town Hall, 53095 Main Road
TOWN CLERK . N = % P.O. Box 1179
P 4$$ Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER :. t '��0 Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER �l �a���� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ,,���
OFFICE OF THE TOWN CLERK -,
TOWN OF SOUTHOLD ' �n U 9'�
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: July 22, 1996
Transmitted herewith is a copy of application No. 1577 for a Cesspool/
Septic Tank Construction Permit submitted by:
Robert F. Spitzenberg Jr. •
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. 1�
DISAPPROVE � D
Comments: 7.gapl'
�,J (kA) , 13- $
6
Signatur i..--
Y 4./66
Da d
110
OFFICE OF THE TOWN CLERK
Town of Southold Application No. /5-77
Judith T. Terry, Town Clerk t41/y�
Town Hall, 53095 Main Road ; Construction -
P. O. Box 1179 tai
�, _
Southold, New York 11971 r 11 Alteration•
Telephone =•O��O �� ���� $10.00 - Residential t/
(516) 765 18011 i $25.00 - Non-Residential
I
i,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 7/2 5(o
APPLICANT NAME: /COCA-/ ii/
APPLICANT ADDRESS: 375 67/ja.4ej`lt �s-► , _
JaY //f
SEPTIC CESSPOOL K
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
C.CJY►SPncC.1/. p hew ,� Qpo ee f.s>Oo e / .
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PRQPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: .4Oer7/
OWNER MAILING ADDRESS: 37,5` .
S A0/4 Air/177/
OWNER PROPERTY ADDRESS: /to I /.eeCy cT
�o 0 Sh0//j /tif //97/
TELEPHONE NUMBER OF CONTACT PERSON : f,S -23(c/ 7(F-2SICo
TAX MAP NO. : Section 669. 00 Block 03.00 Lot O0 4.col
CROSS STREET : /J2e/ e_'% 6/Doei-
BUILDING PERMIT NUMBER/` CROSS REFERENCE:
Signat re f Apr i ant
RECEIVED BY: j
/ Town Clerk's Office
DATE; "7/. .- •
li L 0 r NUMBERS ARE REFERENCED TO MAP OF
1M/NOR SUBDIVISION FOR RUSSELL E. 8 JOAN A.
MANN.
/�,��,a t
�Q s sg gi �� •CeSUFFOLK COUNTY DBPARTh2IT OF HEALTH SERVICES
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30. T
et, F 0 A PIRM1T FOR APPROVAL OF CONSraucrioN FOR A
h O �! �Y 1%RSID T�iC`.Z OI4LY
43 A ► 1�- 3S'
t Pte% DATE / / >/V. /
�e. <o 0i APPRO N�.
� FOR IAMCI AUM OF ` = :,• 4•• '
v:'14 i'.<(.
'.. i EXPIRES TREE YEARS FROM DATE OF APPROVAL
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An.
te, D'iF'ED rLjp' xS SURVEY FOR
9. l�O. w L o� ROBERT F SPIT ZENBERG
P o r� ry AT SOUTHOLD
-4. • .�� @ TOWN OF SOUTHOLD
sip ,�,... Q- SUFFOLK COUNTY, N. Y.
�j� 5� `4� ♦,�. ` 0 �Nc, 1000 - 69 - 03- 6.4
4 �Z r \o Scat 1"= 50'
A p ri 1 24, 19 TVIWIFEill
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o • x ` CERTIFIED TO' AN 216 1111 1
`s7 �! trdO ' ROBERT F. SPTZENBERG
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STANDARDS FOR APPROVAL P
) C. TRUCTION OF SUBSURFACE SEWAGE t'0 i The locations of wells and cesspools Of of
Jo-, SYSTEMS FOR SINGLE FAMILY Y RESIDENCES shown hereon are from field observations �Q't� t.ME ry04
will `• by the conditions set forth therein and on the � ;, 5 r� ro ,p
and or from data obtained from others. ,o ¢
lit 1• 'OnSlrUct, AO J ` WA
�� G �� AREA = 93,221 sq.ft. - .
,‘,06 0 0 �
'h v e
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y SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
AL T6 7»aN ADDITION TO TMS SURVEY/S A VIOLATION O Q u� �� FOR APPROVAL OF CONSTRUCTION ONLY ! J" , �[� t 496 N.
iCT1 .F T E•NEW YORK STATE EDUCATION LAN' "�
T.a.A1 l W 7209-SLWIV7 2V 2 ALL C£R7VTCA'T1GrKS g S , ��a
N A FOR THS MAP AND COPIES WHEREOF ONLY F /�� t 1 L1C. NO. 496/8
UP 1 BEAR THE IMPRESSED SEAL OF THE SURVEYOR i
°EARS HEREON. er` cr l DA T1s. REF. No. + PEC0IWC S VEYORS, P.
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o (5161 765 - 5020
,A, CQAPLY WITH.1D LAW ThE TERM ALTEliED BY- EZEVATIO/KS� R ' " . .Y �6IY ervroc. .awav •ern u c � �