HomeMy WebLinkAboutUrel, K • OOFF04
JUDITH T.TERRY I� yj� Town Hall, 53095 Main Road
0€TOWN CLERK N i P.O. Box 1179
�
REGISTRAR OF VITAL STATISTICS t. � Southold, New York 11971
MARRIAGE OFFICER = 0 �/ Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER i O1�J11
�� � 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. 1751 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : SUSAN J. BACON
Address 1 : 18 ROXBURY ROAD
City St Zip GARDEN CITY NY 11530
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 #R10-95-0137
Name Of Owner UREL, K., HAZELL, E., & OTHERS
Mailing Address 1 C/O ABATELLI REALTY
MAIN ROAD
City St Zip CUTCHOGUE NY 11935
Property Address 1 3335 NASSAU POINT ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 111 .00 block 9 lot 2.000
Cross Street OLD MENHADEN ROAD
Building Permit Number Cross Reference:
Issue Date: 10/17/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
/ 7- 7
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•
JUDITH T.TERRY � _ �� 5 o 11, 53095 Main Road
TOWN CLERK ; y 1{ ..0. Box 1179
. .tho 9,New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER y 1r F: . 516) 765-1823
i►..'
RECORDS MANAGEMENT OFFICER .� �►� ••" • e ephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER 0-001
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: October 14, 1997
Transmitted herewith is a copy of application No. 1825 for a Cesspool/
Septic Tank Construction Permit submitted by:
Abatelli Realty for Ural, Hazell, Ames & Kroll •
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 reccoommendations:
APPROVE t/
DISAPPROVE
Comments:
ignatu
1D f! b /21
Dated
•
WITHE TOWN cum( 4\viTtA-c
• I own of Southold
Application Ho. / ( —
I . Terry, l'own Clerk
l'own 5:1095 Main Road a construct'. Ns
t (xi
P. O. Box 1119
Alteration
Southold, New York 11971 '‘efi• • . . . .
* of • Residential I.'''.
Telephone
(
-;":7:•/,741/rt 516) 765.- 1001 Non Residential
TOWN 0 E SOUTHOLD
•
SOUTHOLD WASTEWATER DISPOSAL DIST It 1C1
A PPL1CAT ION
.11,71
h)1.
CONSTRUCT ION or ALT E 12 Al ION PERMIT
• SEPT I(; TANK oc CESSPOOL
Permit No,
•
Fee $
DATE: mitt-liq
APPLICANT NAME: 5 45aAlk j &taps--
APPLICANT ADDRESS: I00
6aideAel ...1153o
sEpric >< CESSPOOL
DES CR I VI' ION OF PROPOSED CONSTRUCT ION OR A LT E RAT ION
KN)(110UVC1•(---
LOCATION MAP: Must be at ladled hereto before permit may be issued.
• LOCAT ION OF PROPOSED comsnzucT ION OR A LT1ERAT ION:
OWNIER OF PROPERTY : ic,OaLt,E. liba-0 I NI tc6t5
OWNER MAILING A DDR ESS: cjo fli9566,c, •
.cliutk(Fs/uL_
OWNER PROPERTY A DDI11. ).....kka5ups_ •
10.1 Itq C
TELEPHONE NUMBER OF CONTACT PERSON : 7.3q- 6000
FAX MAI' NO. : Section 11 I Block C? Lot A.
•
CROSS. STREET : oa N'eAV\Q.de..V.V .•
BUILDING PERMIT NUMBER CROSS REFERENCE :
141.1 /.4P
• Signature o
141iCEIVIED BY : •
DATE :
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en`l t` o �, \ m o SING E PR. L► M'i� G ONLY
T o bf``J- one- z m EXPIRES THREE YEARS CRO f' DATE E OF APPROVAL
2 �+ �\ j8 °L O V.;Q D r
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0 �. m ;� m M SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
PALE'BR. m _ , 1 7i Og,i 0' w. c N D FOR APPROVAL OF CONSTRUCTION ONLY
F TO / N
COARSE a. /
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cd w�P�' t- v ��e6 DATE_ HS. REF. N0.! IO `qs-v1-1 1
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29,3 223 �� undefined ` OT 17 Nr•
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I T'I °`� APPROV -
a s P
0 PI -p C r O f` I am familiar with the STANDARDS FOR APPROVAL
AND, SEWAGE
'" '' �u `� �., ;+�; r� well SURVEY OF DISPOSAL SYSTEMS FOR SINGLE FA SUBSURFACETRUCTION OF L Y RESIDENCES
F .;/,'. ~ b ,q- D Minim'-�m G'S feet LOT 16. and will abide by the conditions set forth therein and on the
end cesspoo is �; ii�
t �
MAP OF NA U POINT CL L8 PROPERTES permit to construct.
16 1995
-NOV - MENDED MAP "A"
"
MAP NO. 156 -
S.C• DEPT. OF A -NASSAU POINT
HEALTH SICVl6E
AREA - 11378 Acres TO WN OF SOUTHOLD
to tie lines SU FOLK COUNTY, NY. .\EOF NEp
00 - 111 - 09 - 02 c,,_,S. ME,. c2,,
Scale: 1" = 50' .o, ��
July 1995 4 ,.:. '
ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION 5,
OF SECTJON 7209 OF THE NEW YORK STATE EDUCATION LAW, Aug. , 1995 (Health Dept. Info ) .Y.S. LIC. NO. 496/8
EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS 9 �
HEREON ARE VALID FOR THIS MAP AND COPES THEREOF ONLY FSAID MAP OR COPES BEAR THE / *
WHOSE SIGNATURE APPEARS HEREON.RESSED SEAL OF THE SURVEYOR (51 -�/ • r ,'i
Vii" _ •RS P.C.
ADDITIONALLY TO COMPLY WITH SAID LAW THE TERM ALTERED BY' The locations of wells and cesspools P. 0.
MUST BE USED BY ANY AND ALL SURVEYORS UTILIZING A COPY I •09
OF ANOTHER SURVEYOR'S MAP. TERMS SUCH AS HVSPECTED-AND shown hereon are from field observations i 1230 TRAVELER STREET
'BROUGHT-TO-DATE' ARE NOT IN COMPLIANCE WITH THE LAW. and or from data obtained from others. ELEVA TIONS ARE REFERENCED TO N.G.V.Datum. SOUTHOLD, N.Y. 1197/
95 - 196