HomeMy WebLinkAboutSeeley, Robert ,gUFFOt, ,,,
%;\ELIZABETH A.NEVILLE _ Town Hall,53095 Main Road
TOWN CLERK o - P.O. Box 1179
vs Southold,rry
= New York 11971
REGISTRAR.OF VITAL STATISTICS � , Fax(631) 765-6145
MARRIAGE OFFICER
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RECORDS MANAGEMENT OFFICER =_�Ql $ )'0.0 Telephone Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ,iNg �'� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3191 R Residential X Non-Residential
=ee $ 10.00 Septic x Cesspool
PERMIT ISSUED TO:
Name : TABATHA BAILEY
Address 1: PO BOX 877
City St Zip JAMESPORT NY 11947
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR ONE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-03-0136
Name of Owner SEELEY, ROBERT & BARBARA
Mailing Address 1 20 WHITE PINE LANE
City St Zip SETAUKET NY 11733
Property Address 1 1250 SOUND DRIVE
City St Zip GREENPORT NY 11944
Tax Map No. section 33.00 block 3 lot 19.004
Cross Street SOUND DRIVE
Building Permit Number Cross Reference:
Issue Date: 9/01/04 Elizabeth A. Neville
Southold Town Clerk
(TowN SEAL)
J
,,,11 ttFFOiet
III CoG; 3191
ELIZABETH A. NEVILLE ��� � Town Hall, 53095 Main Road
TOWN CLERK y Z $ P.O. Box 1179
REGISTRAR OF VITAL STATISTICS O 11 Southold, New York 11971
MARRIAGE OFFICER
Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER Wel jig,
`1►aOTelephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ,,,,s" southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department t o 2004
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 9, 2004
Transmitted herewith is a copy of application No. 3332 for a Cesspool/Septic Tank Construction
Permit submitted by:
Tabatha Bailey for Robert& Barbara Seeley
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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: 'e
,4tAltOle4
Signature
/ ?.6456-
Dated
.64SGDated
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ELIZABETH A.NEVILLE ���It 4 Town Hall, 53095 Main Road
TOWN CLERK a P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ` �j, Southold, New York 11971
MARRIAGE OFFICER : '� Fax Fax(631) 765-6145
=
RECORDS MANAGEMENT OFFICER y D�ii°� Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER O1 I * of. southoldtown.northfork.net
-......,��1
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10 or Non-Residential @$25 Application No. 33 3
Permit No.
Applicant Name w 2.
Applicant Mailing Address es T k Si 30,N•e-may►-\ c‘•---X-1
Septic Tank .-6r Cesspool
Brief Description of Proposed Construction or Alteration 1.'e_ -c\P,(\c_2_,.
Location of Proposed Construction/Alteration:
Owner of Property occ'-\ 4- arbo.ro. `fie_\e....1
Owner Mailing Address: c9K i. r12_ n-e...
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Owner Property Address: ", \A . 15--0 S6vti at bY-
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Name and phone number of contact person TCS c' (La 1 .-1----1(:\C\2
Tax Map No: Section 3 Block 3 Lot 1 Ci-0 4
Cross Street fit- A Z ..k-Nf .
NOTE: LOCATIONMUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQ S SURVEY H.HEALT, I DEPARTMENT APPROVAL
\ ?')3A QX l9 S5 OSI.
J Signature of Apant Date
Received by: �..._ . ._ . .. .....
Young & Young -----Th
400 Ostrander Avenue, Riverhead, New York 11901 „I
v.05
631-727-2303as 1 \ 1\, ` CO s{ \ SLID \w Howard W. Young, Land Surveyor 3
' \ i' 1 a11,/s j 17 Thomas C. Woipert, Profesaionat Engineer s, I
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4,; {011111.. ‘19%/40.,, Cpvht�°St`et. Pfuhl, Landscape Architect ' ,
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kQ4 V 1 1 , i HOWARD W. YOUNG, N.Y 5. L.S. NO. 458,431/
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ROBERT SEELEY 4 BARBARA SEELEY i
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w LOT 4 "ROCKCOVE ESTATES"
w`" AO.a7 / At Greenport, Town of Southold
- m 2-,'b -55' Suffolk County, New York
(r0 0 op /� County Tax Map District 1000 section 33 Block 05 Lotlq.04
NOTES el) m ' -017 r''Qi 1 9UILDIN6 PERMIT SURVEY
e
AREA = 45,563 SQ. FT. i '",' ' , ry
• SUBDIVISION MAP "ROCKGOVE ESTATES" FILED IN THE j
OFFICE OF THE CLERK OF SUFFOLK COUNTY ON .JUNE II, 2001 t , : 1_ 1
Iry MAP PREPARED SEPT. 26, 2003
AS FILE NO. 10631. -_ 1 1
• VERTICAL DATUM = N.G.V. DATUM (M.S.L. 1929) AO-'-'4\r-
, �
N�$o/4,00, SCALE: l'=50'
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p•MOM 14541 SET ■ •Mg04154T POLIO A.sTMCE!PET A A.sT FOUND 404/.y, JOB NO. 2003-0251
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