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HomeMy WebLinkAboutMohr, Robert /��,O�„SufFOl,t0O • ELIZABETH A. NEVILLE 1�) yd• Town Hall, 53095 Main Road TOWN CLERK CI3 Z $ P.O. Box 1179 Pry Southold, New York 11971 REGISTRAR,OF VITAL STATISTICS by MARRIAGE OFFICER � 0� �1 Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER ��� ,,vi0 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. 3250 R Residential X Non-Residential Fee $ 100.00 Septic X Cesspool PERMIT ISSUED TO: Name : MOHR, ROBERT T Address 1: 545 WABASSO STREET City St Zip SOUTHOLD NY 11971 Descripton of Proposed Construction or Alteration ONE STORY - 1200 FT LOG CABIN FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT "name Of Owner MOHR, ROBERT T Mailing Address 1 545 WABASSO STREET City St Zip SOUTHOLD NY 11971 Property Address 1 630 WABASSO STREET City St Zip SOUTHOLD NY 11971 Tax Map No. section 780.00 block 3 lot 64 Cross Street Building Permit Number Cross Reference: Issue Date: 1/26/05 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) 3 _.50 ,IoiO\�S�fFO�,• �co ELIZABETH A. NEVILLE ,�� y�c ` Town Hall, 53095 Main Road TOWN CLERK t y Z P.O. Box 1179 .77 REGISTRAR OF VITAL STATISTICS O 1� Southold, New York 11971 MARRIAGE OFFICER yifJ 0.01 Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER '_ l `�a���� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER ..,,,��� southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: November 1, 2004 Transmitted herewith is a copy of application No. 3392 for a Cesspool/Septic Tank Construction Permit submitted by: Robert T. Mohr 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: ► " do- 00, 2040014 Signature J Dated too *4\FFO(,f-c ` O� �' 9 G ELIZABETH A. NEVILLE �'� y<` Town Hall, 53095 Main Road • TOWN CLERK y Z • P.O. Box 1179 REGISTRAR OF VITAL STATISTICS O Southold, New York 11971 MARRIAGE OFFICER � *%\.11.1 Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER �! $s�,, Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER „,," southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: November 1, 2004 Transmitted herewith is a copy of application No. 3392 for a Cesspool/Septic Tank Construction Permit submitted by: Robert T. Mohr 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 * * * * * * * * * * * * 1 have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE DISAPPROVE Comments: Signature Dated „ o fisOFFOUreo ELIZABETH A.NEVILLE ��j 4‘ Town Hall, 53095 Main Road TOWN CLERK ; p , P.O. Box 1179 REGISTRAR OF VITAL STATISTICS sy, Southold, New York 11971 MARRIAGE OFFICER • O yC �� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER = i Oriel Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER 491 jilt �a0” southoldtown.northfork.net 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 @ $25 Application No. 339 a- Permit No. , Applicant Name d Belo 7 AAA4+ Applicant Mailing Address L y3J,, SCr J2aijC. so thafc At)( /197/ Septic Tank or Cesspool' Brief Description of Proposed Construction or Alteration /-LS' 6200,1-‘9414/114 4i14/114 Location of Proposed Construction/Alteration: Owner of Property: oaek T /''o 2 Owner Mailing Address: CSV-Z4496 ds jr/U21— u rr/O�q/ i/e(.0)1'0e1/97( Owner Property Address: l 4.30 0-49556 ._...47,104. c9ouAoid e )/6. i r47 Name and phone number of contact person 'l!, 7c9 Tax Map No:iouo Section 72 Block c3 Lot 41 Cross Street NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL Signature of Applicant Date Received by: _ L/L'1(-{1k _._• 141AWATHA.S PATH Su2vE�l of DE SCIZa�pyZOPERT y ATStiff" C(LAUGHIA.I6 WATER11M • I ToVl¢ipir iUTHOLD +_ 0I SUFFOLK CDU,.lT'Y, WI LAND 1...i/F L15A A. 4 KEtiNE�1-1 M. BURNs� 5.figrtEr i lies80176-O3-64 h 1,6 tn ovr ,_.L. _ CJ I AREA 2 14,13051 SF (oELE�/ATICAAS 114 ASSUMED DAT Ur1. .r 2 h 130.00 f OP i'� N•84"21' E. cN. LK. Ja$. o.5'±rJ fifer Lo1.1Eb R 40 ti Q —. o f + W1k w� ISA n^ r -f 3(0 X5.10' I L meq'+ .:.r o Q Q TEST HOLE In FR. `.W B_to_p4 EL.1S-o ® Z 4' _ S a SHLD DARK sraowIJ aL- T 6ANCy LOAM fOL) 14.5 F ,o, W 0 J � pt 1 ( S c (Anil o xv• O T 0 J OC QJ yt tl 4 .1 W V 8 a d 3 .i w1oTE: " PALE eEO'JI I 3 to Q �.. EXISTING WELL USED FINE To MED. (�) S' g- p 0 ,/t u- 3 FOR 1RR16ATION SAIUD (Sr) Sit) •> al I,L IL 1 PURPo8ES ONLY. E®:O 11 sZ4"sD ) 0 L o Q S`8 V n CF; y /2.2' WATER 1N PALL • Q 5 /1V•j� l 1i SHED 1, To MED.SAND in l Z 1 (SP) v NL 2. d P20P• DNLr J. °,t z.e 0 '� I E 8E G. .U. O `1E.` II LKCOUNTYDEPARTMENTOFHEALTH SERVICES J - Zu. 3 PEIs�t�TT FOR APPROVAL OP f'.ONV-1,.A FOR A �Yl �/� 3©z� s� `1�g� 1 1 n IN[��/�{,�1E Fy,A, ILI RESIDE, C'?ONLY D {!9\ SWITCH S. W�\ j +1 'i ATE.No %\O 1, Fis ,NO. \ V pj 6 (11 / 3 4 POST n T tri ill 5 4 A PROVED11�.r.��, �[ �t Wc. 0C P2or=. FOR1:lAX fUMOF`( ,E BEDROOMS . ROOMS In �A2� Poi.E ��,,.,) . L o Ft= di [RES THREE YEARS FROM DATE OF APPROVAL r4 (1s.a) 0OAK 1 Vi Vi `1'1.8 �1�y UILKf c1� e� — p z ��' a: ivi t•I'. ..- In in IV' 4- 0' /41%, til + G E fo S• 134' 21' W. 1'35..32 f f'' I J ..., 4,-, o LA,....,,,:, hl/F AGUES 6L ' iL IL%AM ALEaRo 1 ' * uce,°- } a LOGK.+NG cAST•N4 LISA MC e • KIM Ow ELL - �..-1 To GRADE FINISHED GRADE MIN EL. 14.8 _ LA1�1D SURVEy11.1G Unauthorized alteration or addition to this survey is a violation of section 7209 of the New York f' 1 ` x 2'14 EAST MAl 1J ST. State Education law. Copies of this survey map not bearing the lad S uflYyOfa hiked M embossed P—��ITON+ ^ �_..---- ...._....L 1 6L.13.8 , e-' seal is not considered to be a true valid copy.Distances shown from property lines to existing Y4":re Ur PIT-"' j EAST l SLIP, Y 11-7-3c, II a'4' cP 1�_ � um structures are for a specific purpose and use and arc not intended to guide in the erection of fences or I t000 Ga L ST 4n";12 - I � EL. 8.8 Co 31 - 2-i') - 360S Other structures.Certification indicated hereon shall ronly to the person for whom the survey is ` 3• awns, so ATE 4.EL,.5.8 prepared and on his behalf,to the company or agencies listed hereon and to the assignees of the -- — _— 0' lending institution.Certifications are not transferable to additional institutions or subsequent SAIJ\TA,z-i sy5TEN1 PIzor/LE (N-r5) t ATE: SEPT. 2-1, 1O)C)e) (Sari ' 8-1.)--o4owners. ' a Job Klo. 1041 - raj