HomeMy WebLinkAboutMartin, James • %pV SOUjy-
ao ELIZABETH A.NEVILLE r� l0 : Town Hall, 53095 Main Road
TOWN CLERK ; JutligP.O. Box 1179
coSouthold, New York 11971
REGISTRAR OF VITAL STATISTICS ; G Q
MARRIAGE OFFICER Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER l /io Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER -#COUN 1 l,VIII1 , southoldtown.northfork.net
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3430 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JAMES AND DENISE MARTIN
Address 1: 11 EAST 68TH STREET - APT 8B
City St Zip NEW YORK NY 10021
Descripton of Proposed Construction or Alteration
-NEW 6 POOL LEACHING SEPTIC SYSTEM W/ SEPTIC TANK
-FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENTS
Name Of Owner JAMES AND DENISE MARTIN
Mailing Address 1 SAME AS ABOVE
City St Zip 0000
Property Address 1 129 SUTER'S RIGHT OF WAY
City St Zip MATITTUCK NY 11952
Tax Map No. section 116.00 block 4 lot 31.000
Cross Street
Building Permit Number Cross Reference:
Issue Date: 4/27/06 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
•
��,•o��pF SOulyol
ELIZABETH A. NEVILLE '` ( Town Hall, 53095 Main Road
TOWN CLERK * • P.O. Box 1179
REGISTRAR OF VITAL STATISTICS
�n �r Southold, New York 11971
MARRIAGE OFFICER its ..% •1 //� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER `► NW. ���� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFER UUNT`I,,.of southoldtown.northfork.net
...
OFFICE OF THE TOWN CLERK
APR _ 7 TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED:
Transmitted herewith is a copy of application No. 3585 for a Cesspool/Septic Tank Construction or
Alteration Permit submitted by:
James & Denise Martin
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: , =4.4-.:6-0 :2a
/.
-71ede -9
Signature
e9 V/
Dated
OFFICE OF THE TOWN CLERK �' � •
TOWN OF SOUTHOLDt
�•�rwFFOLkc�y_. Application No. / 1
ELIZABETH A.NEVILLE,TOWN CLERK 0.
P.O.BOXi179 = Constructio
SOUTHOLD,NEW YORK]1971 P rn
•
(.11(.11Aiterafio
Telephone ,�� %O. $10.00 - Residential _
(631) 765-1800 _ Afit It'
00 $25.00 -Non-Residential
•
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. •
Fee .$
DATE 100 LP
APPLICANT NAME: jai4$QS (�e't c- filarLi-
APPLICANT ADDRESS: I \ O (Q( ,S4• • 4-pA4- ei
t\)i K)1 i 06D. 1
SEPTIC*CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
i
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
• OWNER OF PROPERTY: JSi +
OWNER MAILING ADDRESS: 11 &kik ( ; -,yi.- �'T3
i o-oa ► �"
OWNER PROPERTY ADDRESS: , 'a°1„ SuriS 634+4
W 0
144 Q . , N
TELEPHONE NUMBER OF CONTACT PERSON: —73tf' OIKC
TAX MAP NO. : Section 110 Block Lot 3
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE: . IR 30000 ?-
OP
OL7Q0O •
fro,
ignature of Applicant
RECEIVED
Town C erk's Office
DATE: 17/7&
li
miN.r.12', &RADE LINE ELEVATION ±II.25 Pr. .:. Oyu I NH ff I ISVIIP•I I 1:10.4...3 I
PROPERTY: 129 sutoris Right of Way
ADDRESS Mattitudic,NY q
-.............:
OWNER: JIM'S P. &Deltlise N.Martin
( I/4'mT. 145 East 81st ., NY, NY 10028
I " . , TOP eyr Foot_ lam FT.
SITE: 160,781 SQ. FT. a 3.69 ACIIES
SE'PT'IC .
LEAGNIN6 , . 7 AR
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Agricultural Conservation(AC) IL '
IE. +II 2.5' IE. 4111.161 X
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•,,,..._. ............ 61101.1412-1T. ,f, t- A 2'ii ,,L,.n,''';',- SURVEYOR: John C.Ehlers C
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EXPIRES THREE VF.1.7... 5M DATE OF APPROVAL
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SEPTIC PROFILE RESIDENCE - . NT -,,, - ",','' 0414,- ‘14K *
, ,' '','•- ' -.4,.. ....,.'.4.s LICENCE NO.50202 2
46 DATED: 05/21/02
(N.T.S.)
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