HomeMy WebLinkAboutCannell, Steven JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK v T P.O. Box 1179
REGISTRAR OF VITAL STATISTICS tri Southold, New York 11971
MARRIAGE OFFICER Fax O� � Fax (516) 765-1823
'/I�.1 �1D 66 Telephone (516) 765-1801
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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. 1037 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : STEVEN P. CANNELL
Address 1 : RR 2, 222 LAKESIDE DRIVE
City St Zip SOUTH SALEM NY 10590
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR A NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 7/29/93. SCHD REF. # 93-SO-60.
Name Of Owner CANNELL, STEVEN P.
Mailing Address 1 RR 2, 222 LAKESIDE DRIVE
City St Zip SOUTH SALEM NY 10509
Property Address 1 215 KOUROS ROAD
City St Zip NEW SUFFOLK NY 11956
Tax Map No. section 117.00 block 6 lot 13.000
Cross Street GRATHWOHL ROAD
Building Permit Number Cross Reference:
Issue Date: 8/20/93 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
K
JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK z. T P.O. BOX 1179
REGISTRAR OF VITAL STATISTICS crs � Southold, New York 11971
MARRIAGE OFFICER yQ O� �4, Fax (516) 765 1823
;'j l 'Poo"
Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD �,...._ry
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: August 4, 1993
Transmitted herewith is a copy of application No. 1067 for a Cesspool/
Septic Tank Construction Permit submitted by:
Steven P. Cannell
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
DISAPPROVE
Comments: W (IC/4) -10X9
c5'0 D 4 ,2," 9 3 - So 6 a
I
AUG 191 i /
Signatur
t
Dated
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OFFICE OF THE TOWN CLERK c,\‘;1-FZi
Town of Southold C�O, -; \ ��✓'-.
Judith--•T. Terry, Town Clerk , ' ,'"``
r", �;r . Application No./06 ?
Town Hall, 53095 Main Road c �. ,��: _ _ -
P. O. Box 1 179 u' �'� n Construction --�
_ n,
Southold, New York 11971 �`r c7 ''-�` r Alteration
'G% .0
Telephon
Telephone '°l .a4 rb-f Residential
(516) 765- 1301 ni��
Non-Residential
•
TOWN OF SOUTHOLD
• SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
----
• •
for
CONSTRUCTION or ALTERATION PERMIT
•
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE F- 4--93
• APPLICANT NAME: . ,rte •€AS P 4/\J
f,) u__t___
APPLICANT ADDRESS: Q2... c9d /-, '1&, I .
- 4 _74 ,: _..AAA /0\ Q
SEPTIC CESSPOOL
DESCRI
PTION OF PROPOSED CONSTRUCTION OR ALTERATION
Al z"/At 6[ e_ FO-t^1 ► L AA)P
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRU TION O ALTERATION:
• OWNER OF PROPERTY: > / e
• OWNER MAILING ADDRESS: •
j • z, ZZZ
OWNER, PROPERTY ADDRESS: _ U
�/ S 1�DU� D S rzio
•
• (Ar r0 i%-ILS A •
TELEPHONE NUMBER OF CONTACT PERSON: -
TAX MAP NO. : Section fr7 f/7Block
Lot / 3
CROSS STREET: 4 a 3 0 A '
BUILDING PERMIT NUMBER CROSS REFERENCE:_.
. ._
�...111( i - P •
Signature of Applicant •
•
RECEIVED BY:
61-/A-14(-1/4"
ow 1 Clerk's Office
DATE: (�, 3
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SUFFOLK CO.HEALTH DEPT.APPROVAL , ".
'14,2' H.S. NO.
• +
Pill?:MOLYC ctow
M , 1 = Pr�r- c2r�� Ea AS 714,71E TEARS R;>r DATE OF APPROVAL t
Sup_\F=;- .
-'rI. f _!i___ L .r^3f\1 f /' / I STATEMENT OF INTENT
P THE WATER SUPPLY AND SEWAGE DISPOSAL
aT I!y r—'T, SYSTEMS FOR THIS RESIDENCE WILL
I'flTiVv :::,..._,F4-70/....k:
�} • / f 11 � 1 CONFORM TO THE STANDA- ;S OF THE 1
-. ,_ *Q�O �.. SUFFOLK CO
,12 �•F HE SERVICES.�� � 1 JUL 1993 (5) APPLICANT •*
� * ,
GY SUFFOLK COUNTY DEPT. OF HEALTH
`' SC. E OC SERVICES — FOR APPROVAL OF ,,-,'
S E5
rSp CONSTRUCTIO Y �/
� ,"`.a F-(Sl-(EG... t `� ' DATE: q 93 2-9 I2
'',:.\;:,� /
H.S.REF. / Sa`_eoO 4. 9-50-08 '
9 Area=2‘,298 ts.f. (,/ ? / :. 454S-
_} 5.81'2130'E. - 141.37 -7cO. i�
Scale: SO'on 1' r SUFFOLK CTRXJMP DESIGNATION:
PAST OR
215'4o meadow i — DIST. SECT. BLOCK PCL.
507 `�...r ,--, Q rttOHQtrierr+
Il exp'n- ,,„q �..+/ /000 117 6 13
r °o N •• ` Walt OWNERS ADDRESS:
-.11:-..p.4.
_ i a cas�aool 5. CANNEL(_ 2_(Z- 2_
In N I ' ((�� �� l 222 LA�.�S(CE C2tVE
M 1 6 / \0 / SouTN S:LEMN.Y 10500)
D , • (mI.914- 1
533 2244
^1 F=f5l1EC: �� %\ r DEED: L.2278 P.Z5Y3 C t�
t'vacanfi _ _ r ig
�- -,b,-0071 / TEST HOLE STAMP ,r,
I NC'It!i E7e1(1!. 140 r';k Unautfhondaed alteration w additlori
I to Chia survey b a viole8oih d (,;
I 6 /��([}\ v� I_ Section 7208 of tlhe New York Stela •f
_I T I " V QT'f .RI r�YVI�'��YFiT Cir •ij Gd.....I�aW. ..
t 49 I ,1 N- bdd 1.2r for<r rt sea lever--* _- --- 4., Cc es of mis survey imp not boarNn
t+�,�3ec•. *'t ','+3°` `- ...'�S '44
•wq i�� ' w :` the(and surveyors Inked seal w
'+�" '�-X '�I 1 `�: � \� embossed seal shell not be aonWwsd
i G1 Ii \ t x '.�''' "\ - - Gla a to beavasd Rtie copy.
:3,, i1 �l '` "n 1`"n 't �+ yyGuarantees Yi aned hereon shall nm1 �'h \ },v:` : 5 �..""i.� ' - (o tt oNy to the person for whorn the sunnyx Qv, is prepared.and on Ns behalf to Rhe '1`� 1 �-t \ "i ^� �� / `-, titlewnhpanY�9overnnurhtalonside mtdi`'i - >Ame►tciec JV �� 7 '�' -- ...3' landing intim lfisted hereon ,3 drop iwtfl �, x• -. ,n r . - � end- r,rl-,�.�.,�tOI ,ti •' „J, ro�additionalInsuwtio sor ,4i D 141.0N.81 2130 W 1/1.37 `' , '. "1 Y�' -5"44
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