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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK •
O I •
P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS t!'� �� Southold, New York 11971
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MARRIAGE OFFICER �_ ,, Fax (516) 765-1823
'' �� 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. 942 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : NORA CONANT
Address 1 : 629 SECOND STREET
City St Zip GREENPORT NY 11944
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH SANITARY SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 8/3/92.
Name Of Owner CONANT, NORA
Mailing Address 1 629 SECOND STREET
City St Zip GREENPORT NY 11944
Property Address 1 4263 ORCHARD STREET
City St Zip ORIENT NY 11957
Tax Map No. section 27.00 block 2 lot 2.005
Cross Street NARROW RIVER ROAD
Building Permit Number Cross Reference:
Issue Date: 12/22/92 Judith T. Terry
Southold Town Clerk
(TOWN SFAI
*41
JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK : c=1
eZr P.O. Box 1 179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS y Fax (516) 765-1823
%kiloMARRIAGE OFFICER O 0�,�� Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK Li
TOWN OF SOUTHOLD i NOV Z THE
BLDG.
TO: Southold Town Building Department TOWN OF
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: November 27, 1992
Transmitted herewith is a copy of application No. 969 for a Cesspool/
Septic Tank Construction Permit submitted by:
Nora Conant .
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 p<
DISAPPROVE
Comments: o►.. . Cp �F�.w�i.Cri�►� ,k,Uok.c.Lo
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REMO
ccItm, j2CLA. DEC 1 1992 Sigure
It l— Clerk Southold
Dated
OFFICE OF THE TOWN CLERK c��FOLe
Town of Southold c -,;' : ` e% r.
Judith T. Terry, Town Clerk �:�s` ' 61i Application No. (h
Town Hall, 53095 Main Road , :� tics ` Construction
P. O. Box 1179
Southold, New York 11971 0jO� Alteration
Telephone / ,�1 xi �� Residential
(516) 765-1801
Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
y
RECEIVED
for
CONSTRUCTION or ALTERATION PERMIT NOV 27 1
SEPTIC TANK or CESSPOOL Southold Town Clerk
Permit No.
Fee .$ 40, -er,,,...--.--1;-.
DATE N ome.Annlrzape r 2(+, too 2_
APPLICANT NAME: Nora Cav\Qj '
APPLICANT ADDRESS: G2-c1 SECor41) STi>z '1'
C -i-i N Poe-q" (�1 1 1 q Li-Li.
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
C.c--)NST2u C-Tl o/U OF &ISA& S I NC—ME �- I t_Y le-Es I t ENc-•- • .
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: t10I21A Cor f} N i
OWNER MAILING ADDRESS: G2.9 S�cc)N� s:nz E..,1
GTtLe-sits 'Qo I2-` N1 1 tci 14 i
OWNER PROPERTY ADDRESS: 2,3 ORG
(13121EI3T N 11 GIST
TELEPHONE NUMBER OF CONTACT, PERSON: Wore; i{41. • IUD
S- or $24. 220 t C461)
TAX MAP NO. : Section 24 Block 2-
Lot 2.�'
. CROSS STREET: O12GI--Alie.i NpIig-g-ow gtv-yam
BUILDING PERMIT NUMBER CROSS REFERENCE: .
.
•
Signature of Applicant -
/ •
RECEIVED B :
I own Jerk'soffice
DATE: rr ' N - q •
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i Lot 4
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p Lot 6 NOTE
?t (VACANT) ELEVATIONS ARE REFER
N.G.VD.(MSL 19291.
4) •
—857.12 TO HALYOAKE RD. N.57°27`30"W. 821.90
n•,B •
457'27'36'W' ORCHARD STREET •
25.16' REVISIONS YOUNG & YOU
Y JUL. I, 1992 400 OSTRANDER AVENUE, RIVER:
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT 'SINL7� �AP.�It�Y bV'dE���N� �N� 1/AL ALDEN W.YOUNG
AI-NEAREST NATER MAIN_M- ±;SOURCE OF WATER PRI VATE_PUBLIC X11 Rs FRDOW oArEaF�apPRo PROFESSIONAL ENGINEER AND
;SURF CO.TAX MAP DIST 1000 SECTION DET BLOCK Ot LOT 2.005 EXPIRES
LAND 9URV EYOR.N.V.S.LIC.NO.12BA0
;MERE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY CMi� . SURVEY FOR:
OTHER THAN THOSE SHOWN HEREON. _
•THE WATER SUPPLYAND SEWAGE DISPOSAL SYSTEM FOR OHS RESIDENCE —'— • UNAUTHORIZED ALTERATION OR ADDITION TO NORA CONANT
WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTYDEPARTMENT 1 TNN SURVEY IS A VIOLATION OF SECTION
7205 Of THE NEW YORE STATE EDUCATION
OF HEALER SERVICES. LAW LOT N0.5 "SETTLERS AT OYSTERPON
APPLICANT M. NO2 aUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
N � COPIES OF THIS SURVEY MAP NOT BEARING c9‘�P
ADIGSS // :•. - THE LAND SURVEYORS INKED SEAL OR
lD2 SEGO N_D_S e . _ FOR APPROVAL OF CONSTRUCTION OPI Y EMBOSSED SEAL SHALL NOT SE CONSIDERED '
TO SE A VALID TRUE COPY. AT ERT
• Cr.Ee-n,Pop...T TEL (sic) 474. II(oS } _ ORIENT 4.0 At
A (ACJ (� • ..r. �� OUARANTEES INOICATED HEREON SHALL NUN W ER M
UG 03 "` REF, NO EMILY TO THE PERSON FOR WHOM THE TOWN OF fl ST A
NOTES Q z STAKE OAT SURVEY IS PREPARED,AND SN HN BEHALF SOUTHOLD NE'
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF • C./ ,I TO THE TITLE COMPANY,GOVERNMENTAL
�� 'AGENCY AND LENDING INSTITUTION LISTED Y• SUFFOLK COUNTY ON MAY 4,1984,AS FILE N0.7T29. ,PSDnvFD � __ HEREON.AND TO THE ASSIGNEES OF THE SUFFOLK CO., N.Y, i.
( / ` i I LENDING INSTITUTION. GUARANTEES ARC
*THE LOCATION OF MELLIW),SEPTIC TANN(STIGCESSPOOLSICP)SHOWN HEREON '/L/U.-Z 3,',. !. NOT TRANSFERABLE TO ADDITIONAL SCALE: u 1 DATE: J
ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS. ..- • • INSTITUTIONS OR SUBSEQUENT OWNERS. 1 =100 OCT. 18, 91
,