HomeMy WebLinkAboutCulkin, John 40
JUDITH T.TERRY Town Hall,53095 Main Road
TOWN CLERK c.o Z P.O.Box 1179
REGISTRAR OF VITAL STATISTICS 1 O 1�, Southold,New York 11971
MARRIAGE OFFICER �� � ��'°� Fax(516)765-1823
RECORDS MANAGEMENT OFFICER i j $ „op Fax
(516)765-1800
FREEDOM OF INFORMATION OFFICER - Si",
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1353 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JOHN F. CULKIN
Address 1 : 354 WELLINGTON ROAD SOUTH
City St Zip GARDEN CITY NY 11530
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES.
Name Of Owner CULKIN, JOHN F.
Mailing Address 1 354 WELLINGTON ROAD SOUTH
City St Zip GARDEN CITY NY 11530
Property Address 1 405 THE SHORT LANE
PEBBLE BEACH FARMS
City St Zip EAST MARION NY 11939
Tax Map No. section 30.00 block 2 lot 6.000
Cross Street THE LONG WAY
Building Permit Number Cross Reference:
Issue Date: 7/12/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
- oath
o =
/3 s--
�O Gy:
JUDITH T. TERRY • < ; Town Hall, 53095 Main Road
TOWN CLERK •
z p rZ Z P.O. Box 1179
Is' .� • Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER = 0 �" �. Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER =�'�1 `��O/'• Telephone (516)__ 765-1801
FREEDOM OF INFORMATION OFFICER �����,i,ii,"�' C. j z
OFFICE OF THE TOWN CLERK Alk 1 0 mg
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: JULY 7, 1995
Transmitted herewith is a copy of application No. 1405 for a Cesspool/
Septic Tank Construction Permit submitted by:
JOHN F. CULKIN
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 v—
DISAPPROVE �
Comments: ,, _��� 5C ,C
/
1995 _ _Air
� ,.�
Si. a re
Date
d' "
•
.
OFFICE OF THE TOWN CLERK ,,,,""""'
Town of Southold .„ �
Judith T. Terry, Town Clerk ��'� �� Ol/ Application No./ 105
Town Hall, 53095 Main Road ;��` `' Construction 1/
P. O. Box 1179 : o :' rn ; Alteration
Southold, New York 11971 1
Telephone % • $10.00 - Residential 1/
(516) 765-1801 = Ol �, ' $25.00 - Non-Residential
• — „ i0,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
NOCIIIVID
for ((JJ��
CONSTRUCTION or ALTERATION''�P LIT'
SEPTIC TANK or CESSP Chi*
Permit No.
Fee .$
DATE ( _ r- 95''
APPLICANT NAME: tT9,94/ , C (l�-frfJJ/
APPLICANT ADDRESS: 3,5'* ,P=�4...eMca7bw AD So.
GARPE,Y c./.9, lll�' /%6 3C
SEPTIC x CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
U O
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: J0/1 N /- C i -fyJ M
OWNER MAILING ADDRESS:3S* sem/=/.i...CN&7 v R 7 ,So•
GA 1%N C i Ty ,v 6/' //67g D
OWNER PROPERTY ADDRESS: 40,5 r ,,,eLr—e,Z a-..e.
P.#(- -,e F ►a- -..”'
TELEPHONE NUMBER OF CONTACT PERSON: 3-/6 Sr..?!ic'. 3 9.'6'
/000
TAX MAP NO. : Section 03 D Block 42, Lot 6
CROSS STREET: 7 G efr.„y
BUILDING PERMIT NUMBER CROSSOREFERENCE:
Signature of Applicant
RECEIVED BY: r�
own lerk's Office
DATE: 7 ' 5
. ..
•
II , I
L MAP OR PI2OPEI2TY I •
, a".` wAreca MAI1,4 I
.9UTZVEY ED F0i2.
_.
Oe Oi ,4041' THE 51-10121-- Likt-siE
li JO. N±F - CL- LidN THE
SYS1
: 0:1 295.27 TO CUI2VE CONN,A r
k 1 r_ i1-(l L01.4 WAY - CON.
-- - SUFI
I Al-
EASr PlAIZEQN
...------i.
sup
..,..„ ..,*(Y• , _ ,,o-_ F SOL):1-4QL.C), N. Y,
r..2 co,,„Ac.2, ,,,,,$) • . -.'- -;:::',NA,8,4 o 8 ___ _ , S E F
POST'S
:,..)."d: r 2 1 i tri CON
---R-` --- • - -- 45. k 1 ! .0
(.1
' .I /
,
,
4
\ ' At
r- I
i \
: 0 la, (n r la; •iSF*.IPIL---HO.
--20--I /il K
r t*-19 ;
,,, OWN
Lit 1 //
! , i48
. ,.
DEC
-; A.R.E.A i744,s4-7 5,E
TE
/ Li MONUMENT
I .
(vAcANT) .
1 izi- •
•,., i u
- I z !,•-10TES ; . •:.!
. .• , :
...
g i.LOT NIO'5,12 fi:F EL:. TO'MAC.7:0F,PE1313.;,.. ...,WC_f-i•FT,4,1/4J2I'v,I,...'.., E:i .-._-:. E,."
' .
11,4-n4
1 ff,5U----F-,:=CO3 ...L.A121‘...•51DP51C,C f4,--frIAPIC40•6a66
;uj
(.-
2ELEvAI/ON5 i2EFE12..in 1.4.1ANI SEA LEVEL.
i I
0 i c\I
MAP AMENDED- FE6.231995
.._ ......__
_ _.. __ •-'• 7-)Cif-,...,.vy.et." FE:-B, i':-.,`, ,V-2&3.)
•
i 41.* 5.:7?--6Q;"•=,/'7,8"',".--/. '4=1.-- --- - - ----
.„1. ..11. .. ___..........,... ._-_
R13:agN21( VAN4MYL,P.C.
H
:: -z. f l',/,\c-AN---) LICENSED LAND SURVEYORS
GREENPORT NEW YORK
, 1 ,
w—
: T E LED Y nli POST ,461 nu
J ...