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Home My WebLink AboutMonahan, Jennifer SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 3990 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : JENNIFER MONAHAN Address 1: P 0 BOX 795 City St Zip CUTCHOGUE NY 11935 Descripton of Proposed Construction or Alteration ADDITION TO EXISTING SYSTEM. APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION REQUIRED. Name Of Owner JENNIFER MONAHAN ------------------------------ Mailing Address 1 P 0 BOX 795 ------------------------------ ------------------------------ City St Zip CUTCHOGUE NY 11935 -------------------- -- ---------- Property Address 1 1100 STERLING ROAD ------------------------------ ------------------------------ City St Zip CUTCHOGUE NY 11935 -------------------- -- ---------- Tax Map No. section 104.00 block 4 lot 11.000 ------ --- ------ Cross Street SKUNK LANE ------------------------------ Building Permit Number Cross Reference: ---------------------------------- Issue Date: 11/03/10 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) o��OF SO�Tyol. ELIZABETH A.NEVILLE,RMC,CMC O Town Hall, 53095 Main Road TOWN CLERK l l P.O. Box 1179 REGISTRAR OF VITAL STATISTICS y Southold, New York 11971 MARRIAGE OFFICER COQ Fax(631) 765-6145 RECORDS MANAGEMENT OFFICERl Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER �COWsoutholdtown.northfork.net OFFICE OF THE TOWN CLERK D E " E � V TOWN OF SOUTHOLD OCT 2 7 2010 TO: Southold Town Building Department BLDG.DEPT. TOWN OF SOUTHOLD FROM: Carol Hydell, Southold Town Clerk's Office DATED: October 27, 2010 Transmitted herewith is a copy of application No. 3990 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Jennifer Monhan 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 Carol Hydell * * * * * * * * * * * * I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE DISAPPROVE Comments: Maintain required setbacks from adjacent wells buildings property lines and water Bodies. EXCAVATION INSPECTION REQUIRED. ti Signature Dated c ELIZABETH A.NEVILLE Town Hall, 53096 Main Roe TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER Fax (631) 766-6146 RECORDS MANAGEMENT OFFICER y�fQ �O�` Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER '� �` southoldtown.northfork.nel OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @$10-y- or Non-Residential @$25 Application No. 3 (` Permit No. ��' Applicant Name yy\k4e'c MOV\0 `%0_V\ Applicant Mailing Address l •G - F>0)( Utc'6%u - Septic Taiilc�or Cesspool Brief Description of Proposed Construction or Alteration Qe(�Otc� t3}�tit�, vq- s Usk (� Coastl�ae. l x�„ti{ 5 6- °la 3 15 39 Cc pk Location of Proposed Construction/Alteration: Owner of Property:_ j.e_V\1tii-f 2 C Mo V\0."� U Owner Mailing Address: R O 1115 Owner Property Address: OC `-tCrlIlkI Boa- , Name and phone number of contact person (c3 l- D _11 -3 -0-jje�; Tax Map No: 10M Section Block� Lot CC QQ_ Cross Street S"j,,ILaJAk NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL / __'_ . Si f Applicant Date Received by: J IIm Sfi QQ RDS. -1-2 loo 40 .y �6 � I S a , 61 AW t000 (-AL 17A I,- SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 4426-R Residential X Non-Residential Fee $ 10.00 New X Existing Name Of Owner JENNIFER MONAHAN Mailing Address 1 P 0 BOX 795 ------------------------------ Mailing Address 2 0 n o,�)a-Y ------------------------------ City St Zip CUTCHOGUE NY 11935-0000 12-010 -------------------- -- ---------- I Property Address 1 1100 STERLING ROAD ------------------------------ Property Address 2 ------------------------------ City St Zip CUTCHOGUE NY 11935-0000 -------------------- -- ---------- Owner Telephone No. 631-734-4289 ------------ Tax Map No. section 104.00 block 4 lot 11.000 ------ --- ------ Cross Street SKUNK LANE ------------------------------ I ---------------------------------- i Issue Date: 12/08/10 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) ELIZABETH A.NEVILLEco� Gym Town Hall, 53095 Main Road TOWN CLERK W $ P.O.Box 1179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 -6145 RECORDS o RMANAGEMENT OFFICER RIAGE OFFICERy�o® ��0�� Tele Fax n5 Telephone(63 31) 6765-1800 P FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION OPERATION PERMIT ! CESSPOOL or SEPTIC TANK Residential @ $10-)Lor Non-Residential @$25 Application No. Permit No. Owner Name J1ex*\'k4.r Owner Mailing Address Q 50 X I CiI,LfCkO 6AaAe , OY I 3S Owner Property Address StC'-o'L'�' R D 0 I I I -S5 Owner Telephone No. rp �]3 q"- 14 9101l Tax Map No: Section l ')C'0" 104 Block 4 Lot Cross Street Skin_ Uwke, Please check each that applies: New Construction 1v,C Ce-syd— meets 1-e-pItw_-ek 11� Alteration to Existing System t, 3 c(�czr se Su • Residential _Non-Residential NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. (Locate building and system; give north arrow and approximate distance in feet from system to building and closest road. New construction may submit copy of survey with SCHD approval.) C Si re of Applicant Date Received by: a a � T ; , ® I000 G-AL.�-- NUJ VDX6 Ccs s Pao Ce- P t 1 or-2> ANn FIU E j �ato p x � f ' r,U55f6 L- ' A S m � } k t i Y } 3 y} l � E tl y I- - --- - o14 r ..o tJ ' A Lr jp Ar r Ir � l N v IS p ° b ` . 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