HomeMy WebLinkAboutMcIlvain, Bob SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3985 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : COASTLINE CESSPOOL & DRAIN SVC
Address 1: 4225 BRIDGE LANE
City St Zip CUTCHOGUE NY 11948
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 BOB & CAROL MCILVAIN
Mailing Address 1 895 DELMAR DRIVE
City St Zip LAUREL NY 11948
Property Address 1 895 DELMAR DRIVE
City St Zip LAUREL NY 11935
Tax Map No. section 127.00 block 4 lot 15.000
Cross Street JOSEPH STREET
Building Permit Number Cross Reference:
Issue Date: 10/18/10 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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••,�o��pF SO!/Tyol
ELIZABETH A. NEVILLE,RMC,CMC I Town Hall, 53095 Main Road
TOWN CLERK 4 411 , P.O. Box 1179
N Southold, New York 11971
REGISTRAR OF VITAL STATISTICS G
MARRIAGE OFFICER .O 11 Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER l Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER O�0110 ail��' southoldtown.northfork.net
viii
OFFICE OF THE TOWN CLERK ---_
TOWN OF SOUTHOLD 1
8 J
TO: Southold Town Building Department _ CCT —J
FROM: Carol Hydell, Southold Town Clerk's Office BLDG.DEPT.
TOWN OF SOUTHOLD
DATED: October 7, 2010
Transmitted herewith is a copy of application No. 3985 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Coastline Cesspool& Drain Svc for Bob & Carol Mcllvain
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 1 cation 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.
Signature
A/r/O
Dated
1,t\OIEFOLt
ELIZABETH A. NEVILLE ,``1` y Town Hall, 53095 Main Road
TOWN CLERK t P.O.Box 1179
Z ; Southold, New York 11971
REGISTRAR OF VITAL STATISTICS % n9
MARRIAGE OFFICER / Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER . 0*0 Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER - * ,,,'0 southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10 or Non-Residential @$25 Application No. 36/M---
Permit No.
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Applicant Name 0 QQ3\I`(� 1 ) of t�C
Applicant Mailing Address '(l ClaZ ( ant..
C"(-1)t � wL° \\qs
Septic Tank or Cesspool
k.
Brief Descri tion of Propose4 Construction or Alteration \ \ ( I ) X
Location of Proposed Construction/Alteration:
Owner of Property: q n , � ��c; CCA(t
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Owner Mailing Address: Aq
I-G 0,-cA . (v(1 v vg4-8
Owner Property Address: J�
Name and phone number of contact person li \- 5\U g103`
Tax Map No4.130 Section , `� Block 41 Lot 15
Cross Street aS C i- h
NOTE: LOCATION MAP MUS BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES ' R. ,Y WI ' ' EALTH DEPARTMENT APPROVAL
(011110 2/ L,t r _ (0\5\ )0
Signature of Applicant Date
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P.O.BOX 673 / iC"'_" rIIONE
NORTIIPORT,N.Y.11768 LAND SUIIVEYOIS (516) 754-0733
LIC.NO.46021
SURVEY OF LOT(s) 6 BLOCK
MAP OF LAUREL COUNTRY ESTATES
LOCATION LAUREL, TOWN OF SOUTIIOLD, SUFFOLK CO. N.Y.
DATE 6/13/91
CERTIFIED ONLY TO FIRST AMERICAN TITLE INS. CO. OF NY, ALL STATE ABSTRACT
CLARE BARBADILLO
�p--a- ��- -,. TITLE //630 S q619 OLI
NOW OR FORMERLY OF ROMANOWSKI
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LINES ARE FOR A SPECIFIC 111R• I
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ARE 001 INTENDED 10 GUIOE IIIE
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AREAS, A00111011 10 BUILDINGS I
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Unauthorized alt ion or addition to lhi.survey Ira violation Guarantee Indicated hereon shad run only to the potOn for
of Section 7209 of the N.w Yotk State Education Law, Copies whom the survey it prep.r•d, and on Ida behalf to th•Title
of tide Survey Map not bearing the Land Surveyor's Inka11 Seal Company, government Agency and L.nding institution listed
or Ernbottad Seal shall not be eonsldored to tut a valid Nu1 copy. hutaon, •1111 to the Assignees of this Luullng Inatltulloo.
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