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Town Hall, 53095 Main Road
v'Q', �� ;� P.O. Box 1179
---70/ � /10.0 Southold, New York 11971
JUDITH T.TERRY _�,,,,I,# FAX(516)765-1823
TOWN CLERK TELEPHONE(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 631 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : JONATHAN T. BAKER
Address 1 : 7 PANORAMA DRIVE
City St Zip HUNTINGTON NY 11743
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 4/11/87
Name Of Owner BAKER, JONATHAN AND CHRISTINE
Mailing Address 1 7 PANORAMA DRIVE
City St Zip HUNTINGTON NY 11743
Property Address 1 ROW OFF GRAND AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 107.00 block 2 lot 2.004
Cross Street GRAND AVENUE
Building Permit Number Cross Reference:
Issue Date: 8/01/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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.. - r a 4 Town Hall, 53095 Main Road
`a' h P.O. Box 1179
""-'- ®� a �%('6 Southold, New York 11971
ort
JUDITH T.TERRY „0„„0 TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD 10
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iik: JUL 3 I 1yy0
To: Southold Town Code Enforcement Officer 0
From: Linda Cooper, Southold Town Clerk's OfficeTOWN D gp 0�
Dated: July 31, 1990 �'
Transmitted herewith is a copy of application No. 647 for a Cesspool/
Septic Tank Construction Permit submitted by:
Jonathan T. Baker ,
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
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Signature
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Dated
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OFFICE OF THE TOWN CLERK """
Town of Southold �,' ��FF��K`►�":
Judith T. Terry, Town Clerk s`'Q Application No. Y1_*
Town Hall, 53095 Main Road ; Construction
P. O. Box 1179
Southold, New York 11971 �� yc Alteration
Telephone 0 Q �' $10.00 - Residential
(516) 65-1801 1 �*. $25.00 - Non-Residential
-- .,_l,,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL }
Permit No.
Fee $ /
DATE /7/ 45/ ?o
APPLICANT NAME: 1JI47 )\J T, L�hK
APPLICANT ADDRESS: 7 PAio2.i4t.iA D2itj
k M Jii t 1 G Tnf f r 1 3
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION R COA,45-ieUGT
A AJCW < ' ,G 5 (K.1 cco‘Det-AKW,?7/ U1/PJf tTS
A N Drt/E "'WM/ 1967U J
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: c_AVAWM(.J /but)
MAILING ADDRESS: 7?RtioteAt /4 JitiE"
u77J6lbIv 7Y3
OWNER PROPERTY ADDRESS: ROW OFF 6,QA9D /4t/E) LYI(J)1 SJ Jar s
TELEPHONE NUMBER OF CONTACT PERSON: 35/-5788
TAX MAP NO. : Section 107 Block 2 Lot Witt-
CROSS
STREET: 6-61 /1IEXJ SE
BUILDING PERMIT NUMBER CROSS REFERENCE: lei 5°�
Signature of Applicant
RECEIVED BitiCEIVED
Town Clerk's Office
DATE: JUL 31 1990
t
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f o Title No. T/284- 3006
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c2SURVEY FOR FEB. 25, /987. +x';"
NOV. 28; /986
SUFFOLK COUNTY DEI'/.,j..''_".• r" -• '7• 1i Jit\11�E$ MAR. /2 , /985 '
71 ^r^+r JONATHAN BAKER B CHR/ST/NE BAKER auG. 23, /984 •
AUG. 6,1984 i' s k W
FOR rPROVAL OF CONSTRUCT; ':",I AT MATT/ 'U.CK DATE: JULY 27, /9841• .; , � F
gle Family Residence G )ly Cf TOWN OF SOUTHOLD `
SCALE / = /00
DATE // ,�� SUFFOLK COUNTY, NEW YORK NO. 84 - 742
H. REF
APPROVED / 'rN UNAUTHORIZED ALTERATION OR ADDITION TO THIS . GUARANTEED TO = y , ,,= Itl
-�0� SURVEY 5 A VIOLATION OF SECTION 7209 OF THE ' THE OB 'F' TEE CO � Y
;,: .i i NEW YORK STATE EDUCATION LAWS. ,
____
EXPIRES T *COPIES OF THIS SURVEY NOT BEARING THE LAND .0VV j YEARS FROM PATE OF APPROVAL MOATVEYOR'S INKED SEAL OR EMBOSSED SHALL Q (y I..„
p
i MOT LE CONSIDERED TO LE VALID TRUE COPY A% y .r 41'r
II GUARANTEES INDICATED HEREON SHALL RUN ONLY TO Q 0 ,�° .is
i THE PERSON FOR WHOM THE SURVEY IS PREPARED 4 �`-
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERN- Z " 1{K=
• MENTAL AGENCY AND LENDING INSTITUTION LISTED
M NEAREST WATER ■AIN MI.- M SOURCE OF WATER. PRIKRTEPIJBLIC_ j ti� p `.:
II SUFF CO. TAX MAP DIST/ SECTION /B7 BLACK Al_LOT HEREON,AND TO THE ASSIGNEES OF THE LENDING \.e.;.*
INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE .%^ ,..:-.1!:114:44s
:S
�� THERE ARE NO DWELl11Nf WITHIN 100 FEET OF THIS PROPERTY .
OTHER THAN THOSE SHOWN HEREON. TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT
M THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE **DISTANCES SHOWN HEREON FROM PROPERTY UNEP A,�' 4,.•.'WNERS ' 9 / . x;
WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT TO EXISTING STRUCTURES ARE FOR A SPECIFIC / i' 4 .• ,
OF HEALTH SERVIC lQ+/ Xk/,�9C�E72 Cfl.¢/snNE 0.9K Ere. PURPOSE AND ARE NOT TO LE USED TO ESTABLISH ' �� ,/I ;"
r APPLICANT �� � A /��� � /Z/1_- . 3��j� PROPERTY LINES OR FOR THE ERECTION OF FENCES fl'SUVA ,� V
ADORE �4A ��ii��� -- �.1 p ,cc 1 w'�""
l 7 P�►.oeg,4a AQ v� ! .
-1 TEL
A73-9700 CHR0sn0uE •
400 OSTRANDER AVENUE
` E-lvrunNGra� N.Y. Ir7,/3 �k.)47r-9780 �/
YOUNG a 1 OUNd RIVERHEAD, NEW YORK , ..
\ NOTE: AREA: 4. 091 ACRES az STAKE •=MONUMENT . 1
ALDEN W.YOUNG,PROFESSIONAL ENGINEER
RE: LOT NO. 4 , "M/NOR SUBDIVISION RN LYNN SAN AND LAND SURVEYOR N.Y.S.UCENSE NO.12845
ANDRES. HOWARD W.YOUNG, LAND SURVEYOR
*THE LOCATION OF WELL(w),SEPTIC TANK(11T18 CESS'OOLS(CP)SHOWN HEREON N.Y.S.L CENSE NO.45893 `
ARE FROM FIELD OBLERVATIONS MOOR DATA OBTAINED FROM OTHERS
BRANDIS 1. SONS INC. 1046
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