HomeMy WebLinkAboutBrown, Inez • .',eltA�fFO[1(�o
JUDITH T.TERRY I o < Town Hall,53095 Main Road
TOWN CLERK k H Z ; P.O.Box 1179
't Southold,New York 11971
REGISTRAR OF VITAL STATISTICS VO y o-•06 1 Fax(516)765-1823
MARRIAGE OFFICER �Q a � Telephone(516)765-1800
RECORDS MANAGEMENT OFFICER I ' go
FREEDOM OF INFORMATION OFFICER ..1 .... ,4
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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. 1371 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : DENICOLA/BROWN-INEZ
Address 1 : P. O. BOX 841
City St Zip SOUTHOLD NY 11971
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. SCHD REF. #R10-95-0092
Name Of Owner BROWN-INEZ
Mailing Address 1 P. O. BOX 841
City St Zip SOUTHOLD NY 11971
Property Address 1 245 FIRST STREET
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 103.00 block 8 lot 32.001
Cross Street STILLWATER AVENUE
Building Permit Number Cross Reference:
Issue Date: 8/14/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY • Town Hall,53095 Main Road
TOWN CLERK ti Z P.O.Box 1179
REGISTRAR OF VITAL STATISTICS ‘10,
# Southold,New York 119711 Fax(516)765-1823
MARRIAGE OFFICER :SI a0-
RECORDS MANAGEMENT OFFICER : Ol * .,1 Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER '6,........„„ ,,i”
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: August 10, 1995
Transmitted herewith is a copy of application No. 1422 for a Cesspool/
Septic Tank Construction Permit submitted by:
DeNicola for Brown-Inez •
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 I -
DISAPPROVE
Comments: ,r„, 2 JrGA /9/�h- ?J 9
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SI ami Signature
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OFFICE OF THE TOWN CLERK ,,''""""'
Town of Southold es''���FFotkcl
Judith T. Terry, Town Clerk Ol/y Application No./ �L'
Town Hail, 53095 Main Road �' ;' `'
Construction v
P. O. Box 1179 := �
Southold, New York 11971 .. in Alteration
0 %N.' 9'� $10.00 Residential
Telephone ,y
(516) 765-1801 ~= �1 '�' $25.00 -Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
3 .
: for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE ai 1 o 1199
l..
APPLICANT NAME: De i,CO t Y ,? P0w r 'IDA Z
APPLICANT ADDRESS: 1.41524 yS -(, rt 5+ S
Ct k Lo yam'
SEPTIC CESSPOOL •
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
C;LA 1lA , / Jb1
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 2ow -Tr '2
OWNER MAILING ADDRESS: F, LO , (otic g `f I •
Set,4-1,0LN t -1,
OWNER PROPERTY ADDRESS: 2 kl f [ t r+ S
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TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section / 03 Block 0-'? Lot 32 . /
CROSS STREET: it,U I,U A 'eft- 6L)
BUILDING PERMIT NUMBER CROSS REFERENCE:
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• Signature of Applicant
RECEIVED BY: AL
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DATE: � /o ��--
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102.90
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DWELLING DWELLING VACANT
(CESSPOOL LOCATION UNKNOWN)
WELL
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SURVEY OF PROPERTY
SITUATED AT
CUTCHOGUE
TOWN OF SOUTHOLD
I SUFFOLK COUNTY, NEW YORK
S.C. TAX. Na. 1000-103-07-32.1
SCALE 1"=20'
JULY 16, 1993
JULY 20. 1995 (PROPOSED HOUSE & 0.0.11, DATA)
JULY 28, 1995 (ADDED ADDITIONAL B.0.11 DATA)
i AREA = 22,300.48 sq. ft.
0.512 co.
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CERTIFIED TO:
FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK
TITLE No. 632-S-3771
.CENTERBANK MORTGAGE COMPANY
STEVEN BROWN-INZ
` PAMELA BROWN-INZ
NOTE:
I. ELEVATIONS SHOWN THUS:0 ARE REFERENCED TO AN ASSUMED DATUM. I�I
2. TEST HOLE DUG BY•McDONALD GEOSCIENCE ON JULY 17, 1495,
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
FOR APPROVAL OF CONSTRUCTION ONLY
DATEMJS 08 1996 H.S. REF. No.I-lo=a5-oo'iZ
APPROVE
+�tF
THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD
OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS.
The water supply & sewage disposal Sys-
tems for this residence will conform to the
standards of the Suffolk County Department
of Health Service*. .
ICSill 7-1Z
?.17
~ 1995
j01
11EAlSN 'r
TEST IIULE DATA '