HomeMy WebLinkAboutKloepher, David OFFICE OF THE TOWN CLERK �FFo((`,
Town of Southold
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road
P. O. Box 1179 .u-3
Southold, New York 11971 01'
Telephone l
(516) 76$-1801 '
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 282 Residential x
Non-Residential
Fee $ 10.00
Septic Cesspool x
PERMIT ISSUED TO:
NAME: Liso Construction Corp.
ADDRESS: Herricks Lane, P.O. Box 439
Jamesport, New York 11947
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling with Cesspool System •
APPROVED as indicated on surve and a a. •rove• b ff. . • . - . Dept.
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: David Kloepher
OWNER MAILING ADDRESS: 221 Birch Avenue
South Farmingdale, New York 11735
OWNER PROPERTY ADDRESS: Grissom Lane
Southold New York
TAX MAP NO. : Section 78 Block 1 Lot 10,4
CROSS STREET: Sleepy_Hollow Lane
BUILDING PERMIT NUMBER CROSS REFERENCE:
• r..I
Judith T. T ry
Southold Town Clerk
DATE: January 26, 1988
(TOWN SEAL)
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''',^ j ,„ Town Hall, 53095 Main Road
ra ° -4 v_`o0''v%/ P.O. Box 728
-- ":It-' Southold, New York 11971
it,DITII T.TERRY TELEPHONE
TOWN CLF RI (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 286 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by Liso Const. Corp. for David Kloepher
Please review the application and location map and advise if the
project has received Suffolk County Health Department approval
and if we may issue the permit.
Please complete the form below and return it to my office.
Thank you.
•
egea
Judith T. Terry
Southold Town Clerk
* * * * * * * * *
I have reviewed the application and location map of the project
cited above and make the following recommendation:
APPROVE - x
DISAPPROVE -
•
COMMENTS: u.40 ,„, c cQ- h,l► 11' C4Pram.4441.. 1.3.4.A.,
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Signature
Date
OFFICE OF THE TOWN CLERK5�FFUL4
Town of Southold Q�� CSG ; Application No.��
Judith T. Terry, Town Clerk pp
Town Hall, 53095 Main Road Construction
P. O. Box 1179 `
Southold, New York 11971 ,y� ��J Alteration
alt �� Residential
Telephone
(516) 765-1801 " Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCT ION or ALTERAT ION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ l�
DATE 3r -4 .
APPLICANT NAME: \ S 0 S l . C v R P.
APPLICANT ADDRESS: RE. - {>0 30•IC 4-3C(
NS tom, r-,. ,a.r P� �=c Irl -Y ( l°'l LO .
SEPTIC /CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
\3 ‘, ‘ L C) o tee. Y-� r. .L-c p .A-L.k-Le t .
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: , 1-`Lo EQt.( FL •
OWNER MAILING ADDRESS: vA . 1 Rc..� AvL .
SD NN a c Da •LE.j N •Y //2 3S•
OWNER PROPERTY ADDRESS: G(Ztsso n L, S tld�_7 .. t .( .
TELEPHONE NUMBER OF CONTACT PERSON: 2,,z2- 4g5--/
/ao0
TAX MAP NO. : Section 78 Block p / Lot AQ, 41 •
CROSS STREET: S L Com/ y 140 La-rc=
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of A plicant
RECEIVED B ECEI4t-It_ac,1C
own C 's Offic
DATE: JAN 22 1987
7nwP Merk Southold
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C112/1L--------------12
SINGLE FAMILY D+ ' �� 3 �ft'�I v
IXPIES TWQ YEARS FF F!. ! �_ , -
SUFFOLK COUNTY DEPARTWft.T OF HEALTH SERVICES r
FOP, hPFRC'��A.L CF CCP:STr.t'"`?Cti CNLY
SLEEPY H DEL 1F= �IAAPP�,-t .'\l..
DATE (kSht l:' _________0____R,tt0 d3 R=20�
L=3142
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t APPROVED N
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n p SURVEY OF
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I he water supply n sewage dform i tthe II
Q�N', x M AP O F SLEEPY H O L L O W
terns for this residence will conform to the
a''f 63
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ac - ° to FILED FEB . 4 , 1976 FILE NO. 6351
standards of the Suffolk County Depart- Z7 S_ t$ aD (r
t of Health Services , V 3
L.0s -o AT SOUTHOLD
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FIRST AMERICAN TITLE INSURANCE
'I . COMPANY OF NEW YORK . ,
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,'Prr ' TITLE NO. 121 S 4374
` ,, DAVID KLOEPFER
�� tLANps& I ,..tCATHERINE KLOEPFER
. �4, cot $‘0
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.../ N.Y. S . LIC . NO. 49668 .77,-.?/ ���C � ��
+ fat �a Via. /-7+ RM 1/IP AA t r A/ Y. l 17 ‘
q� �' % -- 79e,
PEC 0 '�4/° 4.."'go.' "�T R S a ENGINEERS P. C. Prepared in accordance with the iti�ir s num ��
• standards for title surveys as eta'olish u by
( 516 )
�- � N C�'`N 2 0 t d
P. 0. B 0 X ' • ' the L.I.A.1.S. and approved and adap e
MAIN ROAD for such use by The New York State Land AREA = 40, 012 SQ. FT.
Title Association. ELEVATIONS ARE REFERENCED 70 AN ASSUMED CIATUM.
SOUTHOLD , N. Y. 11971
86 - 382
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