HomeMy WebLinkAboutKoke, Alexander •
OFFICE OF THE TOWN CLERK c�FFOLA-t
Town of Southold
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971 *.$
Telephone ` "?l [ 116
(516) 765-1801 '
TOWN OF SOUTHOLD
•
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 223 • Residential • X
Non-Residential
Fee $ 10.00
Septic Cesspool X
PERMIT ISSUED TO:
NAME: John Bertani Builder
ADDRESS: 1380 Oakwood Drive
Southold, New York 11971
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling with Cesspool System
•
LOCATION OF PROPOSED CONSTRUCTION *or ALTERATION:
OWNER OF PROPERTY: Mr. and Mrs. Alexander Koke
OWNER MAILING ADDRESS: 145 Schooner Drive
•
Southold, New York 11971
OWNER PROPERTY ADDRESS : Kimberly Lane
Southold, New York
TAX MAP NO. : Section 70 Block 13 Lot 20.2
CROSS STREET: Pine Neck Road •-
BUILDING PERMIT NUMBER CROSS REFERENCE:
•
Judith T. Terry
Southold Town Clerk
DATE : September 3, 1987
(TOWN SEAL)
•
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TOWN OF SOUTHOLD : U,
�_�� ...c. Town Hall, 53095 Main Road
i'�01 Alt �����' P.O. Box 728
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,,��'� Southold, New York 11971
.1111)ITI I T TI'RR\' TELI:PHONI.
TOWN('LI RI: (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
September 2, 1987
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 226 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by John Bertani Builder for Mr. and Mrs. Alexander Koke.
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. .
eg •
ea
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 - I(
DISAPPROVE -
COMMENTS: _ 1 . .k__. • `` •' Ali.
•
\Ct.:6*A— 4)... 2...•04X,A.Z____
Signature
, C\\:1-\%-\
Dire
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OFFICE OF THE TOWN CLERK S�FFUL4
Ton of
Judith TW Terry, e SoutholdTown Clerk �O �CD : Application No. c=2
Town Hall, 53095 Main Road s Construction
P. O. Box 1179 %,>& $ Alteration
Southold, New York 11971
Telephone *1 4 N.a0 •. /
, Residential 17
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ / 2,tn.)
DATE 56,'i z , /f67
APPLICANT NAME: j op (,c,[ /E,:l,4„,4 , 544,
APPLICANT ADDRESS: /3co Q,KGcd 600 c/c
"photo ,ub y. '/97/
SEPTIC CESSPOOL /
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
foo/S 7L .5E,2/[C / "a,c /�
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: /Lid f4 /(-02$ "gt.6)(4/t /JE2 /6/(6
OWNER MAILING ADDRESS: /,[,L3T S /ko,Et2 0211/4-
'av 4 L0 � 'Of /197/
OWNER PROPERTY ADDRESS: 6K.!/340aV
goc. ti) / �t/� y. //97/
TELEPHONE NUMBER OF CONTACT PERSON: 76 /6-9Y.
TAX MAP NO. : Section 070 Block / 3 Lot Z2-
CROSS STREET: giE JJCt/! /'&4e,
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signa ure of Applicant
RECEIVED BY: :ell
n
'ler s Office
DATE:
11E SUFFOLK
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EN-CONSULTARTs
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FOR APPROVAL OF CONSTRUCTION ONLY
1 DATE HS REF. NO.
APPROVED
SURVEY OF
LOT 2
M AP OF PARADI SE BY THE 8 AY "
FILED NOV. 4 , 1976 FILE NO. 6463
AT SOUTHOLD
TOWN OF SOUTHOL D ,^-
SUFFOLK COUNTY , N. Y . ;;�:=l�~ 4I;� ;Rr�
1000 - 070 - 13 - 20. 2 �r
SCALE I " = 20 ' JUL 6 1987
DEC . 12 , 1986
HEALTH SPT OF
ERVICs •
ME LOCATION Cr WELLS AND CESSPOOLS SHOWN utNr0NARE
OBSERVATIONS AND OR FROM DATA OBTAII n FROM OTHERS. FROM 11Ete
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The water supply & sewage disposal c
tems for this residence will conform to tthhe
standards of the Suffolk County Depart'
merit of Health Services.
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rdance with the minimum
surveys as established by
d approved and adopted
The New York State Land — = P Propos c ce coq do ci t
ELEVATIONS ARE REFERENCED TO
N. G. V. DATUM OF 1929 .
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P. O . BOX 909
for such use by The Naw York
MAIN ROAD Title Association.
SOUTHOL D , N. Y . 11971
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