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HomeMy WebLinkAboutNosk, Walter ELIZABETH A.NEVILLE Town Hall, 53095 Main Road TOWN CLERK y Z P.O. Box 1179 �. rrii Southold, New York 11971 REGISTRAR OF VITAL STATISTICS ! '1 MARRIAGE OFFICER �� y �1 Fax (631) 765 6145 RECORDS MANAGEMENT OFFICER \ Ol $i ��� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER � OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 2443 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : ROBERT SWEDBORG Address 1 : 40 TWIN RIVER DRIVE City St Zip OAKDALE NY 11769 Descripton of Proposed Construction or Alteration SANITARY SYSTEM FOR SINGLE FAMILY DWELLING. APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES. REF #R10-00-0208 Name Of Owner NOSK, WALTER Mailing Address 1 27 LEE AVENUE City St Zip BABYLON NY 11702 Property Address 1 830 ED'S ROAD City St Zip SOUTHOLD NY 11971 Tax Map No. section 79.00 block 6 lot 34.000 Cross Street SUMMIT ROAD Building Permit Number Cross Reference: Issue Date: 10/30/00 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) 311101 ,I,,o��$�FFO(,�co G.: ELIZABETH A. NEVeLtE + ���= y� Town Hall, 53095 Main Road TOWN CLERK .�..1 y Z P.O. Box 1179 REGISTRAR OFVITAL atl .I SKS A t� Southold, New York 11971 GT t9L� :,. 1i �`�'1� Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER �__*Ol �a0��,� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER �.: .,•,o" OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: October 24, 2000 Transmitted herewith is a copy of application No. 2531 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Robert Swedborg for Walter Nosk 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. Linda J. Cooper * * * * * * * * * * * * I have reviewed the application and location 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 (4. I a--- (a a Dated -11 • OFFICE OF THE TOWN CLERK •'•' — TOWN OF SOUTHOLD �%.• .�J CQG Application No. 2�3 ELIZABETH A.NEVILLE,TOWN CLERK n , P.O.BOX 1179 ; Construction 'Vx` SOUTHOLD,NEW YORK 11971 • • Alteration ••, • $10.00 - Residential Telephone --- 0/ ��� (631) 765-1800 -=y�1, �;,I•',� $25.00 -Non-Residential • -- >l' TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee .$ DATE X16 .23/0 APPLICANT NAME: RC)/De(---b Swedb() APPLICANT ADDRESS: ya u01 h kWer1)r11-e_. Oadd , A/ l • 111'0 / 79 SEPTIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION -4 T i i7 LOCATION. MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: (I)ri l-i r 1\1os OWNER MAILING ADDRESS: a`7 Lem AV e_ eyi r-) n nada OWNER PROPERTY ADDRESS: ' 'J � 30 �� Road Sou-1i0 id TELEPHONE NUMBER OF CONTACT PERSON: Cc 3 / S 7 - / (o77 TAX MAP NO. : Section 77 Block 06 Lot 311 CROSS STREET: 6com,14 k BUILDING PERMIT NUMBER CROSS REFERENCE: 1 IO- 00-Oaco ,-4/„d • Signature of • .plicant RECEIVED BY: Town Clerk's Office DATE: /0/93X,.. I0/9-X 6 ., 0 SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES PERMIT FOR APPROVAL OF CONSTRUCTION FOR A o- 'LE FAMILY T�i�.SIDENCE ONLY • . . . DATE, l0i'6 O© HS REF.NO. (0 __/-02C? APPROVED tAa■fi 'A ,r► • FOR MAXIMUM OF @iROOMS • • EXPIRES THREE YEARS FROM DATE OF APPROVAL • • ' ,. unaumonze• Iteration or addition - : is a violation of 206 of tel New York Stale �.,� VJ ,on law. • - /�/-� Copies 01/nes-ower mop not Wiring Veil/C OL0/<//.9L •G L/. N ( c ) the land surveyors Inked sed a .mboeeed sold Wad notal.considered V to be a veld Me espy. 13 Ouaramess Itltiloetud Moen shed tun only to the person Ow whom Ow WM/ r• /4///CJ'(�i9tet /VO/O.0 N i d ae�o6fi�oweilti::::;« ►NW `9 4tending Institution Med herein nl to me assignees al the lending Inlde/on• V ,i i wnntees w rot ttwgrabN }. \*' s•z 96.17 Z� W /0o•© sddidonal institutions a subeetFMnt � j twnerl. 4— • pilon,, ao yF Q 1,)1 Zb' ---------•-- --- . i' t..,.., ‘sa-4 I-- , kb N .\.) iAl ' k . '`V It! 40 'A tt e ' o 1\4 ' %I ____. 6______t b n► 3 �' .- o F� N W �� //29°J 7'Zc"t /oo,o V Tow,v a"c" �ve)ryatp t4 kl:' (✓, ,c,1./T-J TWT,&& ., y LE 1Y6 04 ,8filw.ve9e7Y 3 O o e v vo vir> o ,1.1 A 9 5 = tr 4~ 4,0,i4,-;.:'1,41L,�,, "':.,Fid' g-Pe `,Save / C,r-Inds ., .5941M1/7 ,70 , . f" -,� ,,, .�o• �w 'I), c3eg° — /7 Qu ry6'Y ,, o :C7 v 'GrJ-C .: 4A/M X/e j- 447(4411ZP ,ti. ,t/ ycte CcY•yfAv'• Sov�?CGo �v �rx.0 Cou<!7j�-Y% "AA).-1, . W 19 dt:.54'3,7vno X./9Gd',/"'rya' p•/,811H/S,