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ELIZABETH A. NEVILLE
14"$ Gy� Town Hall, 53095 Main Road
TOWN CLERK • o - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �+' Southold, New York 11971
MARRIAGE OFFICER � 1i/ � °, Fax (631) 765-6145
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RECORDS MANAGEMENT OFFICER l Telephone (631) 765 1800
FREEDOM OF INFORMATION OFFICER _ •��,�
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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. 2286 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : STEPHEN MOECK
Address 1 : 1525 AQUAVIEW AVENUE
City St Zip EAST MARION NY 11939
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 #R10-97-0175
Name Of Owner OLMSTEAD, SARAH
Mailing Address 1 309 WEST 93RD STREET
City St Zip NEW YROK NY 10025
Property Address 1 365 MAJORS POND PATH
City St Zip ORIENT NY 11957
Tax Map No. section 26.00 block 2 lot 39.015
Cross Street KING STREET
Building Permit Number Cross Reference:
Issue Date: 4/14/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE /_e *\ Town Hall, 53095 Main Road
TOWN CLERK t o P.O. Box 1179
% tiZ Southold, New York 11971
REGISTRAR OF VITAL STATISTICS %%.14,6 ��
MARRIAGE OFFICERFax(631) 765 6145
RECORDS MANAGEMENT OFFICER `. _'j101 �a��1�,, Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ...---4-....., �,,.'
ee. . ./
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: April 4, 2000
Transmitted herewith is a copy of application No. 2374 for a Cesspool/
Septic Tank Construction Permit submitted by:
Stephen Moeck for Sarah Olmstead
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
Comments:
Signat re
Dated
a
a
,,.-- --,-
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD 1O��FF��KCOI/ Application NoOC37�
ELIZAB ,
ETH A.NEVILLE,TOWN CLERK O
P.O.BOX 1179 Construction ✓
SOUTHOLD,NEW YORK 11971 = •v T
• IP ; Alteration
Telephone =,0 �F/ v'$10.00 - Residential
(516) 765-1801 : l �c' $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE Woo
APPLICANT NAME: ,STEPytA/ /'r1oEc..K
APPLICANT ADDRESS: /S-.2s- 4cioth4fiEui A-UR,
'4sT mmiau ALy. //7 37 .
SEPTIC V--CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
HgALrii ,°T, 5,EPr/L S'Y57-yi49 FaR ti's
5IAi6-LE FA-mi47 Owe Li LOCATION MAP: Must be attached hereto before permit may be issued.(Cee Arrigrf-gh\
svkv'ey
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: .:.5,r 4/4 otm stead
OWNER MAILING ADDRESS: 304 cu `/3 rd St .
1t/ Ay i a 'z s'
Yo41A-fogs OWNER PROPERTY ADDRESS: PoAio PA-71/ O�
Wit Lou) r E If r ' FA 5 Let y
TELEPHONE NUMBER OF CONTACT PERSON: 9-77' 8a -7,4
TAX MAP NO. : Section '26 Block .2 Lot 37, /3
CROSS STREET: ibtio- ST
BUILDING PERMIT NUMBER CROSS REFERENCE:
ft (12_,_
Si• ature of Applicant
RECEIVED BY. - "
Town Clerk's Office
DATE: "► d�
• '
KING SURVEY OF LOT *4
ExYELL
p S E—. SUM
UC-'o ---''fART11�'''°FERALTHlERVxR$ WILLOW TERRACE FARMS, INC'
P�IpAA'wo�'•0i•acaeixa•�fortiogA FILED IN THE OFFICE OF THE
o lAaux Ore SUFFOLK COUNTY CLERK
m t"` ° DATE 9a-91'7-0/ ON OGT.4, 1994 A5 s x512
E%1,� SITUATE: ORIENT
N P Nor X APPaOVSD_ TOWN OF SOUTHOLD
o
:L.. x,47KANzPOR MAXIMUM OF OOMSSUFFOLK COUNTY,NY
Y" �'E 73.er• EXPIRES TNYFF YEARS FROM DATE OP APPROVALO EL•
' S.9 r SURVEIED 11-4-TI
..A''' SUFFOLK COUNTY TAX MAP
Q 1000 26 2 99.155
LAND Non a ti q Cy,
(RAIN D.I AP,,.0,1/4 Z' .1.
'\1p tl
O p� CERTIFIED TO: •
_ Ivo p0h vsu
0. S MZ'3i1�a• SARAN JANE OLMSTEAD
Q.1 cs \� •- 5 PIDELITY NATIONAL TITLE
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1 NOTES.
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O 1 g 9e AREA•48,645 S.P.OR I:O02 ACRES
N o ° ■ MONUMENT POUND
A 0
TEST MOLE LOT 01 PIPE FOUND
SHOWN ON J r"
PILED MAP VACANT ;...1
WOODEN PENCE .p
e SC Io WIRE PENCE 77,.
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Z OMELL•i LAND NON ova�n� 1,✓.HnE�R x
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GRAPHIC SCALE 1"= 50 , .y.S. LIC. NO. 50202
111•10' 11901
0 50 100 150 369-8288 Fax 369-6267 REFERENCE 0 97-0066