HomeMy WebLinkAboutHellermann, Glenn ,
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ELIZABETH A. NEVILLE �, Town Hall, 53095 Main Road
TOWN CLERK _ P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS �y, Southold, New York 11971
MARRIAGE OFFICER �
O Fax(516) 765-6145
RECORDS MANAGEMENT OFFICER 0./1�� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER :.l'l1' 4100.
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2173 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : EDWARD FAIVRE
Address 1 : P.O. BOX 229
City St Zip MILLER PLACE NY 11964
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 #R10-99-0150
Name Of Owner HELLERMANN, GLENN AND LISA
Mailing Address 1 42 TUTTLE LANE
City St Zip EASTPORT NY 11941
Property Address 1 LUTHER ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 106.00 block 9 lot 7.006
Cross Street MILL ROAD
Building Permit Number Cross Reference:
Issue Date: 10/22/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE ' y�; Town Hall, 53095 Main Road
TOWN CLERK ; p -'t P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS �. Southold, New York 11971
MARRIAGE OFFICER * 1 Fax(516) 765-6145
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RECORDS MANAGEMENT OFFICER �` �fO 1 Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER '' 416°���
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: October 12, 1999
Transmitted herewith is a copy of application No. 2260 for a Cesspool/
Septic Tank Construction Permit submitted by:
Edward Faivre for Glenn & Lisa Hellermann •
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.
4A---k-amu
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments:
ignature
0 / I ' 144
Dated
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(II I Ic.l- OF 111E TOWN LI..t_RRK< ,► �,\1ti WA's,
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T (twit I tall, 5:1095 Malls
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Construction e'1P. 0. Ilox 1179 O
AlterationS( 111( lc , 1 ( w Y( ' ( 11971
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( 516) 7(i5 1UU1 jmult(r
Noir Residential
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'TOWN U1 SOU 1.1101_1)
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SOUTI101.1) WASTEWATER DISPOSAL I)IS-f It ICT
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APPLICATION
1111
CL,7;141 �
CONSTRUCT RUC ION oi. ALTERATION ION PERMI.I-
• SFI''I 1(: I'ANI< (:rSSI'OOI �OWfJ Clerk 5afltllvl(7
Dort $ h
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APPLICANT hMAMI: : D i. (
AI PLICAN F AI)I)RESS: .Q0.:..._-. .80s.._. .�
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CESSPOOL L/
DESCRIPTION OF PROPOSI::L) CONS-I RUC-I ION OR AI..TERATION
Th!5 t- .(tt".__ .oF._.._. NLS c SP.oc _._..._.rte .1` Sirs: .....RRrtt_t>,
LOCATION M/\P: Mtist be attached hereto before permit may be Isstie(1.
• LOCATION OE PROPOSED) CONST RUC I. ION OR A1_TEUA l• ION:
OWNIER 01= PROPERTY L
OWNER MAILING AI)I)RESS:
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-I I:I_I:PHONE NUMIIER OF CONTAC:'I PER SON .
_31.75
AX MAt' NO. : Section - /pio Itl(tcic
CROSS. STREET : 01,LL. (200. ..
BUILDING I'LRMII' N11MItl_R (::ROSS REFERENCE :
e7P#(.4>-a,114,,
5iq►laIore of nl)1>licanl
I(I:CL'IVII) I)Y :
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'fowtl Clerk's Office
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Young & Young, Land Surveyors °'€
f oun>g /
400 Ostrander Avenue, Riverhead, New York 11901 P<k
516-727-2303
g g 30 / w Aiden W. Young, P.E. k L.S. (1908-1994) ;x
b Howard W. Young, Land Surveyor o
/ - Thomas C. Iloipert, Professional Engineer
/
John Schnurr, Land Surveyor
C !_s ) r y a3
Ir. lnrninq 3 ' ' now O
Dare v /O /EL`ts, S ��• „eve_Or
S/eormer/y NOTE 7 ''
0 oma `3300+f (v00p�/)dJeskig
/moo AREA = 47,007 SQ. FT. .s;
2i Li
`' ;QO - / ,, • RE: MINOR SUBDIVISION MAP PREPARED FOR STANLEY ike
SLEDJESKI & HELEN SLEDJESKI LAST DATED AUG. 30, 1977
L l A.:
Q co h a\ .---'2-PL O O vii • ELEVATIONS SHOWN HEREON ARE FROM THE MINOR SUBDIVISION €,
P
3' / °"sED \ c
/ = ° R \ 314 / F J L.
c MAP PREPARED BY US '4'g
o ^v COJ(�Q �E'RN°E.\ .2O' N4q / y0 i�ti."? r ?, ,f
3 ,° '"�e77' ' E. 3 CERTIFICATION Pr'
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� syyPrit ° g E��S�� 3 O • WE HEREBY CERTIFY TO GLENN G. HELLERMANN, et ,
0. \ ,, SIS/Fy r �Td 0,o O, 3 LISA M. HELLERMANN 6, STEWART TITLE I"_
/ �' sr c• c Q INSURANCE COMPANY THAT THIS SURVEY WAS K5,
tine s..._.. PREPARED IN ACCORDANCE WITH THE CODE OF PRACTICE FOR as
`on / „� "'"F' A�� LAND SURVEYS ADOPTED BY THE NEW YORK STATE ASSOCIATION
3 `• 4-.9., o as` 0^ `\ OF PROFESSIONAL LAND SURVEYORS. °
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2 dam, Jr N SCHNURR, N.Y.S. L.S. NO. 49517 ��If
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. r0 0 r OWARD W. YOUNG, N.Y.S. L.S. NO. 45893 .j E
114/Choe/ 0Ow 3 E o c h '0iT , �:
z J Viso or for 1'Sti Co ,o ._9.. SURVEY FOR 0
0 0 lowe/% wy 8c rheri EL$5j . i
n9 wlh P Renee ° a GLENN G. HELLERMANN & USA M. HELLERMANN Mr
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TEST HOLE At Mattituck, Town of Southold is
ti / S' Suffolk County, New York = �
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ca.C`"" SUFFOLK couNri DEWARD/BM oiffLuBiSERVICES Top SOIL 00 County Tax Map District 1000 Section 106 Block 09 Lot7.6 gr.
O. /I 05' ,,!_
. *. m TIOaAPPROVVALO III, U!UON,DRASANDY TITLE SURVEY VEg
ARC=e�n-PAWL,f1�QK'i Clii.? LOAM 3.6' kg!
0 EXCAVATION INSPECTION REQUIRED 0
cT N '� S"'Y—Q(� CLAY
+_ ��'• ,• 0 FOR SANITARY SYSTEM
W-/ 7.4'
0 -C I BY HEALTH DEPARTMENT' ,� ex,
f Y— SAND MAP PREPARED JULY 1, 1999 Bit's•
MILL R°IND POR MAXIMUM Or..,_, !!, .. k
GRAVEL x�
EMPIRES THREE TEAM PROM DATE OP APPROVAL SCALE 1" = 40' j
1-9,..
0 MONUMENT 4T • -4d11AAENT MUM A STAKE XT A-STAVE FOUND • JOB NO. 99-0407 N
7.0' DWG. NO. 990407 OF 1 O sOi