HomeMy WebLinkAboutMeyer, Kenneth (2) t
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ELIZABETH A.NEVILLE 4 h`1`1 �f.�; Town Hall, 53095 Main Road
TOWN CLERK p P.O. Box 1179
C/3 2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS s-
MARRIAGE OFFICER 9 1 Fax (516) 765-6145
RECORDS MANAGEMENT OFFICER �41* aO1/11 Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER = ' I
-0
FREEDOM 1�11
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2182 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : KENNETH J. MEYER
Address 1 : P. O. BOX 1238
City St Zip HOBE SOUND FL 33475
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 #R10-99-0188
Name Of Owner MEYER, KENNETH J. AND CAROL M.
Mailing Address 1 P.O. BOX 1238
City St Zip HOBE SOUND FL 33475
Property Address 1 630 THE CRESCENT
City St Zip EAST MARION NY 11939
Tax Map No. section 30.00 block 2 lot 30.000
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 10/25/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
x•••01 UFFo4
ELIZABETH A.NEVILLE '�'Z\ Ot% Town Hall, 53095 Main Road
TOWN CLERK 0 1 P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ,'% Southold, New York 11971
MARRIAGE OFFICER
Fax(516) 765-6145
RECORDS MANAGEMENT OFFICER ;Wig ` S .o' Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER = '� * e i
,"
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: October 22, 1999
Transmitted herewith is a copy of application No. 2271 for a Cesspool/
Septic Tank Construction Permit submitted by:
Kenneth J. Meyer
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.
4
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments:
Si nature
(di).-514 q
Dated
a
OFFICE OF THE TOWN CLERK ',l,C�OgUrG _
TOWN OF SOUTHOLD ,�t' /1 QGy�' Application No. a a7 J
ELIZABETH A.NEVILLE,TOWN CLERK44'
P.O.BOX 1179 Construction
SOUTHOLD,NEW YORK 11971 . 0 `
IP W Alteration
Telephone °,j%, � iit �Qr�;� $10.00 - Residential (y______,(516) 765-1801 .�
, ,,,,��. $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE /o • aa • Qy
APPLICANT NAME: / /Y/v'L-7 H 4 • `^'! EYL�
APPLICANT ADDRESS: ,'oi3ox i s
flwdg c�d 0 t-v f-�� 3 E `l 7.5_ - /A3
SEPTIC CESSPOOL (-- ---
DESCRIPTION
--�DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
. ' ti.
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: /.4 yAyt-"-j ,J d erq29L N. HL-L-
OWNER MAILING ADDRESS: 6 eox 138-
f /3L- (Poem--v --/ 33475- /. , 3k
OWNER PROPERTY ADDRESS: 3v - 77:-/&- e2 cscL-Ti
:- sr 1--1 /a/0/1- Ngo
TELEPHONE NUMBER OF CONTACT PERSON: e5-6 / - ..Z 8g • 6 897
TAX MAP NO. : Section 30 Block 02 Lot 30
CROSS STREET: /(-1/9//v jeo4�
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signatur o4Applicant
RECEIVED BY: ES
Town Clerk's Office
DATE: 1C)/2----0--•-7�
-
, i
I am familiar with the STANDARDS FOP APPRC'\a_ - --
CONSTRUCTION OF SUBSURFACE SEWAGE
DIS SURVEY OF PROPERTY
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES
and will abide by the conditions set forth there,n and on the -
permit to construct AT E'AS'T A[AR�IO/N 7�
The location of weds cr'a cessaoo's srawr nereor cif' ���w �F ���L'H//7-�
trorn veld crser:ot,ors lr.; ar C_ ; ::c':'—ed - •,,
l� 4 {/L/
Eie.ations are referercec to or�assur"e.c dat;� SUFFOLK COUNTY, NEW YORK
1000-30-02-30
mpe' 'er tr1a;, -erT e = j, SCALE: 1'=40'
e. AUG. 31. 1999
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OCKs-. ��t.ME TZC��4 .
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�P. /' %2j 96` ;44i. NO. 49618
ANY ALTERATION OR ADDITION TO THIS SURVEY S A JIOLATION 'ECONIC Sir:'ra4W
OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW
\ EXCEPT AS PER SECTION 7209—SUBDIVISION 2 ALL CERTIFICATIONS (516) 765 — : - 1
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF P 0. BOX 909
AREA = 20.703 ft SAID MAP OR COWES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1 230 TRAVELER STREET
• �� WHOSE SIGNATURE APPEARS HEREON1,99.�
SOUTHOLD, N.Y. 11971
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