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ELIZABETH A.NEVILLE .ZO/ `----,
Town Hall, 53095 Main Road
TOWN CLERK c -4 P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS17
MARRIAGE OFFICER O ,O Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER Telephone (516) 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. 2045 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : WARREN STEINERT
Address 1 : 605 GROVE ROAD
City St Zip SOUTHOLD NY 11971
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 #R10-99-0016
Name Of Owner STEINERT, WARREN
Mailing Address 1 605 GROVE ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 DUCK POND ROAD
City St Zip CUTCHOCUE NY 11935
Tax Map No. section 83.00 block 2 lot 19.013
Cross Street DUCK POND ROAD
Building Permit Number Cross Reference:
Issue Date: 3/23/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE ,��0 l/y� Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS N Southold, New York 11971
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MARRIAGE OFFICER 0 Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER �4 ,� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER • ,�� ���
'• . • •
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: March 19, 1999
Transmitted herewith is a copy of application No. 2127 for a Cesspool/
Septic Tank Construction Permit submitted by:
Warren Steinert
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.
641L5e-e'
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments:
�Signatur ,�/ 4-4.(4-1
, /
Dated
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OFFICE OF TilE TOWN CLERK �,��'' c0f0U(6 Application No. q?�ol�
TOWN OF SOUTHOLD %` O G '
ELIZABETH A.NEVILLE,TOWN CLERK ,
P.O.BOX 1179 , ` Construction i --_
SOUTHOLD,NEW YORK 11971 0
.
Alteration
01
Telephone Dijj� Q�,
�i' $10.00 -Residential '- '
(516) 765-1801 - Ol 1�'' $25.00 -Non-Residential
-- >,''
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
MAR 1 9 199
Permit No. lows ClerK Joumold
Fee $ Q
DATE -5- l9 - ! 7
APPLICANT NAME: (f ...)C.-t--Nr-re--9/‘ S-6. 1 AC-r T
APPLICANT ADDRESS: (, 7D rc /e_ r8-'
�3o0-300 - j y3 -y_. in r1 I .
SEPTIC CESSPOOL
DESCR PTION OF PROPOSED CONSIRUCTION OR ALTERATION
V)425...ALD Uie- \ 1 n5
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: LO�y-may\ 5{eA.v\ .,,-+
OWNER MAILING ADDRESS: GO3 r-p✓, rc�..
3 4-�tL , ik 1 ' (
OWNER PROPERTY ADDRESS: butic fb,„ . x 1.
Go-k_li\owe_ , u3 A�
TELEPHONE NUMBER OF CONTACT PERSON: r 5 - G3O5
TAX MAP NO. : Section P3.3 Block Lot 1 6;13
CROSS STREET: .4N Calk- coUl-c 1�o
BUILDING PERMIT NUMBER CROSS REFERENCE:
r ('\
A X i,,,.. ..,_ -,1f5)-3 -L
Signature of Applicant
i , 0
RECEIVED BY: Illy 4
own Clerk's Office
DATE: 3VI\c‘c
A
.11
SURVEY OF PROPERTY N
SITUATE: GUTGHOGUE
TOWN OF SOUTHOLD W E
SUFFOLK GOUNTY, NY
S
SURVEYED 12-1?-98
SUFFOLK COUNTY TAX k
1000-83-2-19.13
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4 edge of mowed lawn j
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_ �9 ` Test Hole from
40 , 4�' "JO• MacDonald
l G`��q/��.� GeoSclence
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Bre.CERTIFIED TO: ""
WARREN STEINERT
SUFFOLK CO BEPAR 'MF h'T OF HEALTH SERVICES
CAPITAL LAND SERVICES PERMIT FOR APp',:,I'?VAI'OF(:OXSTRU:'ITODi FOR A .aa
SUFFOLK COUNTY NATIONIAL SANKLY
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Apr:C,�_si-_ _. -,.,:,,,,.,. ,,,....(_...-,e,/-
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NOTES:
I Fi 'c1 i ire1r^. BROOMS n.0
EXPIRES THREE YEARS FR:3141 DATE OF APPROVAL
• MONUMENT FOUND
O PIPE FOUND .Test "
I;la::LUa.L HEDGE .,.....«.�«.�,««...«...««
AREA= 40,133 SF OR 0.92 ACRES ..' 0 NEly-_ i.;, W "
A.:Cr C.E l' r,%.,.... ::I:.Pa„.««i.
is EIA.I «.•:::::4,12../Euii` «.i •
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wiV.e!��''ii �` N.Y.S. LIC. NO 50202
JOS►: ',
rugr-
RIV • /..VEVOR
GRAPHIC.SCALE I"= 40' 6 E"E• .y '
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369-8 - abA l99'r 'c7 REFERENCE N 98-295
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