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ELIZABETH A. NEVILLE y� ,y< Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
y Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS :� vrri
Fax (516) 765-1823
MARRIAGE OFFICER �`Dy �� Telephone (516) 765-1800
FREEDOM ORECORDS F INFORMATION OFFICER NAGEMENT OFFICERT' it 01 4. 4„1 P
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2007 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MARK & HELEN LEVINE
Address 1 : C/O C. MESIANO
City St Zip EAST MORICHES NY 11940
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 #R10-98-0170
* Name Of Owner SLANETZ, CHARLES
Mailing Address 1
City St Zip 0000
Property Address 1 2510 GRANDVIEW DRIVE
City St Zip ORIENT NY 11957
Tax Map No. section 14.00 block 2 lot 3.007
Cross Street PETTY'S DRIVE
Building Permit Number Cross Reference:
*Name of owner corrected 2/22/99
Issue Date: 2/18/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
je F00(
ELIZABETH A.NEVILLE 1ti. Ot Town Hall, 53095 Main Road
TOWN CLERK c 1 ;' P.O. Box 1179
N = Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Z '^{
MARRIAGE OFFICERFax (516) 765-1823
RECORDS MANAGEMENT OFFICER ` # o!r{ 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. 2007 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MARK & HELEN LEVINE
Address 1 : C/O C. MESIANO
City St Zip EAST MORICHES NY 11940
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 #R10-98-0170
Name Of Owner C. MESIANO
Mailing Address 1 12 MILL POND LANE
City St Zip EAST MORICHES NY 11940
Property Address 1 2510 GRANDVIEW DRIVE
City St Zip ORIENT NY 11957
Tax Map No. section 14.00 block 2 lot 3.007
Cross Street PETTY'S DRIVE
Building Permit Number Cross Reference:
Issue Date: 2/18/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
lir
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trex(fFO(q O
ELIZABETH A. NEVILLE Town Hall, 53095 Main Road
TOWN CLERK % = 1 P.O. Box 1179
N
= Southold, New York 11971
REGISTRAR OF VITAL STATISTICS . Fax (516) 765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER 'y% ,p\-,cy Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ' 11'1 1 '1: i)
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: February 11 , 1999
14
Transmitted herewith is a copy of application No. 2091 - for a Cesspool/
Septic Tank Construction Permit submitted by:
Mark A. and Helen H. Levine •
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:
r-_
gtur-'
P-1 " / 1 5
Dated
OFFICE OF THE TOWN CLERK %C3VFF�(�•���
Town of Southold �� COG' Application No. Q o rl/
Judith T. Terry, Town Clerk .`
Town Hall, 53095 Main Road a
$10.00 - Residential
P. O. Box 1179 (a, $25.00 - Non-Residential
Southold, New York 11971 O O *7
Telephone .fit , '/
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
agilA-4-74-cArkojCif
ER
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
• DATE ,2111 9
OWNER NAME: M p9 rL,c A. i-1 EC.6,0 Conr-2,9 q V ENDt✓
OWNER MAILING ADDRESS: C(o C.1'463(ftrI'
12
M01 MILL, P0pD L A. E. Mn P.Ic i+€5. H 44)
OWNER PROPERTY ADDRESS: 5 7 p Gi IZikNDv iEv)
Ofivenf", N• `I.
OWNER TELEPHONE NUMBER: 277S)- 3 ?5 (
TAX MAP NO. : Section 114 Block i-- Lot .3. 1
CROSS STREET: Nil Perry'," D21VC
TYPE OF SYSTEM: Septic Tank New / Existing
Cesspool New t/ Existing
/
Residential V Non-Residential
LOCATION MAP: Must be attached hereto before permit may be issued.
(Locate building and system; give north arrow and feet
of distance, approximately, to building and closest road.)
,�L� he1
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE: x//,797
5UR Y OF LO# 3 N AMENDED II-30-913
AMENDED OI-2 1-99(HSE.SIZE)
--�,� T ORIENT" SUFFOLK COUNTY TAX*
�
=IILED AS MAP * 70153 W _ E 1000- 14-2-3.
SITUATE: ORIENT CERTIFIED TO:
TOWN OF SOUTHOLD
SUFFOLK COUNTY,NY S CHARLES A.SLANETZ,JR.
Island
Long sound
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Minimum distance between well /d` / oe\�Sl� 4r
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and cesspool is to be 150 feet. Brow
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NOTES: Lot#13 °° P45 " •
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e � ss°F 03 eat .......... ..:......
■ MONUMENT FOUNDK.
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O PIPE FOUND /y't"�1 CEHF�{.
Irar1 iia HEDGE I '1� �
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ELEVATIONS REFER TO
AN ASSUMED DATUM `• f p
fEB 1 1999 :'�►�V•. �E'
AREA=bZ63S SF OR 1.44 ACRES ICeS _ Np J '
3 k SP i
Dept Ot Waal
$ P p(1 JOHN C. EHLERS L,`S SURVEYOR N.Y.S. LIC. N0. 50202
6 EAST MAIN STREET
GRAPHIC SCALE 1°= 40' RI EAST
NS. 11701
1-----M--
---------- INIMIIM 369-8288 Fax 369-8287 REFERENCE M 98-0266