HomeMy WebLinkAboutSchwartz, Mark 0, °cAlfFO(
ELIZABETH A.NEVILLE , � �y Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
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c g 2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS rry
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MARRIAGE OFFICER Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER #4, e Telephone (516) 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. 1942 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MARK SCHWARTZ
Address 1 : 275 CLEARVIEW AVENUE
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 #R10-98-0069
Name Of Owner SCHWARTZ, MARK & PRAUS, LAUREN
Mailing Address 1 275 CLEARVIEW AVENUE
City St Zip SOUTHOLD NY 11971
Property Address 1 SLEEPY HOLLOW LANE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 78.00 block 1 lot 39.000
Cross Street WILLOW POND LANE
Building Permit Number Cross Reference:
Issue Date: 10/06/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE � � OGyl��� Town Hall, 53095 Main Road
TOWN CLERK p _ P.O. Box 1179
ti 2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS rr7 Fax (516) 765-1823
MARRIAGE OFFICER �=y�Ol ��,SI Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER i�
...... ',-
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: September 29, 1998
Transmitted herewith is a copy of application No. 2019 for a Cesspool/
Septic Tank Construction Permit submitted by:
Mark Schwartz •
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 „1
DISAPPROVE
Comments:
ignatu
9/4-ci/q2
Dated
OFFICE OF THE TOWN CLERK ,'•• j/
TOWN OF SOUTHOLD /441s*
��� Application No."2�1
F1.17ABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 < t Construction
SOUTHOLD,NEW YORK 11971
Alteration
• $10.00 -Residential f_
Telephone �.j' 0�•�•
(516) 765-1801 - .1 �,,�'• $25.00 -Non-Residential
• -4-
TOWN
-TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE 9./?/)
APPLICANT NAME: A44/21Z-
APPLICANT
v(4/zJLAPPLICANT ADDRESS: Z7T CC, '/, C,4 .. -' &i
S v1-1LL ti l
SEPT I CXCESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: M (/f i y( -174.4 7-7 Au1 LiY4 &,v /012 /1
OWNER MAILING ADDRESS: %7T Ci. OP& A/r_
so L1'i-hr,r9 All
OWNER PROPERTY ADDRESS: ' S( �(� Fi7)L OkiLAVC
SOI/rtiVi0.
TELEPHONE NUMBER OF CONTACT PERSON: /(44g JC ,4 "l Z_
TAX MAP NO. : Section 7 I Block 0 / Lot 3
CROSS STREET: 1/V'1(iL Glv in/7
BUILDING PERMIT NUMBER CROSS REFERENCE:
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Sign .. . of Applicant
RECEIVED BY: cje.„(
Town Cleric s Office
DATE:
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SURVEY OF PROPER T Y -
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'.AT SOUTHOLD
TOWN OF SOUTHOLD
CONTOUR LINES ARE REFERENCED TO N.G.V.D. SUFFOLK COUNTY NY
1000 - 78 - 01 39
SCALE 1" = 30'
MAR 12, 1998 N
AREA = 40,051 sq. ft. w—h-E..
P\ -oF NEw fr $
ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION S� o`,, • M�l2G 43,.f._OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW, -, s > `�43
EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS :A A,
HEREON ARE VALID FOR THIS MAP AND COPES THEREOF ONLY F 1, C..-4 >`73
SAID MAP OR COPES BEAR THE IMPRESSED SEAL OF THE SURVEYOR ��t1 , r ��j��,,,,��;,,,. S. LIC. NO. 49618
WHOSE SIGNATURE APPEARS HEREON. 114 , fi �
ADDITIONALLY TO COMPLY WITH SAID LAW THE TERM 'ALTERED BY' ''. a' Ov 'S R Y i;,''+ P.C.
MD
MUST BE USED BY ANY AALL SURVEYORS UTILIZING A COPY (51, •„ , 4'-•a
P. X �
OF ANOTHER SURVEYOR'SMAP. TERMS SUCH AS "INSPECTED' AND � Z.
'BROUGHT-TO-DATE' ARE NOT W COMPLIANCE WITH THE LAW. 1230 ' • - STREET
SOUTHOLD. N.Y. 11971
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