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JUDITH T. TERRY : .0 Town Hall, 53095 Main Road
TOWN CLERK ►r P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ` .,�� Southold, New York 11971
MARRIAGE OFFICER Q �- Fax (516) 765-1823
1Telephone (516) 765-1801
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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. 833 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : LUCIA FARRELL
Address 1 : 41-44 GLENWOOD STREET
City St Zip LITTLE NECK NY 11363
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 4/21/92.
Name Of Owner FARRELL, LUCIA
Mailing Address 1 41-44 GLENWOOD STREET
City St Zip LITTLE NECK NY 11363
Property Address 1 THE SHORT WAY
City St Zip EAST MARION NY 11939
Tax Map No. section 30.00 block 2 lot 10.000
Cross Street THE LONG WAY
Building Permit Number Cross Reference:
Issue Date: 5/07/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY Z .G Town Hall, 53095 Main Road
TOWN CLERK ; p T P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ,, Un .W ;` Southold, New York 11971
t v'0 �- ��� Fax (516) 765-1823
i �,�� °'� Fax
(516) 765-1801
} ` MAY 41992
'' " OFFICE OF THE TOWN CLERK
s .1..,
a5` TOWN OF SOUTHOLD
To: Southold Town Code Enforcement Officer
From: Linda Cooper, Southold Town Clerk's Office
Dated: May 4, 1992
Transmitted herewith is a copy of application No. 857 for a Cesspool/
Septic Tank Construction Permit submitted by:
LUCIA FARRELL .
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.-,7._-6-6 C,(--"' _ 4 *1%4
Linda J. Cooper -110
* * * * * * * * * * * * C/e/tt ,p`�.,
I have reviewed thea application and location mapof the '
pp project cited above
and make the following recommendations:
APPROVE pX
DISAPPROVE
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Signature
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Dated
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OFFICE OF THE TOWN CLERK Oc��r��(k^
Town of Southold � ''Q�
Application No.��
Judith T. Terry, Town Clerk , r .
Town Hall, 53095 Main Road o f.� "'� _ /
� txz •, Construction V
P. O. Box 1179 !,
Southold, New York 11971 P- r e Alteration
. �0 �0 /
Telephone 1 xt N 1 Residential +'/
(516) 765-1301 "� Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
•
Fee $ J�
DATE ��7
APPLICANT NAME: Lucia Farrell
APPLICANT ADDRESS: 41-44 Glenwood Street,
•
Little Neck, N.Y. 11363
SEPTIC x CESSPOOL X
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION Single
family tin (2) story dwelling
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Lucia Farrell
OWNER MAILING ADDRESS: 41-44 Glenwood Street
• Little Neck, N.Y. 11363
OWNER PROPERTY ADDRESS: 133.96' w/o• The Long•'Way, North side of
ThP Short Lane, East Marion, N.Y.
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section 030 Block 02 Lot 010
CROSS STREET: he Long Way
BUILDING PERMIT NUMBER CROSS REFERENCE:_.
/
Signature of Applicant
Lucia Farrell
RECEIVED BY : �l
To n Clerk's Offic-
DATE: / f
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APR s 1992 11-\E
i SINGLE FAMILY D
S.C. DEPT. OF ' EXpIRESt 1E�LING ONLY
HEALTH SERVICES•
3 YEARS FROM DATE OF APPROVAL
SURVEY FOR
SUFFOLK COUNTY DEPARTMENT OF hEALIM aLNVICe JOHN J. FARRELL
LOT NO.9"PEBBLE BEACH FARMS" APRIL 2, 1992
•
FOR APPROVAL OF CONSTRUCTION ONLY AT EAST MARION DATE JUN. 16, 1991
TOWN OF SOUTHOLD SCALE I°=50'
)ATE APR 2 1 1Q9� ;Fi3}REF. NO.I/ SD-....:,2.:„7 SUFFOLK COUNTY, NEW YORK NO. 9i...:,9503
_ wUNGUrI N11z[o ALTER.Tl ON OR AD OI TION TO THIS CERTIFIED T. 41/4°6 OF IV.
+PPROVED I SURVEY W A VIOLATION OF SECTION T200 OF THE (
SLI JOHN J. F--RE O
NEW YORK STATE EDUCATION Loot/ ( .R W, T*
DA VINCI OW j *co►HEs l S THIS SI.SEAL NOT BESRwr, THE LAND CT'ON, Z
�`E'/ .�� d7O 0— SUR VE TORS INKED SEAL OR ENROSSEO SEAL SHALL ,r
NOT SE CONSIDERED TO RE A VALI; TRUE COPY41
*GUARANTEES INDICATED HEREON SHALL RUN ONLY TO "I O
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTPU!'i THE PERSON FOR WHOM THE SUR.FY IS VREPARED kW ic
AND ON HIS BEHALF ) THE TITLE COMP.NT,G(:VERN-
N NEAREST WATER SWIM MI • *SOURCE OF WATER:MATE_-PUBLIC__ MENTAL AGENCY AND LENDING INSTI'DTtom LISTED
Mf
Lf CO. TAX MAP DIST IOo SECTION 050 *LOCK_Q2_LOT Q� HEREON,AND TO THE ASSIGNEES of THE ',ERRING
*THEME ARE NO DWELLINNS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION GUARANTEES ARE NOT TRANSFERAILE !4 % 5893
OTHER THAN THOSE SHOWN HEREON OWNERSTO IIONAL INSTITUTIONS OR SUBSEQUENT / CFM P
N THE WATER SUPPLY AMD SEWAGE DISPOSAL SYSTEM FOR THIS RES,DENC[ q
WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT *DISTANCES SHOWN HEREON FROM PROPERTY LINES / 1, SI '
4
OF HEALTH SEMI p TO EXISTING STRUCTURES ARE FOR •SPECIFIC I i
APPLICANT, I T PURPOSE AND ARE NOT TO RE Ul EO TO ES nBI_ISN
�y�, ,\•��-/r' PROPERTY LINES OR FOR THE ERECTION OF FENCES
"4°, ESS /_i V V- /p I'` J t)C �'
1/tt/P Air CP (\t ) //3 G 3 rEL VI-440-3 0 V/ YOUNG a YOUNG 440 OSTTAANNEW AVENUE
RI ,NOTE ■=MONUMENT
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF ALDEN W.YOUNG,PROFESSIONAL ENGINEER
SUFFOLK COUNTY ON JUN.11,1975 AS FILE NO.6266, AND LAND SURVEYOR N.Y.S.LICENSE NO.12845
HOWARD W YOUNG, LAND SURVEYOR
*NE LOUTS:MOf MELLOW),SEPTIC TANK(ST)R EESSPOOLSh71 SHOWN NEREOM N.Y S.LICENSE NO.45893
ME FROM FIELD*NERVATIONS MD OR DATA OSTMNED FROM OTHERS
RRANDIS A SONS INC. 1046