HomeMy WebLinkAboutFisher, Robert ,�o�FLc� F O k i
,44 �Gy,
JUDITH T. TERRY 0 :C Town Hall, 53095 Main Road
TOWN CLERK Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS rT+ Southold, New York 11971
MARRIAGE OFFICER Fax (516) 765 1823
%°40 ��0� Telephone (516) 765-1801
sig 1 ,1
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 732 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : ROBERT FISHER
Address 1 : P. O. BOX 962
City St Zip RIVERHEAD NY 11901
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 5/2/91 .
Name Of Owner FISHER, ROBERT
Mailing Address 1 P. O. BOX 962
City St Zip RIVERHEAD NY 11901
Property Address 1 435 HUMMEL AVENUE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 63.00 block 2 lot 16.001
Cross Street YOUNGS AVENUE
Building Permit Number Cross Reference:
Issue Date: 7/01/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
____ _
- r.:.,,k , ,_:‘e
.,,,,
A- ..,,
:-e-et.
..‘
„,,, , ....,, ,,, -, .,-„,...%
, _.___;;,z laid r
44 = t' —mac
' Town Hall, 53095 Main Road
` P.O. Box 1179
;,/ Southold, New York 11971
JUDITH T.TERRY ''a•;- _ ' ; F TELEPHONE
TOWN CLERK if I, i! 0161V-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERKV 5,,�`;,
TOWN OF SOUTHOLD ' JUN 2 01991 --7_3
3----
. ,
,..., „,
To: Southold Town Code Enforcement Officer z ,
From: Linda Cooper, Southold Town Clerk's Office
Dated: June 20, 1991
Transmitted herewith is a copy of application No. 750 for a Cesspool/
Septic Tank Construction Permit submitted by:
Robert Fisher ,
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 X
DISAPPROVE
Comments: a,,,, ,,,,. t,i>\Y.n.el e l'o,c�•a.& %1/4.A.Axx.1 9-
GirA-L).5a Slx-1/4. 11(&)).0..‘t .,1, i‘sk. . .slszl--, oN,
s•\�`t11
..c 1 cam. a.4,,D.-
Signature
(0) 2s' 9i
Dated
•
.. •'' ,
OFFICE OF THE TOWN CLERK O��FFUL4-ZO
Judith
Town
T. TerryO11Town Clerk nF -`h;,.•��s . Application No.
?s0
Town Hall, 53095 Main Road c,�•�•�.;t ; .� '�
„ �� Construction ,-------
P.
P. O. Box 1179 0.1.”
. � ' t71-'''
,!�
Southold, New York 11971 �• �_ Alteration
Telephone
r( �.a� Residential
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DA E4
APPLICANT NAME: fa lJ -/1 3
ey-
APPLICANT ADDRESS: h Ci (0.)
' ) elhems-
'/ 1 q l
SEPTIC !� CESSPOOL (/r-
DESC�T`ON Q�PROPpSED NU
CIAG'f �/V�OR A ERA-fieulABION
ikiclitAi<
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONST C IONR T RATION:
JI'tbe/OWNER OF PROPERTY: , `The{"
OWNER MAILING ADDRESS: ,9 0)C ?•(;# a
ai,p1 iergALY /(91
OWNER PROPERTY ADDRESS5 (Of � e�� ciao b`c
Irl
TELEPHONE NUMBER OF CONTACT PERSON: --D . 1 --- -----6 6 l
TAX MAP NO. : Section (72) 10 -S Tock C") .„1- Lot ) (p , I
CROSS STREET: Y)N,A,--0 9 .i
•
BUILDING PERMIT NUMBER CROSS REFERENCE:_. e , 7S` .
Si natelf%
/ ) � t
RECEIVED BY: LU/Wk-f-
/
o n Clerk's Office
DATE: 6 GJ`
(Tel
•
y ' (VACANT) I �_ I! I i VW `.
I66
N/O/F JAMES M. GRATTAN ,'''
1 ' _-----,--1.0'
----1'I I'
N 70' 45' 10" E 142.00' a----
LO ..37.6 J'\ !74 377 "FE
O
SHED 1
0 LSI
P. __. OUTHOUSE
VV i.0 W
OE
Fit
11
Z
h
y 0
R .1 ae N Y
Y
a N I� y Wcx
W W
2 W Ir° lc W
=
Q N--O.IE � Q
w Y
a 's )c as IN Z m P?CrL '/r•I'o z ® C7
Q O4 `n • W W Z s
Jy
.3I3 Q 4. W
> c '' • 3S
i. O
3 .• , Q _
R LI W Oh 20 X10 a tu
W j
a
0 ! J
I
it IOt 2 1 _
L[ rP
* q Se,r„ ',op
� ..., O cy''>`ern
i .z
. i h
32 0.7" PPEFRO .37 2 37 0 3('`6
LOT •
-
•
142.00' S 70 45' 10" W
1WATER MAIN AP?ROXMATE LOCATION
RUNNEL AVENUE •
TEST
DORMS
• !LO 36.7 363 DATA
ITOISOL 0.?"(
LUMBER YARD 1
SUR VE Y OF LOAM ,.
USES PUBLIC MATER PR OPER T Y
SANG t SRAYEL
' SUFFOCOUNTY DEPARTMENT OF HEALTH SERVICES A T SO U THOL D
LK
? FOR APPROVAL OF CONSTRUCTION ONLY TOWN OF SOU THOL D 17•
DA + "' - •' G 3` SUFFOLK COUNTY, N. Y.
J ,' �A II �ti-____ 1000 - 63 - 02 - 16.1
; APPROVED
A' _. Scale 1" = 30'
.3 o. &l/ .. /L Dec. 2, 1987
The locations of wells and ceaspo•a shown hereon are from field
observations and or from data obtained from others. April 12, 1991(revise lot)
. AREA= 28,400 sq. ft.
SINGLE FAMILY DWE LING ONLY
CERTIFIED TO, EXPIRES TWO YEARS FROM PATE OF APPROVAL
TICOR TITLE GUARANTEE TITLE No. T 1290-0834
ROBERT L. FISHER
NORTH FORK BANK& TRUST CO. The water supply and sewage disposal
systems for this residence will conform
to the Stan da o T e Suffolk County __
Depart of iervicsa. ;•>VA�'r's;q
Prepared in accordance with the minimum i t
standards for title surveys as established :.
by the L.I.A.L.S.and approved and adopted EAST E1lD REAL ESTATE ,�fd+�7 4I
for such use byThe New York State Land ��5 IVlontauk Highway /f�� ."��-
• S. LIC. NO. 488/8
Title Association. �.i..
Shirlecy,N.Y.11967 PEC, •'" 9t1Z`" ORS, P.C.
ELEVATIONS ARE REFEREN CED TO �a/"���� MAIN ROAD(SW 7cI5-5020
08
'SN ASSUMED DATUM. • SOUTHOLD, N.Y. 11971
L
87 — 886 B