HomeMy WebLinkAboutFleet, Evelyn soocoftllire
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JUDITH T. TERRY :,' Town Hall, 53095 Main Road
TOWN CLERK : p r= P.O. Box 1179
ifs �� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS BYO sc. �,' Fax (516) 765-1823
MARRIAGE OFFICER = '`� s �) � Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER .l
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. 1163 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : EAST ISLE CUSTOM BUILDERS INC.
Address 1 : 278 JAMAICA AVENUE
City St Zip MEDFORD NY 11763
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY
DEPARTMENT OF HEALTH SERVICES. SCHD REF. #R10-94-0038
Name Of Owner FLEET, EVELYN S.
Mailing Address 1 C/O EAST ISLE CUSTOM BUILDERS
278 JAMAICA AVENUE
City St Zip MEDFORD NY 11763
Property Address 1 FLEETS NECK ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 103.00 block 12 lot 15.000
Cross Street DARTMOUTH PLACE
Building Permit Number Cross Reference:
Issue Date: 7/20/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY %
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Town Hall, 53095 Main Road
TOWN CLERK : =v rTI : P.O. Box 1179
VS .� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = �. '' Fax (516) 765-1823
MARRIAGE OFFICER '_.,`^1 *.�0 .1' Fax
(516) 765-1801
RECORDS FREEDOM OF MANAGEMENT
ON OFFICER "'-..."''.• ,,,,,i/01-
_______
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OFFICE OF THE TOWN CLERK D 1110111
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TOWN OF SOUTHOLD 1
11
TO: Southold Town Building Department -3 -s
FROM: Linda J. Cooper, Southold Town Clerk's Office ,� 8 �wN OF Mew j
DATED: June 30, 1994
Transmitted herewith is a copy of application No. 1207 for a Cesspool/
Septic Tank Construction Permit submitted by:
East Isle Custom Builder, Inc. for Evelyn S. Fleet .
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: •
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REGIVED
Air
`JUL 2. n 1994 ..
Signatu e
Tarn Mk Southold //
/9
Date
S
OFFICE OF THE TOWN CLERK
Town of Southold
Judith T. Terry, Town Clerk Application No. 1 a 7
Town Hall, 53095 Main Road Construction 1Y _
P. O. Box 1179
Southold, New York 11971 Alteration
Telephone Residential c/
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
lir
APPLICATION /11 111
11 12
t _ C5
for Z wJ JUN 2 7 to
CONSTRUCTION or ALTERATION PERMIT i
SEPTIC TANK or CESSPOOL To D 10LD
Permit No.
Fee $
DATE
APPLICANT NAME: East Isle Custom Builders, Inc.
APPLICANT ADDRESS: 278 Jamaica Avenue, Medford, New York 11763
SEPTIC x CESSPOOL x
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION _
si_-nglP family dwP11ing
r
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Evelyn S. Fleet
OWNER MAILING ADDRESS: c/o'East Isle Custom Builders, Inc.
278 Jamaica Avenue, Medford, NY 11763
OWNER PROPERTY ADDRESS: NEC Fleets Neck Rd and Dartmouth Place
Cutchogue
TELEPHONE NUMBER OF CONTACT PERSON: 727-6023
TAX MAP NO. : Section 103 Block 12 Lot 15
CROSS STREET: Dartmouth Place
BUILDING PERMIT NUMBER CROSS REFERENCE:
i, '.T .LE CUS F. pUILD • , INC.
I
� . . 6,_ AFRO
Sig a't of App icant
'K Richard Oppedis. • President
RECEIVED BY: 10/ -
Town Clerk's Office
DATE: iG ( G / 9Y
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�. ,,\ P1569 ytG SURVEY OF
LOT 1
�° V �.. z �vs -* "MAP OF BIG GREEN ACRES"
ti,(,/` ti`' �� � -oq ,n�' 4 .om-9 FILED xx Y �r2 MAP NO. 5757
i o-Q AT CUTCHOGUE
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4- ,� ? R2-�P AS 4 �•P TOWN OF SOUTHOLD
- A,, Fs• � �� IP •• �� �,4� \ Lp SUFFOLK COUNTY, NY.
�� y •4,\ / .rsF e �,°�. 1000 - 103 - 12 - 15
00 V 7 �o��� ��01e. �� 0 Scale • 1" 40'
�`^`J P.1 / ()f "A
_ /� 101 April 14, 1994
TV �/ (VQ PK 4 'd'C ✓
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4 1� CERTIFIED TO,
O o a^ D6 0%., WARREN YANTZ X49 LAMOS,,
AREA = 39,864 SQ.f f. 0' 0 5' USDAAFARMERS HOME ADM/NIS TRA TION �RA YANTZ � ���N'i,..- Q���<,\
4. ti , * 0
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ELEVATIONS ARE REFERENCED c , l ` 53
TO AN ASSUMED DATUM. �5 2 N3 +,.• #
The locations o/ wells and cesspools 940 assts AP's
shown hereon ore from field observations �
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES NEW�
FOR APPROVAL CONSTRUCTION ONLY and or from data obtained from others.
I am familiar with the STANDARDS FOR APPROVAL
AND CONSTRUCTION OF SUBSURFACE SEWAGE Prepared in accordance with the minimum / N.Y.S. LIC. NO. 496/8;
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES standards for title surveys as established 4
DATE ►S REF. NO. and will abide by the conditions set forth /herein and on the by the L.I.A.L.S and approved and adopted CONIC EYORS, P.C. •II
permit to construct. /or such use by The New York Stole Land (516) 765 - 5020
Title Association. P. O. BOX 909
7 r
4 MAIN ROAD
APPROVEDZI } SOUTHOLD, N.Y. 11971
94 — 166