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Home My WebLink AboutHolzapfel 11''��ff®Q� ��* - • JUDITH T.TERRY ` ® z^ ;'' Town Hall,53095 Main Road TOWN CLERK t t P.O.Box 1179 v �' t Southold,New York 11971 REGISTRAR OF VITAL STATISTICS ® 0 MARRIAGE OFFICER t' ° Fax(516)765-1823 / RECORDS MANAGEMENT OFFICER =:1®1 ED V�®l°�I Telephone(516)765-1800 FREEDOM OF INFORMATION OFFICER ,,s0' OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1346 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : SAMUELS & STEELMAN ARCHITECTS Address 1 : 25235 MAIN ROAD City St Zip CUTCHOGUE NY 11935 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. #R10-95-0041 Name Of Owner HOLZAPFEL, JOHN AND JOYCE Mailing Address 1 P. O. BOX 210 City St Zip SOUTHOLD NY 11971 Property Address 1 1670 KING STREET City St Zip ORIENT NY 11957 Tax Map No. section 26.00 block 2 lot 42.001 Cross Street DOUGLAS ROAD Building Permit Number Cross Reference: Issue Date: 6/15/95 Judith T. Terry Southold Town Clerk (TOWN SEAL) / -J ,,g//Z•”...,,,''I / -'(,/ .'[_ ' 2 ® s JUDITH T. TERRY z ....E. Town Hall, 53095 Main Road TOWN CLERK :i. P.O. Box 1179 Southold, New York 11971 REGISTRAR OF VITAL STATISTICS = V® t1 Fax (516) 765-1823 MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER `__4®ej' ®I.� Telephone (516) 765-1801 ,� i FREEDOM OF INFORMATION OFFICER '%.,0riiIi° OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD (JET riF, C� - 8 TO: Southold Town Building Department i�i�F JUN 1995 g FROM: Linda J. Cooper, Southold Town Clerk's Office �--BL0G D____-1 1 T. DATED: June 8, 1995 T __21, f01 9ti11-91.D Transmitted herewith is a copy of application No. 1397 for a Cesspool/ Septic Tank Construction Permit submitted by: Samuels & Steelman for John & Joyce Holzapfel • 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: &?zF *//ee, —/�,�'-- 07 cil/ C iIP !i, ! Signature Or 6/c‘i 9S----- Dated/ OFFICE OF SHE TOWN CLERK c3IFDLj Town of Southold • Judith T. Terry, Town Clerk x; z ; Application No./J P.`T Town Hall, 53095 Main Road ` o �; . rviu>� Construction P. O. Box 1179 cry mss ' ' Southold, New York 11971 �, Alteration Telephone *14 ' &' d 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 $ DATE Ci J/2 7 (7 APPLICANT NAME: (--91,12(i�6.-S ( 6'T�EZ ..-'0c-9 7S APPLICANT ADDRESS: 25 ZZ S / /x.) /269-1--4) e 7 e'4 //r0.5 SEPTIC lam' CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION /U, giiz'/ 451,-9/ �vs, G / d%©0 .e7-41-2..,� 3/T )0i4 ) if-- T /&/c ,�- Pooh LOCATION MAP: Must be attached hereto before permit may be issued. • LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: J(6)//* 00WQL �� OWNER MAILING ADDRESS: p_p. ,/3?X 2// ,(3,6: OWNER PROPERTY ADDRESS: /6 70 ,//j.) 57 7 &,,J7' �,��C��f` ,//V v 7 TELEPHONE NUMBER OF CONTACT PERSON: .7c3 ,6-09.5 TAX MAP NO. : Section :°--i(0 Block 2. Lot 46 Z, CROSS STREET: _ ' BUILDING PERMIT NUMBER CROSS REFERENCE: S gnature of Applicant RECEIVED BY: RECNIVED Town Clerk's Office DATE: JUN 13 1995 town Mt Southa • i k1 17-!-0-• •- •-• 7ss ir.....-_ ��. %Z2 Dated: May 21, 1993, „ - N : NOTES: Elevations shown are based (� on Suffolk County . '""'"' Department of Public WorksC:11 •Aerial suryey.Public'water,is a ,'j not avaiyible Within 590 ft ,--1--y,3,-.,,-. of property, CI) 1R-,,?.,i, :,' -, ' .. . The,locations of wells and ' WI 4�: ` I, cesspools shown herepn areCe '.izz • 18 ID from field observations and or data from data obtained .,,� .0.-,,,--,1*- fron others, , mei ,„ HEALTH "I am familiar.with the. y.,,;r standards for approval and UmI : DEPARTMENT construction of subsurfaceiliker ,',,. STATEMENT sewage disposal of supswa rfa systems for Clan .;,.r;,, >I single family residences * /14( ',' - , ,and will abide by the conditions set forth therein f and on the permit to '6, N ,,,;, cQnatrcct." -,. 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'"'.. p fJ'';hpdp N is•^; • �, QtY� s y�� ,' ./ OR I F_ N 7 41 ,,,\ v: <i s C _ - . <7 `SITE: _ DLL'• _'6 • -a' MID:Neck _ r_ \ f �L r =°TION MAp < t-- 3 \ - NGty �drea..N ' 1./).n . -W66.L _ \. s • / \ ' - -. -- , \ `gtgRED 44.4 9 G 1T `' • U .'< / I , / 4 \\ �� t I e 1 r aE9g� � ' O g¢'� J5 1 Q Project No: ,�� t,p��t ��` \1 Drawn By: IST_:.__. i of po� I - -- — -- — \ Checked • \. Date: 3/1°S-.4-'RS----::--:- --_------ sls.---- �y� `y`� Scale: As NoTL17 Fla.iDR:,SED Ty-MT -- L.I E a_L _- 1-10`E Sheet Title: EI...•-14.5 7‘,7...,s1 SUFFOLK COUNTY DEPARTAENT OF HEALTH SERVOS , :'-- SITE . N iF CE P H�S FOR APPROVAL OF CONSTRUCTION UCTI�ON OF : .PLAN. ._ SLkICLe FAMILY TlSIDENCE ONLY z'+44 gra.D .C. 0.,i• L.Gw M I2„ MAK Q 3 iii HS REF.NO R Io.4 o�F! N a�M APPROV _ T .` rt i„ 12•a r i MFRS THREE YEARS FROM DATE Cr S -::' Sheet No: Crr.rn E I 11) / 9.4.0..1G, i'—• fl v=: ire' 9 i 1:1111,155.