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HomeMy WebLinkAboutKehl • OFFICE OF THE TOWN CLERK �FFUL' Town of Southold Judith T. Terry, Town Clerk ." G � Town Hall, 53095 Main Road P. 0. Box 1179 :cn ` =vn Southold, New. York 11971 c :Al' Telephone _ Q( atr t • (516) 765-1801 ' TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK, or CESSPOOL Permit No. 218 Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: NAME: Shelley F. Kehl ADDRESS: P.O. Box 230 Southold, New York 11971 DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION New Single Family Dwelling with Sanitary System APPROVED as per Suffolk County Health Dept. approval. • LOCATION OF PROPOSED CONSTRUCTION or ALTERATION: OWNER OF PROPERTY: Robert and Shelley Kehl OWNER MAILING ADDRESS: P.O. Box 230 Southold, New York 11971 OWNER PROPERTY ADDRESS : Main Road Orient, New York TAX MAP NO. : Section ' 18 Block 6 'Lot p/o 24 CROSS STREET: Browns Hill Road (Private Road) BUILDING PERMIT NUMBER CROSS REFERENCE: Juaith T. Terr Southold Town Clerk DATE :' September 2, 11987 (TOWN SEAL) or.,s.,' •45, 4,4 ''k Town Hall, 53095 Main Road P.O. Box 1179 - .t 4 1 'O Southold, New York 11971 JUDITH T. TERRY "�������r TELEPHONE TOWN CLERK (516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD - September 2, 1987 Robert and Shelley Kehl • P.O. Box 230 Southold, New York 11971 Re: Main Road Orient, New York Enclosed herewith is the Construction, Alteration or Modification Permit for -a Septic Tank or Cesspool System for which you applied. Please be advised that each owner of real property operating an on-site sewage disposal system, such as a septic tank or cesspool must, prior to such operation, possess in the name of the owner an Operation Permit for the system. The Operation Permit is issued by the Town Clerk's Office. The fee for an Operation 'Permit is ten dollars ($10. 00) for residentialuse and twenty-five dollars ($25. 00) for, non-residential. Please have the owner complete the enclosed Application for an Operation Permit and return it to this office along with the proper fee. For your general information I have enclosed an Informational Bulletin regarding the Scavenger Waste Laws adopted by the Southold Town Board. Should you have any questions pertaining to either permits ,or the Scavenger Waste Laws, please do not hesitate to contact this office. We will be glad to assist you in any way possible. Very truly yours, Judith T. Terry Southold Town Clerk Enclosures (3) -JTT/Ijc - 'de 104 `• r Town Hall, 53095 Main Road 06, -'0*,G,0-#;er �1 P.O. Box 728 ••• ✓ Southold, New York 1 1971 ��00.cro IIIUITIl T 11 RRV TELEPHONE Town('I I RF. (516)765-1801 RLGISI RAR OF VU AL SI ATISrlcs OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLI) August 28, 1987 To: Victor Lessard, Southold Town Building Department From: Judith T. Terry, Southold Town Clerk Transmitted herewith is a copy of application No. 221 for a CONSTRUCTION or ALTERATION Permit for a cesspool or septic system submitted by Shelley F. Kehl for Robert and Shelley Kehl • Please review the application and location map and advise if the project has received Suffolk County Health Department approval and if we may issue the permit. Please complete the form below and return it to my office. Thank you. a 80,g70 .,!, 6,01drog="4.. . Judith T. Terry Southold Town Clerk * * * * * * * * I have reviewed the application and location map of the project cited above and make the following recommendation: APPROVE - DISAPPROVE - nn n (/ COMMENTS: (14, d1� • AC Met 11. Signature 431 L4jS � Date OFFICE OF THE TOWN CLERK Town of Southold Application No ( Judith T. Terry, Town Clerk Town Hall, 53095 Main Road Construction' P. O. Box 1179 Alteration Southold, New York 11971 Telephone Residential (516) 765-1801 Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT ' APPLICAT ION for CONSTRUCTION or ALTERATION PERMIT' SEPTIC TANK or CESSPOOL • Permit No. - Fee $ /Q DATE B -/ APPLICANT NAME: ihit en APPLICANT ADDRESS: PO t'5 )( >O - SO LC (r2 /1' AI 1 197/ SEPTIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: • OWNER OF PROPERTY: (.)bet 7 SPG LLMC1 /j E/4 L- ' OWNER MAILING ADDRESS: PO /XO� 2z • , A( cj lq / OWNER PROPERTY ADDRESS:__5' "i" 7 , ,cr _n. fag; fa g; - TELEPHONE'NUMBER OF CONTACT PERSON: • l(9zj " a 7 LI TAX MAP NO. : Section / Block ( Lot - CROSS STREET: , 'i epi ` t D Ogl /tet /6/47A)12-5 mkAva 1/ 5 BUILDING PERMIT NUMBER CROSS REFERENCE: - Sig tore of Applicant RECEIVED BY:f' _ TO-vim CI- k s Off e - DATE: • - _ • 5 I SUFFOLK CO HEALTH DEPT. APPROVAL I I H. S NO. 3U/ C C. 1 L �, _`` "--)J\.1_\'' � 1 / , STATEMENT OF INTENT ,>^=i 7' THE WATER SUPPLY AND SEWAGE DISPOSAL �/ SYSTEMS FOR THIS RESIDENCE WILL d N_ 7 V V. I . CONFORM TO THE STANDARDS OF THE . SUFFOL CO, DEPT. HEALTH SERVICES 5Gr"lM' '6-- ,/ APPLICANT ____.r.__.€15.1:_;___ 7` • 0 SZ 45 . t. SUFFOLK COUNTY DEPT, OF HEALTH sSOCIQ?hv�5 SERVICES — FOR APPROVAL OF CONSTRUCTION ONLY _ / -, r� DATE: C� I v f Li f `' 0 64onunierrf• H. S. REF. NO.. ' c711 17 �► APPROVED: `/_`? . _(--vi PP'ernl.ses aee tirc43e $/JLW21 SUFFOLK CO. TAX MAP DESIGNATION: on aft1bT'oVeS minor �,rtll3'OIiiriolor? DIST. SECT. BLOCK PCL. mdr 16re1 irgd. orn the 1144414r' 1000 016 6 24(iatt , L• /en.Jrx7 peoAier i'y "tar 1Vor/-11 OWNERS ADDRESS: goa d A 0 S[J cl'ai'es v to n..-7,, 19,5u. z3d Narffr Rd. 030. Sox 5) Q 6reetr art, N_ Y. 11,944 _CO r»inUYS from Courr t ' 71101240 #1015. 477- 1226 N DEED: L. P. - TEST HOLE STAMP I' Z c{i.•Pt1*yea-P.fr; ! `�.k _ th• ri!rwri IG.Yin'rilo o C St 7i1 7� .�xr rsy fn a44/ h e5;-<7.0:-,1".'7(:�r;ch^C2't°. e1 i•� .'' '4 t� I r/ rpr - loam {If�C:e9 Leto. 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