HomeMy WebLinkAboutKempler •
OFFICE OF THE TOWN CLERK c,51,F9L'`,
Town of Southold � � �l/
Judith T. Terry, Town Clerk A" 0�'
Town Hall, 53095 Main Road 4 '
P. O. Box 1179
Southold, New York 11971 O Oc- ..'
Telephone
(516) 765-1801 '
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION' PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 230 Residential • X
Non-Residential
. Fee $ 10.00
Septic Cesspool X
PERMIT ISSUED TO:
NAME: -John Bertani Builder Inc.
ADDRESS: 1380 Oakwood Drive
Southold, New York 11971
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New SingLLe Family Dwelling with Cesspool System _
APPROVED as per Suffolk County Health Dept. approval.
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Cecilia Kempler and Virginia Cropper
OWNER MAILING ADDRESS: No mailing address given
OWNER PROPERTY ADDRESS : Indian Neck Road "
PecOnic, New York -
TAX MAP NO. : Section 86 Block 7 Lot 1
CROSS STREET: Robinson Lane "
BUILDING PERMIT NUMBER CROSS REFERENCE:
Judith T. Ter
Southold Town Clerk - -
DATE : September 30, 1987
(,TOWN SEAL) - f
sl /
011/1
FiEjr
14
4 ,422e241%,
"` Town Hall, 53095 Main Road
� ��'�� P.O. Box 1 179
4,�
+��/' /, �� Southold, New York 11971
JUDITH T. TERRY TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
September 30, 1987
John Bertani Builder Inc.
1380 Oakwood Drive
Southold, New York 11971
- = Re': Cecilia Kempler •
Virginia Cropper.
• Indian Neck Lane
Peconic, 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 •
residential use 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, i _ od•
allsibmstadess
• Judith T. Terry
Southold Town Clerk _
Enclosures (3)
JTT/Ijc
•
` f
cta
���}� �� �� Town Hall, 53095 Mair Road
42, "Vfg?V` �% r P.O. Box 728
®% % Ili Southold, New York 11971
_,i///L
JUDITII T f1-.RRY TELEPHONE
TowN('LI RI
(516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
September 18, 1987
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 232 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by John Bertani Builder, Inc. for Cecilia Kempler and. Virgina Cropper.
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.
,1;:e coviantsmarla
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 COMMENTS: Q s / 1 K Vim. 444,19, .
\K.:A (:).‘,E]!..J.
Signature
1 1 �j
OFFICE OF THE TOWN CLERK clW Mire"
Town of Southold aY Application No-L3
Judith T. Terry, Town Clerk . f.4
( .
Town Hall, 53095 Main Road ` 6 Wit' Construction a—
P. O. Box 1179 0 ) ��J Alteration
Southold, New York 11971 ,�,,: a:
Telephone 0! [ •��; 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. DU
Fee $/fes.
DATE
' APPLICANT NAME: , n2/`44.--1I &D „ L1
APPLICANT ADDRESS: /...v6 aleeumaoQar/1,1
c/y-tbe % /by_ , f / 7
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
DA/ Pow
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 6'6C.,-Z/14 /^I�r ipt/ee 1/7d214:adm (1//261-1/62-
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS: jAratlatJ iJtc j' //U4L -
SD1.)`go co 'city t ( 11
TELEPHONE NUMBER OF CONTACT PERSON: Xj`�•-- /T
TAX MAP NO. : Section S-6 Block 7 Lot
j�E
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
(12/ IP)t
4 nature of A licant
� NN
RECEIVED BY:oe( 6,,
EcEpi Drown Clerk's Of ce
DATE: r!rD 3 •,r�c7
sLa -- ani 1
• Town i::crk Southold
r r.. •
• r
•
tvaAtto
f i
gettS
•
ti
+.7
•I J
•
Lr
- 1 -
•
i
0E13 1987 -
S DF( 1SE!-,yICEor
OCAS LTH s
`- i SUFFOLK CO HEALTH DEPT APPRO\
_ H S NO
I
• i' i '•`T L. L) 1•-O
i
STATEMENT OFINTENT
THE WATER SUPPLY AND SEWAGE QISI
- '
1. 1 ' 'I-'yf SYSTEMS FOR THIS RESIDENCE
--- ---__—____-.__- --- - CONFORM TO 'THE STANDARDS 01
SUFFOLK CO DEP-I OF HEALTH SER
..../,...-3 (5) APPLICANT i --
SUFFOLK COUrJ T r DEPT OF H
}rar�_ E'�.MII. � !11^, i�f_1':�l r��itiL`'�' .,� SERVICES - FUR APPROVAL
E TI-2:::.S
l',..'10 YEARS 1: 1 1 1..'i S::. O PI fttl�-., J11
CONSTRUCTIONONL.Y —
DATE - ( 1� -Y7
- t 9 H S REF NO _ __--j
- �- - --
' I APPROVED ----- - ---
I ~-SUFFOLK f-0 TAX MAP DESIGN,
/ �i DIST- SEC I BLOCK
1, i OWNERS ADDRESS
I j I
-1.�` '
\ '`:":"-d-.'4 _
`U ,/ Si/ I 7 _/S-vy
' , I I DEED L f'
I Y.) , �' i PSI I loi_E iSTAMP-
1 _;'• '0 i!,:':S VW'?ie U VIM!'
`, i ., -,,r)7') Y 04 thn N
;1) I th
GUS. G+' 'r Cx•..ry'
I i I ,�-,k-rci v ic,
�' - I I Ln Lod a WO'MO CU;
.•) - I Gun a arr..In itcro•_
I;•i ' I cnty id the.Vit?0.I ir;
1 I I is;.I.y,>srvd.Fant)on 1
tictn comrEiny.gnvcr,
lei•.Stf
nt' lst tUtton IN
r 1 i to ii--a est KJnaos cd t
:,I,;IMI.0.snrantr, 7
r
! I r- _ to L4,41ItYJnal inaaiiut
avr:':''r".SEAL
1
-E �
• 7-'-..... ..
1
•
V` (( yNT:
II
RODERICK,VAN TUYI, PSC i � * �'
-•' ''
C;) 1 i+d,
LICENSED LAND SURVEYORS f L ---- - `� �E�,LAN�
, GREENPORT NEW YORK �'•'�""r
I