HomeMy WebLinkAboutKerbs OFFICE OF THE TOWN CLERK cvFFDLA-
Town of Southold
_
Town Clerk � `' ? � '
Judith T. Terry, _
Town Hall, 53095 Main Road
P. 0. Box 117 9t
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Southold, New York 11971 c'42 �0�-�••
Telephone dl �` 0-
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 285 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool x
PERMIT ISSUED TO:
NAME: Jon Kerbs
ADDRESS: 440 Riley Avenue
Mattituck, New York 11952
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling with Cesspool System
APPROVED provided covers, etc. are designed to sustain vehicular traffic.
Septic to be installed as indicated on submitted survey.
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Jon C. Kerbs
OWNER MAILING ADDRESS: 440 Riley Avenue
Mattituck, New York 11952
OWNER PROPERTY ADDRESS : 5730 Narrow River Road
Orient, New york 11957
TAX MAP NO. : Section 27 Block 2 Lot 5
CROSS STREET: Orchard Street
BUILDING PERMIT NUMBER CROSS REFERENCE:
g$016f6aftg:7°' er
Southold Towey erk
DATE: January 26, 1988
(TOWN SEAL)
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;C4� Town Hall, 53095 Main Road
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7 P.O. Box 1 179
Y Southold, New York 11971
JUDITH T.TERRY Cpl" TELEPHONE
1OWN CLERK (516) 765-1801
REGISTRAR 01 \IT 1L S[ATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD -
January 26, 1988
Jon Kerbs-
440 Riley Avenue , _
Mattituck, New York 11952
Re: 5730 Narrow River Road
Orient, New York 11957
Dear Mr. Kerbs:
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 ($25. 00) for non-residential.
Please have the owner complete the enclosed Application for an Operation
Permit and return it to this office along with the proper fee.
For your general information I have enclosed an Informational
Bulletin regarding the Scavenger Waste Laws adopted by the Southold
Town Board. Should you have any questions pertaining to either permits
or the Scavenger Waste Laws, please do not hesitate to contact this
office; We will be glad to assist you in any way possible.
Very truly ours,,
„ ''-,yam' r'" i�"'.'�
Judith T. Terry
Southold Town Clerk
Enclosures (3) -
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•
d JAN -2 .69 = : _
BLDG. '' _ "t ` Town Hall, 53095 Main Road
-TOWN .,.
01=SOUTFdOL� `� .'_' - � P.O. Box 728
xa ra Southold, New York 11971
JUDITH T TERRY _ - _ TELEPHONE
TOWN CLI-RK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
January 25, 1988 _
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, -Southold Town Clerk
Transmitted herewith is a copy of application No. 289 for a
- CONSTRUCTION or ALTERATION Permit -for a cesspool or septic system
submitted by Jon Kerbs
Please review the application and location map and advise if the
project has received Suffolk County Health Department approval
and if we may issue the permit.
Please complete the form below and return it to my office.
Thank you.
Judith T. Terry
Southold Town Clerk
* * * * *
I have reviewed the application and location map of the project
cited above and make the following recommendation:
APPROVE - X
DISAPPROVEa - n
COMMENTS: 1 j�„�,.A,a.c,eic, C,m4.44.o Jett, GSA, ,7111 ..o
U.LaAidda V_,LAZallsu Zaite.,14, Lua-
:, ,c:16-43c- '
Signature /
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Date !/
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OFFICE OF THE TOWN CLERK c$FOUre+"
Town of Southold � Application No. �Z F.Judith T. Terry, Town Clerk 1 s; "G
Town Hall, 53095 Main Road ` E74 Construction L.,
P. 0. Box 117947,
*144%
'rte ��J Alteration
Southold, New York 11971 ��
Telephone Ng .. 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 .$ /O . 6 1)
DATE
APPLICANT NAME: v. 2,Ac) S
APPLICANT ADDRESS: l}qO '�� ke Aue
futo.-4 KJ Li •
SEPTIC CESSPOOliC
DESCRIPTION OF PROPO CONSTRUCTION OR ALTERATION
o
I Noise
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION—OR ALTE,ATI N:
OWNER OF PROPERTY: &,•&_ �v
OWNER MAILING ADDRESS: l zO NP` � •{ wJ
OWNER PROPERTY ADDRESS: 573 - �-rr
-q x-0.1 P-14-4e
ON/ IeV, tJ -
TELEPHONE NUMBER OF CONTACT PERSON: 516- ( "S S3S
TAX MAP NO. : Section 03- 7 Block a Lot S
CROSS STREET: (3-E&
BUILDING PERMIT NUMBER CROSS REFERENCE:
= Signature o Applicant
RECEIVED BY: _� /
- - • -rrrk'-s Office - _
DATE: Q _ - - _
- -.
AO.
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SUFFOLK CO. HEALTH DEPT. APPROVAL
H. S. NO.
_St ' VEYE . ...F' ,:`• . _.. a:-. _ ' •
STATEMENT OF-INTENT
i - . . - - THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS FOR _ THIS RESIDENCE WILL
.v tf- I fT `M CONFORM TO THE STANDARDS OF THI
SUFFOLK .1 PT OF HEALTH SERVICES
CF UTP QLC NY. - (S) PPL NT -
APPL0. NT _
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES .-
. , SUFFOLK COUNTY DEPT. . OF HEALTI
FOR APPROVAL OF CONSTRUCTION OF SERVICES — FOR APPROVAL 01
Single Family Residence Only ,
•� CONSTRUCTION ONLY
DATE q 2-V"-E4 REF. MO ?(.9 ° " 17 DATE:
1 H. S. REO. NO.._
APPROVED APPROVED:
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,
rink
it 4- . SUFFOLK CO. TAX MAP DESIGNATION:
APPROVAL IS SUBJECT 'ID INSTALLATION OF NECESSARY :1'' DIST. SECT. "-- BLOCK ' - - PCL.
WATER CONDITIONING EQUIPMENT AND RECORDING OF 1C _--- - 027 . - TT._2 - - ' -.5 "."
-
NECESSARY COVENANTS PRIOR '10 BUILDING O ANCY. ?.
- • OWNERS ADDRESS:
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