HomeMy WebLinkAboutSchlumpf (2) 1
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Town Hall, 53095 Main Road
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�__ P.O. Box 1179
j� 62• Southold, New York 11971
JUDITH T.TERRY .01FAX(516)765-1823
TOWN CLERK TELEPHONE(516)765-5-
1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 532 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : ISLAND STRUCTURES CONSTRUCTION
Address 1 : COMPANY, INC.
City St Zip WEST ISLIP NY 11795
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 6/28/89.
Name Of Owner SCHLUMPF, RICHARD A. & JANET
Mailing Address 1 241 WILLETTS LANE
City St Zip WEST ISLIP NY 11795
Property Address 1 POINT PLESANT ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 113.00 block 9 lot 12.000
Cross Street SILKWORTH ROAD
Building Permit Number Cross Reference:
Issue Date: 8/23/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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50G.156- ot.0. k `'w''�'' ;st A Q' �; Town Hall, 53095
"% . r Main Road
'.� WH® t` t ' P.O. Box 1179
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�_ "jf + �� t.� Southold, New York 11971
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JUDITH T.TERRY st `
��,.���yii�yl� TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Victor Lessard, Southold Town Building Department
From: Linda Cooper, Southold Town Clerk's Office
Dated: August11, 1989
Transmitted herewith is a copy of application No. 545 for 'a Cesspool/
Septic Tank Construction Permit submitted by:
Island Structurs Const Co Inc. for Richard and Janet Schlumpf ,
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. •
Clic
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE >(
DISAPPROVE
•
Comments: ct, ,,,,,c9. .c.a�..a. AI Lai ck. H
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Signature
-.-;, 1\ )4\Y\
Dated
es�• a
OFFICE OF THE TOWN CLERK
Town of Southold
Judith T. Terry, Town Clerk ' Application No. ,5-4S—
Town Hall, 53095 Main Road o � = �� -- '� Construction _
P. O. Box 1179 crl ,k ` •� Alteration
Southold, New York 11971
Telephone 'el 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 -
DATE f.�Gl Z /9,,
APPLICANT NAME: j54.,41 STTUCTU ES a:)/V- ./i-
APPLICANT ADDRESS: .3 zs- SUN,;,,JF ol /y1y
l�Ts7sL1P, .9 5-1
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
Ncw 2 s7r9(zy 4119(9A 1/5e4/17/ -, btuEzzlA,"
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Z Jci/Vel" c--1) Sew Ll/7;2i°.F'
OWNER MAILING ADDRESS: 24) WaLErj' l4N
WC-S7- >/021 1/ 7 %r
OWNER PROPERTY ADDRESS: /07 `) if)T " /6Lr,q .5,4 Air
m477/
4777/ �C�.e��
TELEPHONE NUMBER OF CONTACT PERSON : 4t MIFF) 5762 -66,-0673
TAX MAP NO. : Section //J !Block / Lot /
I i
CROSS STREET: Silk'Wog H I_R2) 1-169711�111�� ezff & 7L/,4
BUILDING PERMIT NUMBER CROSS REFERENCE:_
ign-ture of Applicant
•
RECEIVED BY:
Tr�1Gprie Office
DATE:
lownC�,ods oa
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
'__ FOR APPROVAL OF CONSTRUCTION OF
, ,1 Single Family Residence Only
Nix
N_-� r i' ( , 17 M - , APPROVED 'ros.�, ,.M�
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N� I/ I .i//� LIIN DATUM. -- _ ..
I yam' \ g- AIL ELEVATIONS SHORN ARE REFERENCED TO N.G.V.D.
A� �__ � t'� (NATIONAL GEODETIC VERTICAL DATUM). BENCH HARK
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\ //\p9t\ 23731956 ELEVATION - 36 325 (N C V D.) LOCCATED
\ _ __22'-0" SOUTH OF CENTER LINE OF OERCEN AVE ,
j —\ \ / _` -— 133'-0".TEST OF CENTER LINE JUNCTION OF COX NECK RD.
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::' DATE 4/20/87 SURFACE ELEV 18 25'
\I W W / DEPTH FT SAMPLE DESCRIPTION
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PROPOSED PRIVATE DWELLING
PLOT PLAN AT
SCALE I” . so'-o' MATTITUCK
TOWN OF SOUTHOLD• SUFFOLK COUNTY,N.Y.
VOTE.
I AM FAMILIAR WITH THE STANDARDS FOR APPROVAL SECTION 113 BLACK 9 LOT 12
AND MSNSFORCSING OF SUBSURFACE SEWAGE DISPOSALW
"MAP OF POINT PLEASANT"MAP N0.720
SYSTEMS FOR SINGLE FAMILY RESIDENCES AND WILL
ABIDE BY THE CONDITIONS SET FORTH THEREIN RICHARD
p �+��y1 f '`®
AND ON THE PERMIT TO CONSTRUCT. APPLICANT: RIVHARD A. S'OFILUMPF
X111! , 8i
JANET J. S-ILUMPF
RIC RD, A. SC PF P.E. 241 WILLETS LANE
} DATED, 5/28/:8 WEST ISLIP, NEW YORK 11795
i (516) 422-1666