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OFFICE OF THE TOWN CLERK S�FFoure,
Town of Southold e
Judith T. Terry, Town Clerk Pgz
Town Hall, 53095 Main Road a ' itAtF,,� '
P. 0. Box 1179 u'
Southold, New York 11971 OC�► O�'•��
Telephone - � O N
Lr , i0
(516) 765-1801
TOWN OF SOUTHOLD
- SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 305 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool X
PERMIT ISSUED TO:
NAME: Sagg Farms
ADDRESS: P.O. Box 345
Sag Harbor, New York 11963
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling with Cesspool System
APPROVED as indicated on Suffolk County Health Department survey.
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Mitchell Maks
OWNER MAILING ADDRESS: 60 East 8th Street
New York, New York 10003
OWNER PROPERTY ADDRESS : Main Road
Orient, New York 11957
TAX MAP NO. : Section 14 Block 2 Lot p%o 1 .6
CROSS STREET: Mullford Court
BUILDING PERMIT NUMBER CROSS REFERENCE:
gOiro �
fri h T. T617-7
Southold Town Clerk
DATE : March 15, 1988
(TOWN SEAL)
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e 'Fab'.,`,-.-4.,,,;----,'"= .:,-`-.:-',f: 'r` Southold, New York 11971
JUDITH T TERRY -U .�' &� � `✓ TELEPHONE
ioWN CLERK
(516) 765-1801
REGISTRAR 01 VIT,L S rnTisTics OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
•
• March 15, 1988
Sagg Farms
P. O. Box 3115
Sag Harbor, New York 11963
Re: Mitchell Marks
ROW off Main Road
Orient, New ,York 11957
Dear Sir:
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 ($25. 00) for non-residential.
Please have the owner complete the enclosed Application for an Operation
Permit and return it to this office along with the proper fee.
For' your general information I have enclosed an Informational
Bulletin regarding the Scavenger Waste Laws adopted by the Southold
Town Board. Should you have any questions pertaining to either permits
or the Scavenger Waste Laws, please do not hesitate to contact this
office. We will be glad to assist you in any way possible.
Very truly yours,
• .43064,.......
Judith T. Terry
Southold Town Clerk
Enclosures (3)
JTT/Ijc
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Ip//ss its,
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4"t1 1 °lien,' +1
Town Hall, 53095 Main Road
Z;$ � P.O. Box 728
4 ‘1 r� or Southold, New York 11971
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JUDITH T.TERRY TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
March 11, 1988
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 309 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by Ssa'cx Farms a/c Mitchell Marks •
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 - ,C
DISAPPROVE -
COMMENTS: fa.o vyy U.A,LA •
<7.0
Signature
C\
Date
i. ....%
OFFICE OF THE TOWN CLERK �cvFFO1J'',-
Town of Southold � � R 0% pp • , •,0.3
Judith
Judith T. Terry, Town Clerk . �.; - . Application No.
Construction
Town Hall, 53095 Main Road ‘ R t,� x��.,.� . ,� \,,..--
P.
P. O. Box 1179 � " _ � � �
p ® �. Alteration
Southold, New York 11971 ' �._ -` ��.•
Telephone O. 4t'1%, 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 $ / 0.. Old C
DATE f'1�\dtc� \k. 1 1�S r
APPLICANT NAME: cscçcVjc1u s
APPLICANT ADDRESS: ?,0 ,.a.0 X 3/15
; Oeu) -el_ \\C(foa
SEPTIC CESSPOOL
DESCRIPTION OF ,PROPOSED `CONSTRUCTION OR ALTERATION
\ V.Pe"1l e-\ \.vJc ) si ' Y ) A'''tc1
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: V(17►� €X1l1'1vl
OWNER MAILING ADDRESS: 6o Ph-A" g —c$Ce
Ike ( .ke-- I Qew U0k.1r— 1 n O b 3
OWNER PROPERTY ADDRESS: l
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section OV-t Block 2 Lot fo 1, t
CROSS STREET: \ --S Vq_ ZS
BUILDING PERMIT NUMBER CROSS REFERENCE:
dzi4,,,,,... / .
Signature of Applicant
RECEIVED BY: / • "�.,
T wn erk' Office
DATE: /// •/ e
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SURVEY FORAi
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES MITCHELL MARKS .
__FOR APPROVAL_ _OF CONSTRUCTION ONLY __ _ . _ _ -_ AT ORIENT -- -- - - -- --- -- - --
-- - ---- DATES FEB. it 1988--------
---- - - ----
DATE r.:p - f' Irsm MO U ' E TOWN OF SOUTHOLD SCALE: I"=200'
• SUFFOLK COUNTY, NEW YORK NO. 88 -0088
r WIP '', ,� ) *UNAUTHORIZED ALTERATION OR ADDITION TO THIS
A �` SURVEY IS A VIOLATION
FPROVlD OF SECTION 7209 OF THE
NEW YORK STATE EDUCATION LAW �P�E OF Nl��y,
•
• *COPIES OF THIS SURVEY NOT BEARING THE LAND S �� •
' I SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL ��(kD W } I*
6 . 1 P 1 �i NOT BE CONSIDERED TO BE A VALID TRUE COPY G
1 l ' , *GUARANTEES INDICATED HEREON SHALL RUN ONLY TO 0
HEALTH DEPARTMENT-DATA FOR APPROVAL/TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY IS PREPARED 41 Z •—•''' Z •
AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERN- i,. O
, * NEAREST WATER &AIN_MI.± N SOURCE OF WATER: PRIVATE_PUBI IC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED kms.
$ SUFF CO. TAX MAP DIST Mao -SECTION 0/4 BLOCK x LOT Pio/6 - HEREON,AND TO THE ASSIGNEES OF THE LENDING + �;
If THERE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE v,"
OTHER THAN THOSE SHOWN HEREON. TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT
* THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE OWNERS +r0
WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT •*DISTANCES SHOWN HEREON FROM PROPERTY LINES g i %
OF HEALTH SERVICES. - - TO EXISTING STRUCTURES ARE FOR A SPECIFIC i� 0�
APPLICANT+, _ PURPOSE AND ARE NOT TO BE USED TO ESTABLISH i4MD SUStit '
C 1� 3`/S gc434/.0-1c: i--r--K4 11463 PROPERTY LINES OR FOR THE ERECTION OF FENCES i
ADDRESS r,
•: ',..-.C'c,{ G-t, Yl� • L
= .� � RglS
� TEL. 6-0 7 25 _LY-C.S" _ i I YOUNG a YOUNG 400 RIVERHEAD,"NEW YORK AVENUE
R =CONCRETE MONUMENT "'
ELEVATIONS SHOWN HEREON ARE REFERENCD TO N,G.V.D `r. Vii!. ALDEN W.YOUNG,PROFESSIONAL ENGINEER
'r,.; • .1 AND LAND SURVEYOR N.Y_S.UCENSE NO"12845
( MSL 1929). - . . - .,
HOWARD W.YOUNG, LAND SURVEYOR
*THE LOCATION OF WELL(W),SEPTIC TANK(ST18 CESSPOOLS(CP)SHOWN HEREON
T r ru n .,SLL(,,..,.... ..,., • ° • N.Y S LICENSE NO 458,43
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