HomeMy WebLinkAboutMeklenburg 111 Co
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•FP Town Hall, 53095 Main Road
P.O. Box 1179
`a se Southold, New York 11971
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JUDITH T.TERRY '-- ,.,,,iI
TELE (516)PHONE 765-1823
6j 182
1 765-1801
TOWN CLERK
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. 640 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : KENNETH AND LINDA MEKLENBURG
Address 1 : LESLIE ROAD
City St Zip PECONIC NY 11958
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 8/24/90.
Name Of Owner MEKLENBURG, KENNETH AND LINDA
Mailing Address 1 P. O. BOX 395
City St Zip PECONIC NY 11958
Property Address 1 TUTHILL ROAD EXTENSION
City St Zip SOUTHOLD NY 11971
Tax Map No. section 55.00 block 6 lot 15.001
Cross Street MOCKINGBIRD LANE
Building Permit Number Cross Reference:
Issue Date: 9/13/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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�'�" ' al \41 ,' �,� Town Hall, 53095 Main Road
WI. 0�� p-,53 P.O. Box 1179
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1®�� _v./ t•� Southold, New York 11971
_ DITH T.TERRY ...4.--...,,a00 01 TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Southold Town Code Enforcement Officer •
From: Linda Cooper, Southold Town Clerk's Office
Dated: September 10, 1990
Transmitted herewith is a copy of application No. 655 for a Cesspool/
Septic Tank Construction Permit submitted by:
Kenneth and Linda Meklenburg .
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.
d
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments: '
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Signature
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Dated 1
OFFICE OF THE TOWN CLERK cOFD1,i "�
Town of Southold 0\ 's CO
Judith T. Terry, Town Clerk _.'N Application No. Wap
Toy ,n Hall, 53095 Main Road o •
j':" , *• +�
cr3 ,.',:, V‘, Construction'
P. 0. Box 1179 �y � :
Southold, New York 11971 O. ' Alteration
S
Telephone OI � [' �O� 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 •$
DATE q/00
APPLICANT NAME: / /2/2e4H 11Th in d/ /2ie ,bije
APPLICANT ADDRESS: fioix- (.79 , f cc'//'L /9b
,
eLe.___oh a r Y. 1/90
SEPTIC CESSPOOL I/
DESCR TION OF PROPOSED CONSTRUCTION OR ALT ATION
ei,J CO hu;` iebi — /9•12C-Ii hbl eCe
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONS . RUCTION OR ALTERATION: j�
OWNER OF PROPERTY: rJ%/'/e,` f /L n� ,���0�� 4,,frp`i/i,g_c'
OWNER MAILING ADDRESS: / i x'15 . �d
t/ O1LC 7,,, // L.
OWNER PROPERTY ADDRESS: 77/W//L A ,/ /15-(;)It.)
TELEPHONE NUMBER OF CONTACT PERSON: ZI —5-6/8 � 779 D c,
TAX MAP NO. : Sectior�'J+ '� Block 6
Lot " ._
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CROSS STREET: i,J`" aim f 79,440) i l9;12.,
BUILDING PERMIT NUMBER CROSS REFERENCE:.
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Sig ature of Applicant •
RECEIVED B1gEp 1 A ioWl i
ToWn`°Clerk's Office
DATE: p. CIet s
nR-4000 �_ - •
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1990
-SINGLE FAMILY DWELLING ONLY S;G DFiP�. •
EXPIRES TWO `(EARS FROMDATE OF APPROVAL - HEALT�-I . OF FS
3O2941-5 4/2_6—— SURVEY FOR
KENNETH MEKLENBURG B LINDA M.MEKLENBURG
UFFOLK COUNTY DEPARTMENT OF HEALTH SERVICt3 LOT NO.42, I�HIGHPOINT MEADOWS,SECTION THREE"
AT SOUTHOLD DATE. AUG.15,1990
TOWN OF SOUTHOLD SCALE I
FOR APPROVAL OF CONSTRUCTION
ONLY 40'
SUFFOLK COUNTY, NEW YORK NO 90-0518
Qsa
AG ,7, Hs . F• NO. •uMAUTHonlz[D ALTERATION OR ADDITION TD THIS GUARANTEED a•
a•+T� „ SURVEY A AIElEDUC ION LAW 7209 OF THE KENNETH L RB ;9,
NEW YORK STATE [DUCATIOM LAW
Ai *COMES OF THIS SURVEY MOT BOSSED THE LANDHALINDA !�'' tom.
APPROVED S RVEYORS INKED SEAL OR EMBOSSED SEAL SHALL TICO- TIT �614RIOTI POMPANY
MOT BE CONSIDERED TO BEA VALID TRUE COPY TI' E •�Cyy�1290-01��• �2)•
*GUARANTEES INDICATED HEREON SHALL RUN ONLY TO RN l
HEALTH DEPARTMENT DATA FOR APPR IVAL TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY IS PREPARED c Z
AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERN- 1. t
B %EATER WAIN MI • *SOURCE OF WATER PRINTF_UREIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED }y1l� \{;(�� y
B 51fF CO TAX MAP DIST 1000 SECTION 55 BLOCK 6 LOT D 15.1 HEREON,AND TO THE ASSIGNEES OF THE LENDING mak\`"; T
RTNER[ ARE MO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY IR TITUTION ADDITIONA LUARANTEES ARE HST T TRANSFERABLE
'
OTHER THAN THOSE SHOWN HEREON TOWNERS N , S
N THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE *DISTANCES NSHOWN HEREON FROM PROPERTY LINES e., 40,O, •,'�
WILL COMIORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT TD EXISTING STRUC TV RE3 ARE FOn A SPECIFIC .�
OF HEALTH SERVICES PURPOSE •
AND ARE NOT TO BE USED TO ESTABLISH• 6p LAND S�0
AF'Rp�,e.p4 �‘nC,�Z 'On eK\en\oV rot PROPERTY LINES OR FOR THE ERECTION CI FENCES
A°° C Sas YOUNG a YOUNG 44 0OSTADNNEWAVENUE
•
Qeco�\C NSI \\°lSg TEL
�34—SCD 1 8' •
NOTE A_STAKE ALDEN W YOUNG, ENGINEER
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF AND LAND SURVEYOR PROFESSIONALN YS AE NOIEER
SUFFOLK COUNTY ON MAR 19,1990 AS FILE NO.8912.
12845
F HOWARD W YOUNG, LAND SURVEYOR
S A THE LOCATE•OF W[LL(WI,SEPTIC TAMKIBISTCES1POOLS(CPI SHOWN HEREON N Y S LICENSE NO 45893
LA
a ARL PROM FIELD OBSERWITIONS AND OR DATA OSTMNED FROM OTHERS
BRANDIS& SONS INC.