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Home My WebLink AboutMiesemer • OFFICE OF THE TOWN CLERK S�FFO� Town of Southold �� CDy Judith T. Terry, Town Clerk Town Hall, 53095 Main Road P. O. Box 1179 .v' _" ` r Southold, New York 11971 Off. Telephone- I ��;; • (51`6) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT • CONSTRUCTION OR ALTERATION PERMIT , SEPTIC TANK or CESSPOOL • Permit No. 160 Residential X Non-Residential Fee $ 10.00 Septic Cesspool x PERMIT ISSUED TO: NAME: Inland Homes, Inc. ADDRESS: 315 Westphalia Road Mattituck, New York 11952 DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION • New Single Family Dwelling with Sanitary System APPROVED as indicated by Suffolk County Health: Dept. LOCATION OF PROPOSED CONSfRUCTION or ALTERATION: - OWNER OF PROPERTY: Alfred W. and Margaret E. Miesemer OWNER MAILING ADDRESS: 49 Embargo Place North Babylon, New York 11703 OWNER PROPERTY ADDRESS : 1760 Sterling Road Cutchoque, New York TAX MAP NO. : Section 104 Block 4 Lot 16 CROSS STREET: Pine Tree Road BUILDING PERMIT NUMBER CROSS REFERENCE: • dr4;14411 "-"" ‘-`44e..6 — Judith T. Terri Southold Town Clerk DATE: May 11 , 1987 (TOWN SEAL) 0 c C��1 t 11 1',,�,'N , 1 1,.1_1 11�b.:, • SA tin ' F , % Town Hall, 53095 Main Road ` t. e, ,, -.v. 4 P.O. Box 1179 -6� !�� to Southold, New York 11971 JUDITH T. TERRY yam..,; i' t TELEPHONE TOWN CLERK . (516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD May 11 , 1987 Inland Homes Inc. 315 Westphalia Road - Mattituck, New York 11952 Re: Alfred W. and, Margaret E. Miesemer 1760 Sterling Road Cutchogue, 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 ?fours, Judith T. Terry Southold Town Clerk Enclosures (3) JTT/Ijc \car 1- tiLEIN 1.5:13 n,/ 0"sq, 'r •,7174,00,-:, ; SAY 5 198 t .'. °rte r BLDG OU i O t� � dna ;•� DEPT. ttri'c • .yds ►'Fis 'f00�1 O� - `' own Hall, 53095 MainD Road., P.O. Box 728 ,Southold, New York 11971 ti .. JUDITH T TERRY TELEPHONE TOWN CLERk (516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD May 4, 1987_ (/ To: Victor Lessard, Southold Town Building Department From: Judith T. Terry, Southold Town Clerk Transmitted herewith is a copy of application No. 165 for a ' CONSTRUCTION or ALTERATION Permit for a cesspool or septic system submitted by Inland Homes, Inc. for Alfred W. and Margaret E. Miesemer. 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: . y ate r... , • _:, � ,. t �_ - a.s-AT-JCL'c‘449- Signature b./VI? 7 Date OFFICE Of THE TOWN CLERK Town of Southold j Judith T. Terry, Town Clerk Application No./ Town Hall, 53095 Main Road Construction P. O. Box 1179 Southold, New York 11971 Alteration_ Telephone 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 $ 10.00 DATE Ma 2. 1987 • APPLICANT NAME: ' TwT,aND loot s, INO. APPLICANT ADDRESS: 315 Westphalia Road " Mattituck4 N. Y. 11952 SEPTIC CESSPOOL X DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION 1 Family Dwelling' LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: Alfred W. & Margaret E. Miesemer OWNER MAILING ADDRESS: 49 Embar&o Place ^' North Babylon) N. Y. 11703 OWNER PROPERTY ADDRESS: 60 terl i g Road C � •�h�g�., I� Y. �1935 TELEPHONE NUMBER OF CONTACT PERSON: 298_9696 TAX MAP NO. : Section 104 ___Block_ 4 Lot pcl 16 CROSS STREET: Pine Tree Rd. BUILDING PERMIT NUMBER CROSS REFERENCE: � 1 i1 Sicdnature of rgiecTit RECEIVED 14. . Town cries ffice��.__ DATE: T;'-:;7" Tc,:.sr, ri.•. ` Ui`fl3ci r. '41 I „to.,0 C.-1a ..e.".., SUFFOLK CO. HEALTH DEPT. APPROVAL - H. S. NO. N` SINGLE FA1ti�1LY y)WEL_1.1N,N ONLY , - EXPIRES TWO YEARS FROM DATE c FAPPROVAL , NN:1 ' ' . STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL I SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO .T;iND R S OF THE i r . HH0/EEttlpAd ilG SUFFOLK CO. D 1 • est PIEtH.SER VICESla tia. . APPS•. ''' . . /s' - '/, C J SUFFOLK COUNTY DEPT. OF HEALTH ' ' i t( SERVICES — FOR APPROVAL OF _ j' CONSTRUCTION ONLY G _ �� "� a6 ! ^ � DATE: y-�'G� � H. S. REF. NO.: 8‘47S O Gj • - VE.�Y LC, F O 1.. . - APPROVED: '______ , el/ 3c2e / 4 t' i �, •' "T " '�4 � SUFFOLK CO. TAX MAP DESIGNATION: ' 4 DIST. SECT. BLOCK PCL. - ' 1. NA 1_. 1—) 1000 - 104 , 4 16 ""`) f_ I i_w ,`�."" OWNERS ADDRESS: -,;. '1760 '.-.31-E12..LI ^•1C: L ,,' :ICJ i_21'F",C.a L.tom' ! ,T' t"E=L,E--., i.=7Ut� , .. jiP c I DEED: L.r;:3 (Y TEST HOLE STAMP :an L�LS.. '�-� ''` r it t;le•S:r•t�York wia tD • rua a I 1.Q Jt PJ P tiur�u:>, - !,�� not a�atfirg '(' 'T'+ ��. t/''� «Y'-]...—_94,8' i r-c _._�_�_ 9 JIJ'S iC�kod*?di pfu�.,�.a TI I 1 L E.` �O,. R.- 4,8 V621-5. / ,,,i, t ;Suri shall,,,. 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