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JUDITH T.TERRY ; Town Hall, 53095 Main Road
TOWN CLERK g P.O.Box 1179
REGISTRAR OF VITAL STATISTICS � Southold,New York 11971
MARRIAGE OFFICER � � �S?� ® �
�� Fax(516)765-1823
ED RECORDS MANAGEMENT OFFICER ®1 ��oil. Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER �
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1198 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MARK SCHWARTZ
Address 1 : BATES I; BOOHER ARCHITECTS
City St Zip SAG HARBOR NY 11963
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY
DEPARTMENT OF HEALTH SERVICES.
Name Of Owner NIEBLING, LAURENCE
Mailing Address 1 24 MARGARETTA ROAD
City St Zip BOONTON NJ 7005
Property Address 1 NASSAU POINT ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 119.00 block 1 lot 18.000
Cross Street BAY AVNEUE
Building Permit Number Cross Reference:
Issue Date: 9/15/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK ® '; •- P.O. Box 1179
6.rs Southold, New York 11971
REGISTRAR OF VITAL STATISTICS �® V. ��” Fax (516) 765-1823
MARRIAGE OFFICER _�°� ®pit Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER _ ®1 l
FREEDOM OF INFORMATION OFFICER '����rir�rrrrll
OFFICE OF THE TOWN CLERK M —
TOWN OF SOUTHOLD
i.t 2 1994
TO: Southold Town Building Department z� L-'
FROM: Linda J. Cooper, Southold Town Clerk's Office ij !
BLDG.DEPT.
DATED: September 2, 1994 TOWli®Fa,-
Transmitted herewith is a copy of application No. 1243 for a Cesspool/
Septic Tank Construction Permit submitted by:
Mark Schwarts (Bates & Booher Architects) for Laurence Niebling •
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.
Linda J. Cooper
* * * * * * * * * * * *
I
have reviewed the application and location map of the project cited above
and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: ��6/
ti
Signatufe
Dated
_
OFFICE OF THE TOWN CLERK ,,""""'•,,
Town of Southold .'''• OFULire
-
Judith T. Terry, Town Clerk ��' �� l/y Application No./62, (/3
• O `` k' v
Town Hall, 53095 Main Road Construction� Z ; ."
P. O. Box 1179 ; v •
rn �
Southold, New York 11971 tt� • Alteration
Telephone 0%b® �� • $10.00 - Residential
(516) 765-1801 1 1 , ' $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
•
Permit No.
Fee $
EATE,5 goo DATE z, i 9 94
�0r
APPLICANT NAME: Mkk: 5 tittA �
APPLICANT ADDRESS: Foy cit®
SAC --I4 of, N 'f // Y6.E
SEPTIC CESSPOOL x
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERA-TION
New SSeiic Cyrram
LOCATION MAP: ' Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:�
I
OWNER OF PROPERTY: M . U [ I ENGE t\1113(.1N167
OWNER MAILING ADDRESS: ,¢ M It-4 Aj e 1A- D
gooxiyiwi N ®7oos-
OWNER PROPERTY ADDRESS: NA-55A1/ Pr
eo
coral-mug. dui
TELEPHONE NUMBER OF CONTACT PERSON: 72 O22- R
TAX MAP NO. : Section lig Block ® I Lot / C
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature Applicant
RECEIVED BY: K.
REMIT; %=;n CIeOffice
DATE: SEP Z 199 •
-
Iown clerk Southold
\1
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES S
FOR APPROVAL OF CONSTRUCTION ONLY
DATE HS. REF. NO.• /11/4110\
.0.-
APPROVED S� A
V /SO
I am familiar with the STANDARDS FOR APPROVAL
AND CONSTRUCTION OF SUBSURFACE SEWAGE A
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES .R
and will abide by the conditions set forth therein and on the 6
permit to construct. ki-eV/o S A�
FE ;.� 4oe
0.9SW 4 0
F
` \1/ Iy >6 `�S '
Po`' a ^�9V etre 4000 •e?��� 'Q =
TES T BORING (,' / �" / °
o , Q N
V _ \ UTILITY •• '({
Dr. Grey . k e. Dote
6, Sandy Loam �C' // . FND �-�j
o K6
• -MON
Brown Loamy ,G✓ ' i
Sand0/
l 0.2W \ //0 /
\`�/ �'
Pale Br. Fine LOT 86 CONC. \ /
to Coarse Sand PATIO \
CONC. BLOCK 0.37V {
RETAINING I ��t i
\ WALL �1 !
0.8W 7 / 11
\\ _ �� OO
,--41' \\ \ \ f
6.5'0 l
\ u N
r 1 \� �� tijta•
i
\ \, \ 1 1 urltlrr
par s
z
to /� W LOT 85 �l°x -60 —
N Is I ,I 4r' " ` "' .9 e
AREA = 40,687 sq.ft. 1 , , 4 1 s eo G'
Q v i `o c cto . 8
• TO TIE LINE N // /4S'�05r� -.7%t- '-',-. 1" �\
o 0 1 11, � 4- \
_ • -a LOT 84
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/\ '��IT \5. \\ �_ MAP OF PROPOSED SUBDIVISION
ISIO/Y
F ���' 0991 \ q' SEC TION B
O
NASSAU POINT CLUB
- i „
1/4.. . PROPERTIES INC.
FILED OCT 4, 1919 FILE 130. 745
AT NASSAU POINT
�� TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y.
1000 - 119 - 01 - 18
Scale 1" = 40'
March 20, 1989
April 7, 1994 (revisions)
CERTIFIED TO: May 4, 1994 (N.G. V.D.)
TITLE USA INSURANCE CORPORATION OF NEW YORK
LAURENCE NIEBLING July 7, 1994 (B.O.H. )
DIANE NIEBLING SPP(` ! 1994 (a oc.oc", f _) .
�on5
gt p LAND 6,410
* it 19
Is;; a,r d
Prepared in accordance with the minimum ".;"7��49618 p4
standards for title surveys as established . OF NEWS
by the L.I.A.L.S. and approved and adopted
for such use by The New York State Land / > N.Y.S. LIC. NO. 49618
• Title Association.
The locations of wells and cesspools. The SURVEYORS, P.C.
0
shown hereon are from field observations - 50
P. 0.6) BOX 9
P. O. 909
and or from data obtained from others. CONTOUR LINES ARE REFERENCED TO N.G.V.DATUM. MAIN ROAD
., SOUTHOLD, N.Y. 11971
89 - 174