HomeMy WebLinkAboutNine (3) OFFICE OF THE TOWN CLERK c.1FRA- ,-
Town of Southold
Judith T. Terry, Town Clerk , „ L
Town Hall, 53095 Main Roadc= ='
P. O. Box 1179 .cr2•
Southold, New York 11971 O` - O�•��
' Telephone �l �•i,
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 26 Residential XX
Fee $ 10.00 Non-Residential
" Septic Cesspool XX
PERMIT ISSUED TO: "
-NAME: Inland Homes Inc. =
ADDRESS: Box 117 -
Mattituck, New York 11952
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
Single family dwelling with cesspool system .
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION: -
OWNER OF PROPERTY: Russell and June Nine "
OWNER MAILING ADDRESS: Sunset Drive - --
Mattituck, New York 11952 -
OWNER PROPERTY ADDRESS : Sunset Drive
Mattituck, New York
TAX MAP NO. : Section 115 Block 3 Lot 4
CROSS STREET: New Suffolk Avenue
BUILDING PERMIT NUMBER CROSS REFERENCE: Pending
•
•
Judith T. Terry
Southold Town Clerk.
DATE: September 3, 1986 -
I' (TOWN SEAL)
r �
o
u, kosa
p . § �� Town Hall, 53095 Main Road
4 ` ' _ ��' P.O. Box 728
•0'0Southold, New York 11971
JUDITH T TERRY TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
September 3, 1986
•
Inland Homes Inc.
P.O. Box 117
Mattituck, New York 11952
•
Re: Single family dwelling - Russell and June Nine
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 s
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,
Judith T. Terry
Southold Town Clerk
Enclosures (3)
JTT/Ijc
'moi '
OI FICErOF THE TOWN CLERK
Town of Southold
Judith T. Terry, Town Clerk Application No.,-37
Town Hall, 53095 Main RoadConstruction L�
P. O. Box 1179
Southold, New York 11971 Alteration
Telephone Residential 1..
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or, CESSPOOL
Permit No.
$ /6 °'
Fee
DATE
APPLICANT NAME: DIN Vow e-S .
APPLICANT ADDRESS: IJO?( /17 /11ecT%,riC.Z
SEPTIC CESSPOOL f/
DESCRIPTION OF ROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued. •
LOCATION OF PROPOSED CONSTRUCTION -O�cR ALTERATION:A
OWNER OF PROPERTY: a e.II `1�N� 1`�ivke
OWNER MAILING ADDRESS: SUW\se-T arzW�
/7 OWNER PROPERTY ADDRESS: SJ,Nv,e,,, & _O.\OwE
TELEPHONE NUMBER OF CONTACT PERSON: 2-4g'^Q6Q4;)
TAX MAP NO. : Section //5--
Block 3 Lot y
CROSS STREET: 7')&.) SOI V— . AO E,
BUILDING PERMIT NUMBER CROSS REFERENCE:
LLrJJant
RECEIVED BY:L c-x_ceeL_
Town aClerk's/Office
DATE: cam% /5
tls' M A f N ROAD
( N .Y!S. RTE. 25 )
r
, ( dwelling )
•
N/O/F LAND OF . NINE �`S
r,
• 4 ar . :- . . -
- fns.' i 3
i
o:e I, S. 88°37'40"E. 67 1 2Bs 191.90' P
S 3 7i 6.1v •`LQ��v
_ 28.3 - -_ ,o,r, bnk /e+%teT-10 //i 29.5 29.81 v'
i.
jN _ wood ------r gts. -
Q tl i/79roand / 6Qs'n. III a
2 M p° Roof13
�i�Cl
,yqieck- Lv7 cP . .....
c w /hk fence �, �l' TESTY• OL l/
2 ®s i
4; do �. •_ ( o
�/ N
w N / eco �dt1411'
„fide
� .
fnd a
moan c
f 26.9 pis
30.2 N.88° 37'40"W.
SINGLE. r �t,�r'd .'�1 ' :i_ �.�+�! �:' ��..Y "�V�
- • N/ 0/F SHEIt P3 ° `YEIAFIS-ERQM KM CA- APS
N/0/ F- . mon.
SHELIA A . ' - -
W ._ . _. . , ___ _ __ _ __, ____ __ __._---____-- __-- --_-• • _ •---
( dwelling ) ( dwelling )
- SUFFOLK COUNTY DEPARTMENT Cr HEALTH SERVI %
'- ' . . ' - ,- ', -,`-• • ' - ' - FOR APPROVAL OF CCNSThUCT:C N CNLY
TEST HOLE -- . ,. _ �Z l�
- ' - t;'Z7� HS REF. NO. �--
_ '• e1.30.00 DATE
' brown .— .-- ____ - ___ �._ ._loam 1.2 1 A R EQ = 26225 SQ. F .APPROVED C1-44:--. 1441P°1—"."41 1
brown
coarse ®e q ("q q a7
sans'. 2.3k �, i- „: t,_ . . -SURVEY:FOR _---'''- •.1
Pale `1 %d F
brown - );,.40 RUSSELL , a JUNE . NINE v
- ineo'iiun _ _tis
ti;- 5.1 , AT •-MATT.ITUCK --
• JUL 23 1986 TOWN OF SOUTHOLD
- ' brawn -,` . ;. � •,
coarre - ' . - SUFFOLK COUNTY , N.Y. .
sond•,.; .. - SC DEPT- OF
• - - 171 ---, HEALTH SERVICES--- - - (900 - 115 - 03 - . 04
SCALE ° _=4 _ _ _
JULY 18 , 1986
LAND s - - - - ,
o,1t- i.MEr &4, The water supply & sewage disposal sys- .
���'O,r� SCF tri '' toms for'this residence will conform to the - _ .
11 0 standards of the Suffolk County Depart- CERT 1 FI ED TO
` . mens'of Health Services.
4" - ://1 `RUSSELL NINE
O. --4: A,'1 ic 9 1 ROMA .J'�,� u &edN�Ncfccordance with the minimum
`� k •Q 16 Westphalia Rd. 4/`' 4 standards for title surveys as established by
°� 3 the L I.A.L.S. and approved and ado ted
ox 17�1VIat4ituc N•v. 11962 PP P
�4' ' N.Y. '�,. LIC :1110. 49618 for such use by The New Yolk S4at® Land
e rdite Assockiiinp. -
PECONI-C SURVEYORS a , ENGINEERS ; P. C .
-( 51,6 ) 765 .;--5020 • - , • , -
-P. O. •
BOX 909 -
MAIN-,ROAD. . ' ' ELEVATIONS ARE REFERENCED
-SOUTHOLD , N ,Y-. 11971 TO AN ASSUMED DATUM.
86 —374