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0, iOf. .. 004f 01./(tx- JUDITH T. TERRY ; �► Town Hall, 53095 Main Road TOWN CLERK O T P.O. Box 1179 REGISTRAR OF VITAL STATISTICSt4"04,4_ trS � Southold, New York 11971 MARRIAGE OFFICER 4"Q O�''��, Fax (516) 765-1823 �y j I° Fax (516) 765-1801 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1050 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : NANCY STEELMAN Address 1 : 25235 MAIN ROAD City St Zip SOUTHOLD NY 11971 Descripton of Proposed Construction or Alteration NEW SINGLE FAMILY RESIDENCE WITH SANITARY SYSTEM. APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES REF. #93-S0-62 Name Of Owner PAGE, JOHN E. & MCKAY, JOE A. Mailing Address 1 P. O. BOX 254 City St Zip NEW SUFFOLK NY 11956 Property Address 1 520 GEORGE'S STREET City St Zip NEW SUFFOLK NY 11956 Tax Map No. section 117.00 block 4 lot 18.004 Cross Street NEW SUFFOLK ROAD Building Permit Number Cross Reference: Issue Date: 10/27/93 Judith T. Terry Southold Town Clerk (TOWN SEA I 1 lo ® JUDJTH T. TERRY ; Town Hall, 53095 Main Road TOWN CLERK v T P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 v� •� MARRIAGE OFFICER Fax (516) 765-1823 ® ®� • ---- ,y®1slitT° .� Telephone (516) 765-1801 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department a i' OCTA GT - 6199 FROM: Linda J. Cooper, Southold Town Clerk's Office Iii L DATED: October 5, 1993 js� _ • 1 TOW` Transmitted herewith is a copy of application No. 1081 for a Cesspool/ Septic Tank Construction Permit submitted by: Nancy Steelman for John E. Page & Joe A. McKay . 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 l� DISAPPROVE Comments: *eze- / SC/10 4/ 93 - so 6 -2_ Signature GAJ /0/2-7/Q__,3 Dated Lv. ' .. . ,..•rl•fr OFFICE OF THE TOWN CLERK cr-FO • O� Town of Southold HQ, .LL Judith T. Terry, Town Clerk � r'' I`` '-..-L.1%j /�?7 r,r" ; 5 '-..-L.1%� Application Nd. Town Hall, 53095 Main Road P. O. Box 1179 u' 1 41fr . _ Construction Southold, New York 11971 • '1' '�` Alteration Telephone 1 x 1 Residential (516) 765- 1301 fisfrfl . Non-Residcn tial TOWN .OF SOUTHOLD • SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for r CONSTRUCTION or ALTERATION PERMIT • SEPTIC TANK or CESSPOOL r• Permit No. Fee .$ DATE . 5 J 97 r APPLICANT NAME: APPLICANT ADDRESS: ` c:If . _ I 0,41 r 1C3 SEPTIC2CESSPOOLx - DESCRIPTION OF PROPOSED CO STRUCTION OR ALTERATION 1 )0 , rani —4 . I !Ow III lifil __,,_.4 (ME e___L____ , AD. 1 Y( 1 � �;--eyl,•-; - LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTER • TION: OWNER OF PROPERTY: ishi ii, YAM J A OWNER MAILING ADDRESS: �� C� OWNER PROPERTY ADDRESS: r est. • IL. ..MMALla -... TELEPHONE NUMBER OF CONTACT• PERSON: 34'—(c) TAX MAP NO. : Section IN • Block Lot • CROSS STREET: a ,-) BUILDING PERMIT NUMBER CROSS REFERENCE:_. • 9, , / I A! / _A (2.4/4zic,,_______ ig J tune of Applicant RECEIVED BY: Town Clerk's Office DATE: i_ ' 1 • 19 900 L M ,..A''J - es Pr-70-4,1" sEF'n T.v 1- L�GI"II�1�4� r' zE GFT}q.Fr pL f�60 I�E.L i- C,TiiRE bN L E Mr {. 9'41J1T.4r..b Y6T f0r'OS- I IS ` TYPICAL LEACHING FOOL • • FINISHED GRADE - i CONCRETE COVER I'MIN. 2'MAX CONCRETE CHIMNEY 2'MAX. INLET f t r--20'--4 MIN.4"0IA. APPROVED PIPS . PITCHED MIN.1/8"/1' ' • nn�l f:'y a00pp® j°' H �1 OODpp j s1, I �r Max.2S' 4 i �m - a -�i N If vPR1Es i • see. .� VERU - /1. n O S'MIN. LEACHING In s I1/1l > Q COLLAR SECTIONS / g a : . r =tu !� III � �_ �1i i t --L 2'MIN. • GROUNDWATER 6'MIN. PENETRATION BACK FILL MATERIAL TO 8E CLEAN")INTO A VIRGIN STRATA SAND ANO GRAVEL OF SAND ANO GRAVEL II Ar711J aLJILCINCI P..104/..L. 2'MAK• I'MIN I 2'ktA Gg12�.DE EL*15' • 4'MAX. - • 1 //_________ LcI-11 /B°/Fr YA-0/PT NC7 T1c T 1J TOP FbPOOL. .�►SEPI. r 1 IK `IE, + 13.30 mit__...OUTLET GRCU+JD LAATER IE• +12..8 MIN 4"DIA AP- _ . ELEV, + 2,5' I PROVED PIPE I + 12.7Z i I E, + 13,50 I E PITCHED I/8'/I' 2' MIN :4( BFT i 10 pr Ii E. 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