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HomeMy WebLinkAboutPrizeman ILl��yfcno aiQD 00° C \TUIlLire Town Hall 53095 Main Road �® �y P.O. Box 1179 _-._ ® ��® �� Southold, New York 11971 JUDITH T.TERRYy�1io�" FAX(516)765-1823 TOWN CLERK TELEPHONE(516)765-1801 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. 530 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : PRIZEMAN, JOHN Address 1 : 131 HICKS STREET City St Zip BROOKLYN NY 11201 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 ON8/2/89. Name Of Owner PRIZEMAN, JOHN Mailing Address 1 131 HICKS STREET City St Zip BROOKLYN NY 11201 Property Address 1 ORCHARD STREET City St Zip ORIENT NY 11957 Tax Map No. section 27.00 block 3 lot 2.002 Cross Street OLD FARM ROAD Building Permit Number Cross Reference: • Issue Date: 8/23/89 Judith T. Terry Southold Town Clerk (TOWN SEAL) • ez 11 1 "Il G9 4 l\9 a PUG f , ,rl • . ?, �LpG•O���0�1. p ~ '� „ Town Hall, 53095 Main Road OF �'� : h't` 1� P.O. Box 1179 _� �1 41\4°001" Southold, New York 11971 JUDITH T.TERRY TELEPHONE TOWN CLERK (516) 765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Victor Lessard, Southold Town Building Department From: Linda Cooper, Southold Town Clerk's Office Dated: August 11 , 1989 Transmitted herewith is a copy of application No. 5.43 for a Cesspool/ Septic Tank Construction Permit submitted by: John Prizeman 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 X DISAPPROVE Comments: c� 1,.,S-icox v}, Q ac� �ua p„..9 q/�; - 1- $9 0U svSignature \IA1 Dated OFFICE OF THE TOWN CLERK ��FfCU( Town of Southold O �-u"": Judith T. Terry, Town Clerk ':'r Application No.-5-4/3 Town Hall, 53095 Main Road o 1 >'� r11 >' Construction P. O. Box 1179 ��� # � ' Southold, New York 11971 �� Alteration Telephone Q/^ �� 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 APPLICANT NAME: 0 OW 12gr2rq;(--'r1-/l) APPLICANT ADDRESS: L f f(C 9 ST� � tjF,Q©kz_wu y � z0 SEPTIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION PROF S-FTS LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: Tom' pj-(Z- /l-f/4// OWNER MAILING ADDRESS: 1 ? I OWNER PROPERTY ADDRESS: OP-C/fA-- P ST - ��-l �V1`r • TELEPHONE NUMBER OF CONTACT PERSON: 7/ 5 Cze7 03 FrC / boa-9 2_-7 Z � Z TAX MAP NO. : Section Block Lot CROSS STREET: CNC/ P._ n BUILDING PERMIT NUMBER CROSS REFERENCE:_ � /, / - Signature_ .f Ap.)ica t RECEIVED BY: Il wn" ' Clerk's Office DATE: AUG 198LJ 'Sop CO WW1 . - en N. O ^ � The water supply and sewage disposal , �% systems for this residence will conform to the standards of The Suffolk County Department of Health Services. . `CO +o?+. _--rka? 0);,?,„,.. - f k ` ars Fl Q` + ,....N- • • �r �eL, N �0 .,, v�0 ��wzl/ Rh \eco, t e.. �, / \ 4 �D0kg 0 03 I r ~O}' o° 8 /14' . _ 9* t • ..............je 4; , -; , . m 4) \ ry4/ 0b 14, • ct- \ S.< t �°� - ."''," = SURVEY OF, V ' `�4P PR OPER T y - = .� a'‘ R AT ORIENT " ter: llTOWN OF SOUTHOLD w°r" , - SUFFOLK COUNTY, N. Y. .b o': `"- 1000 - 27 - 03 -• 2.2 • =. June 14, 1989 i mo • - PLEASE NOTE r I/40o, IV r`. + 09. q ev •.1- „,.. It i9 the applicant's responsibility to eq ?o t>. maintain adequate sanitary distance y ~�oi,� 44, he g_, v°.Eos i142YdCei? all Water sup:ly end sewage os s disposal facilities. •+r - - _. Aus yio 7EST - ELEVATIONS ARE REFERENC , -PLEASE ATE TO ASSUMED DATUALmiBROWN aLrr LOAM AREA = 1.1334 acres ,,;• Requires septic tank •M o a r cover to grade. ®Pt s . SINGLE FAMILY DWELLING ONLY - . . '•• SPR TWO YEARS FROM DATE OF APPROVAL ''n ' WATER N PALE BROWN CERTIFIED TO: COARSE TO varr' COUNTY DEPARTMENT OF HEALTH SERVICES AMERICAN TITLE INSURANCE COMPANY COAaSE.WC 312 APPROVAL OF CONSTRUCTION ONLY PIP Z FISRFANO 757 , / a. "%ftLij� - nn 5`f/ z"9 ‘1d 65 �\ ZZ Hilt .o; Qi 41 _ oo ��° __-'. .t *.I .S. LIC. NO. 49668 red in accordance with the minimum 1061 t4':'1 i i'ii 3 AIL ' 7,,,•. ,rds for title surveys as established h L1V J"• c(� X33 r / "+ •N U”V' If-S, P.C. L./.A.L.S.and approved and adopted I,lk1(lu -A10.1' - (\ 1.,•y. 0 •h use by The New York State Land ' asocatron. MAI\-`1i1.1►'. The locations of wells and cesspools shown hereon are from mold SOUTH* 1, .Y. 11871 ob tions and or from data obtained from others. 89 - 275