HomeMy WebLinkAboutSkinner (2) �®,
JUDITH T. TERRY ,O Town Hall, 53095 Main Road
TOWN CLERK ® T P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS tt°s Southold, New York 11971
MARRIAGE OFFICER � ® Fax (516) 765-1823
0,7/ Telephone (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. 940 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : THEODORE C. MARTZ JR.
Address 1 : 145 RYERSON AVENUE
City St Zip MANORVILLE NY 11949
Descripton of Proposed Construction or Alteration
SINGLE FAMILY DWELLING WITH SANITARY SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPATMENT
OF HEALTH SERVICES ON 11/10/92.
Name Of Owner SKINNER, ROBERT AND ELIZABETH
Mailing Address 1 P. O. BOX 583
City St Zip MILLER PLACE NY 0000
Property Address 1 SOUTH DRIVE
City St Zip MATTITUCK NY 11952
Tax Map No. section 106.00 block 11 lot 22.000
Cross Street BAYVIEW AVENUE
Building Permit Number Cross Reference:
Issue Date: 11/30/92 Judith T. Terry
Southold Town Clerk
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JUDITH T. TERRY ', Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
c Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ;
MARRIAGE OFFICER
Fax Fax (516) 765-1823
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Fax
(516) 765-1801
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� ' li NOV 2 31992 ;, OFFICE OF THE TOWN CLERK
1g TOWN OF SOUTHOLD
TOWN ._.= 'F,00"n-101D
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: NOVEMBER 23, 1992
Transmitted herewith is a copy of application No. 967 for a Cesspool/
Septic Tank Construction Permit submitted by:
Theodore C. Martz Jr. for Robert & Elizabeth Skinner .
Please review the application and location map and advise if the project
has received Suffolk County Health Department approval and if this office _, r ,
may issue the permit.
Please complete the form below and return it to me.
Thank you.
*-1(--ce. .../
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: w, ),,,,., .catk a... c, o, a .4.s. , Q4
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Signature _
%,\ks\00..
Dated
OF,,FICE OF THE TOWN CLERKF0(,�r;•
bf Town of Southold �Q,
Judith T. Terry, Town Clerk �; � Application No. 6 C,7
Town Hall, 53095 Main Road '°" � - - J
P. 0. Box 1179 Construction V
wt�riijf
7
Southold, New York 11971 r Alteration
•
Telephone '01 rc !� ,,{i Residential
(516) 765-1II01 " Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
' RECEIVE'D
CONSTRUCTION or ALTERATION PERMIT
23 1992
SEPTIC TANK or CESSPOOL NOV
Southold Town Clerk
Permit No.
Fee .$
DATE
APPLICANT NAME: I heCPCEC C:11.461—
M fl
APPLICANT ADDRESS: 1 -1 \1
'44/40trE_
SEPTIC CESSPOOL
DESCRIPTIO PROPOSED p011STRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CON RUCTION 0 ALTER 10
OWNER OF PROPERTY: (Z 6nn��
OWNER MAILING ADDRESS: e0
4t\e cam , N
OWNER PROPERTY ADDRESS: 1 k=t\I
•
A-717-"A1 r
TELEPHONE NUMBER OF CONTACT PERSON: 616-i3,K1
TAX MAP NO. : 5.ection 1 °14" B ck 11 , 0-D Lot ZZ •Z:1°
CROSS STREET: dielVleo
BUILDING PERMIT NUMBER CROSS REFERENCE:.. _
•
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
•
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9 e N.83°35'00"w m
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FENCE O
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� f 3 : FAMILY �WELLIN �� _ \So. O� EL'7 �y�
t./'�tit N} yl flj IiOtv1 DATE
_r [ ( cOF APPROVAL LA `
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� WELL aY orNEKh
W C.P
NOTE. I
I ■=MONUMENT REVISIONS YOUNG & YO
2 LOT DESIGNATIONS REFER TO MAP OF JAN. 22,1990 400 OSTRANDER AVENUE, RIVER
"SHORE ACRES" FILED IN SUFF.CO CLERK'S
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT OFFICE AS MAP NO.41 ON JAN 3,1914. ALDEN W YOUNG
,3 ELEVATIONS SHOWN HEREON ARE IN PROFESSIONAL ENGINEER AND
-a-NEAREST NATER WIN_'d It SOURCE OF WATER PRIVATE—PUBLIC_ REFERENCE TO NGVD (MSL. 1929) LAND SURVEYOR NYS LIC NO.128.18
i SOU CO TAX MAP DIS'19 2 4SEE CTION 106 BLOCK I�LOT—
THERE. ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY - SURVEY FOR.
OTHER THAN THOSE SHOWN IEREON UNAUTHORIZED ALTERATION OR ADDITION TO JOHN SKINNER
THE WATER SUPPLYAND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE THIS SURVEY ISA VIOLATION OF SECTION
• WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPART HENT 7209 OF THE NEW YORK STATE EDUCATION '
OF HEALTH SERVICES J SUFFOLK COUNTY DEPARTMENT OF htALlF1 ZUWICEy _ LAW
APPLICANLI"ACL r /1 L�"(
�y--{{17'"JJ ..] I"1' COPIES OF THIS SURVEY MAP NOT BEARING
-- - THE LAND SURVEYORS INKED SEAL OR
ADDRESScf) 3 3I FOR APPROVAL OF CONSTRUCTION ONLY 14./L1(-:
EYBOSSEO SEAL SHALL NOT BE CONSIDERED
TEL.__ � � CO BE A VALID TRUE tour ATMATTITUCK
1-,443 .5t..,.__�lyrc4a �1�16- di�iV i
C!�7 r GUARANTEES INDICATED HEREON SHALL RUN
_______ �._ — DATE A! HS REF. N�. 7c•I / ONLY TO THE PERSON FOR WHOM THE TOWN OF
r ' SURVEY IS PREPARED,AND ON HIS BEHALF SOUTHOLD
ry��, TO THE TITLE COMPANY,GOVERNMENTAL
APPROVED APPROVED _ BY AGENCY AND LENDING INSTITUTION LISTED SUFFOLK CO, N.Y.Yr
HEREON,AND TO THE ASSIGNEES OF THE
LENDING INSTITUTION GUARANTEES ARE
*THE LOCATION OF NELL(W),SEPTIC TANK(STIBCESSPOOLS(CP)SHOWN HEREON NOT TRANSFERABLE TO ADDITIONALSCALE I"=601 DATE JULY I, 198:
ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS. INSTITUTIONS DR SUBSEQUENT OWNERS, .....