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Home My WebLink AboutStevens • OFFICE OF THE TOWN CLERK c0FULA' Town of Southold �G Judith T. Terry, Town Clerk .` Town Hall, 53095 Main Road . c �� * P. O. Box 1179 • to a ; Southold, New York 11971O4 , ' ° Telephone �! •,, (516) 765-1801 ' TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 145 Residential X Non-Residential Fee $ 10.00 Septic Cesspool x PERMIT ISSUED TO: NAME: Edmund Stevens, Jr. ADDRESS: Sandy Pond Road Lincoln, Maine 01773 DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION New Single Family Dwelling LOCATION OF PROPOSED CONSTRUCTION or ALTERATION: OWNER OF PROPERTY: Nina Stevens OWNER MAILING ADDRESS: c/o Edmund Stevens Jr. Sandy Pond Road Lincoln, Maine 01773 OWNER PROPERTY ADDRESS : Oregon Road Cutchogue, New York TAX MAP NO. : Section 83 Block 2 Lot 10. 1 and 10.2 CROSS STREET: Between Cox Lane and Bridge Lane BUILDING PERMIT NUMBER CROSS REFERENCE: Judith T. Terry Southold Town Clerk DATE : April 15, 1987 (TOWN SEAL) %�,J ��f/;C' .:yK'.'l']y,�,. ;,y -Y nom'-' ,,:;',:,:•,_., >= ''- . ^5 % Town Hall, 53095 Main Road `V Jl,'S 4 tie , =��, ,_,,a.� �,� r P.O. Box 1179 r r . Southold, New York 11971 JUDITH T. TERRY %,p,ilf°��/` TELEPHONE TOWN CLERK (516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK - TOWN OF SOUTHOLD April 15, 1987 Nina Stevens c/o Edmund Stevens, Jr. Sandy Pond Road Lincoln, Maine 01773 Re: Oregon Road Cutchogue, New York 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 ($25. 00) for non-residential. Please have the owner complete the enclosed Application for an Operation Permit and return it to this office along with the proper fee. • For your general information I have enclosed an Informational Bulletin regarding the Scavenger Waste Laws adopted by the Southold Town Board. Should you have any questions pertaining to either permits or the Scavenger Waste Laws, please do not hesitate to contact this office. We will be glad to assist you in any way possible. Very truly ours, Judith T. Terry Southold Town Clerk - Enclosures (3) JTT/Ijc owes, � .� �* Town Hall, 53095 Main Road .0 . P.O. Box 728 -�� r•r Southold, New York 11971 JUDITI1 T.TERRY TELEPHONE TOWN CLERK (516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD April 9, 1987 To: Victor Lessard, Southold Town Building Department From: Judith T. Terry, Southold Town Clerk Transmitted herewith is a copy of application No. 147 for a CONSTRUCTION or ALTERATION Permit for a cesspool or septic system submitted by Eugene Burger for Nina Stevens Please review the application and location map and advise if the project has received Suffolk County Health Department approval and if we may issue the permit. Please complete the form below and return it to my office. Thank you. • Judith T. Terry Southold Town Clerk I have reviewed the application and location map of the project cited above and make the following recommendation: APPROVE - l� DISAPPROVE - pL COMMENTS: D.,7, VA-LA-R.4- \1(7 r Signature - _ - 9/� Date ht Y OFFICE OF THE TOWN CLERK Tawn of Southold • Judith T. Terry, Town Clerk Application_No. - Town Hall, 53095 Main Road Construction P. 0. Box 1179 Alteration Southold, New York 11971 -- __- -- Telephone Residential (516) 765-1801 Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. • Fee .$ DATE APPLICANT NAME: EDMUND STEVENS , JR. do APPLICANT ADDRESS: SANDY POND ROAD as-76- LINCOLN, MA 01773 _ z�r,�. SEPTIC xx CESSPOOL __ °Y_7 9-57.2/ DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION ONE FAMILY RESIDENCE LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: NINA STEVENS OWNER MAILING ADDRESS: c/o EDMUND STEVENS , ;TR. , SANDY POND RD. LINCOLN, MA 01773 OWNER PROPERTY ADDRESS: OREGON ROAD , CUTCHOGUE , NY TELEPHONE NUMBER OF CONTACT PERSON: 617/2.59-,092n TAX MAP NO. : Section 083 Block 2 Lot 10 . 1 & 10. 2 CROSS STREET: BETWEEN COX LANE & BRIDGE LANE BUILDING PERMIT NUMBER CROSS REFERENCE: Signature of Applicant RECEIVED BY: Town Clerk's Office DATE: -. iLl:,.3 7. .?? IA I< 20 W f.),.. - C^ Q ` • lY - • el'X j �.. �- \fl Quo °r TEgr 9. �.� ��°� y� Qo • f°rmerly N��a • \0 Steve - tf �S \ . C., • _'� TEST HOLE 0{....,� TOP SOIL 0 O -0_, O °�1 0 5" 1 +.:•. CLAY O ,i qp' 7� • :..0 SAND 06 ��Cp ;, GRAVEL .L �- 1 17.0 �..nna C 1.- %�t9. ROAD rn p Cr) 4'.r C 0,�. OREGON TV r�-,� . 0051 rl. v S!�3 02 CO _ =r1 tK ry 'TC) ,s_ ., , .. a y. •: . }; t - ,- . F i r ! I. CO T: i SURVEY FOR ate•,- fes.. . NINA STEVENS • SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICE: . JULY 1986 • AT CUTCHOGUE DATE JULY 81, 1986 • • FOR APPROVAL OF CONSTRUCTION SiNLY TOWN SOUTHOLD SCALE- III = 1001 DATE �` -1-��1 HS REF. NO. 1��u —� ; �`(—) SUFFOLK COUNTY, NEW YORK NaE OF NE 86-593 (..,. --• M UNAUTHORIZED ALTERATION O11 ADDITION TO THIS Ste' yO �- SURVEY IS A VIOLATION OF SECTION 7209 OF THE P.1114'. 1D 14' l'r. APPROVED C /711-/\---(2\ � HEw YORK STATE EDUCATION B �a y *COPIES OF THIS SURVEY NOT BEARING THE LAND /‘ ► 1 C' A St1RvEYQR S INKED SEAL OR ENROSSFD SEAL SHALL r �` G `\ CO `.~\ X11 } V:t 6 NOT BE CONSIDERED TO DE A VALID TRUE COPY $- MGUARANTEES INDICATED HEREON SHALL RUN ONLY-TO HEALTH DEPARTMENT-DATA FOR APPROVAL TO"5ONSTRUCT THE PERSON FOR WHOM THE SURvEY Is r'REPARED y, r AND CN HIS BEHALF TO THE TITLE CONPANY, GOVERN- *tit )./N NEAREST WATER ■AIN MI t *SOURCE OF WATER PRIVATE PUBLIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTEDM SUFF CO TAX MAP DISTT OO SECTION 083 BLOCK 02 LOTLO 10.1 HEREON, AND TO THE ASSIGNEES OF THE LENDING ! F0.THERE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION GUARANTEES ARE NOT TRA1SFERA8LE 4�<`OTHER THAN THOSE SHOWN HEREON TO ADDITIONAL INSTITUTIONS CR SUBSEQUENT •..f{,` •,fM THE WATER SUPPLY ANO SEWAQE DISPOSAL SYSTEM FOR THIS RESIDENCE OWNERS Gi WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT i*DISTANCES SHOWN HEREON FROM PROPERTY LINES OF HEALTH SERVICES TO EXISTING STRUCTURES ARE FOR A SPECIFIC . APPLICANT PURPOSE AND ARE NOT TO BE USED TO ESTABLISH - Edmund Stevens, Jr. PROPERTY LINES OR FOR THE ERECTION OF FENCES ADDRESS Sandy Pond Road / • �' Lincoln , MA 01773 - TEL 617/259,0920 ° YOUNG YOUNG 400 RIVERHE D�NEW YORK AVENUE NOTE: A =STAKE 14': ',et;; i •RE: LOT NO.4 MINOR SUBDIVISION "NINA STEVENS" - '"s.: Ak ALDEN W YOUNG PROFESSIONAL ENGINEER 'd -,4{ ra ; . AND LAND SURVEYOR N YS UCENSE NO.12845 ' T . 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