HomeMy WebLinkAboutSuffolk Landmard •
•
OFFICE- OF THE TOWN CLERK c0fairn
Town of Southold
fea
Judith T. Terry, Town Clerk .`
Town Hall, 5. 3095 Main Road . 9
d ky;� V�1��1t b�iiN ,
P. O. Box 1179 .tn = 'msµ' �4 `
Southold, New York 11971 OOH-••••
Telephone Ol �4
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL -
Permit No. 164 Residential X
Fee $ 10.00 Non-Residential
Septic Cesspool X
PERMIT ISSUED TO:
NAME: Suffolk Landmark, Ltd.
ADDRESS: 16 Ormond Avenue
Oakdale, New York 11769
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single family dwelling with samitary system.
Approval - as par Suffolk County HPalth SPrvicPs
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Suffolk Landmard Ltd.
OWNER MAILING ADDRESS:- 16 Ormond Avenue
Oakdale, New York 11769
OWNER PROPERTY ADDRESS : 275 Henry's Lane
Peconic, New York 11958
TAX MAP NO. : Section 714 Block 1 Lot 20
CROSS STREET: North Road ( County Rt. 48 )
BUILDING PERMIT NUMBER CROSS REFERENCE:
eiXed.49.1"
Judith T. Terr
Southold Town Clerk
DATE : May 21 , 1987 f '
(TOWN,SEAL)
CAW
bi4
1 ,
Town Hall, 53095 Main Road
iQh �� P.O. Box 1179
�� ,�NaYi� YYi
40iff ./ C • Southold, New York 11971
JUDITH T. TERRY `.����ii ss- TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
May 21 , 1987
Suffolk Landmark Ltd.
16 Ormond Ltd.
Oakdale, New York 11769 -
Re: 275 Henry's Lane
Peconic, New York 11958
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 1 $10. 00) for
residential use and twenty-five dollars ($25. 00) for non-residential.
Please have the owner complete the enclosed Application for an Operation
Permit and return it to this office along with the proper fee.
For your general information I have enclosed an Informational
Bulletin regarding the Scavenger Waste Laws adopted by the Southold
Town Board. Should you have any questions pertaining to either permits
or the Scavenger Waste Laws, please do not hesitate to contact this
office. We will be glad to assist you in any way possible.
Very truly ,yours,.
000412241:04
Judith T. Terry
Southold Town Clerk
Enclosures (3)
JTT/Ijc
OFFICE OF THE TOWN CLERK
Town of Southold Application No.' )7.1
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road Construction
P. O. Box 1179
Southold, New York 11971 Alteration
Telephone Residential _
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. /‘
Fee .$ /0
DATE 4//47
APPLICANT NAME: JrJPre/'//1 /44/47'/l49 ' L%'
APPLICANT ADDRESS: /6 Ogt/yl04/a7,4i-
a/A& /pi /067
SEPTIC ✓ CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
/2t iu LJo-l/1,pvG7410, ldmo� ��P.1m�
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ,2c 1/Am (6( .�.Q.e'O//714o ti L i
OWNER MAILING ADDRESS: /G Oc)nto,u,p
l41kdF( = //7G'%
OWNER PROPERTY ADDRESS: a 2$ ,7 E,tiA 1,4 .
/ co 4.1i r // G
,e9(P &RjQkSS'so
TELEPHONE NUMBER OF CONTACT PERSON: _sw, ... ?•-&33
TAX MAP NO. : Section 7<7 Block / Lot o2 0
CROSS STREET: &•,p /e:
BUILDING PERMIT NUMBER CROSS REFERENCE:
IZ1ftif.
Signature of Applicant
RECEIVED BY
•
RECEIVEDTown erk's Ofv'ice -
DATE: tt,
Town Clark Southold
t----.
_—
SUFn I‹ CO. HEALTH DEPT. APPROVAL
if
I H. S. NO.
/
. , c
//./...':„.
k.
4ge•
.-
/ f . • Sibl,-# r.
4,44140s, "'PIFIES ''.as'C PA Alit 8 %.
,1?'
/ V
r,111...11,‘" I- ':t'ARS FFZIYVAALL/A1G Oatvi
DATE n—
•
,
/Az iii,i,4)
pc,„,
' ;17) E.] ,!, — 5%0 ' - —1 ', • ,,,. .
ka?" Is ,- I-rl u VAL
hfr-op.we-II
/ ' 4",t-J-PC1 STATEMENT OF INTENT
prop. s.p_pl-ic iio re.0' / r
'-% v''
,,,
s'ffi (9 ,_ V.,,,*
[
s.4 ;:..,.., --0,-- THE WATER SUPPLY AND SEWAGE DISPOSAL
h o. !
-.'
.. ,
SYSTEMS FOR THIS RESIDENCE WI Li
CONFORM TO THE STANDARDS OF T H E
(.1
•
-c.d.'
,.,
.
,
SUFFOL4 CO. DI,PT. a HEALTH SERVICES
r
,
11-1
. .
1
go%.,,,\ •,' ., (s i ... ., , -4. ..a........A. ....
•..,
A-PL CANT
-
-
SUFFOLK COUNTY DEPT. OF HEALTi
in „•"'
1 / ;`,VvV.4,
SERVICES - FOR APPROVAL U:
•4 , 1 .., 4 Et tilt tt,, ...,
0 tv N Z •, ,
CONSTRUCTION ONLY ,
0
)
,
t--
: DATE:
IR - --
.. N
,.3 .:
i I 1 H. S. REF. NO.: 01111 - 4, -
APPROVED: .44211FLAri
i , ,
, C.) r -- -. -1 (..,,1 €./1 - ,
, . _
___, . .
!
i r p . 4 67-•
LI
se /-i C
. .0 -,- 0
i:Pr'oP - ri-1 , ,.../,
CY C.Dr--- --j fr.J10/6"el,
I ' SUFFOLK CO. TAX MAP DESIGNATION
well
_.: 1 _IV 11 0 4 P 0 r--- /.....c.,)T ,,,,3
_... . . __ ..._ _ DIST. SECT. BLOCK PCL
1 1 Qi sic _. ,
I ....
/000 074
OWNERS ADDRESS:
/6 0 ra/710/-ici Ave.
sja..)Ig7 L . i ,
...
6?e../ht;‘.-i I k. C f:)z,/ii 74 eis illegal l'slt7 Oh 170. 1 18 0
.
?..).1 ..);
44
0,7k,claie., .4.i. V. 1179
.-- r-
1j---D a"C 0 IV I C..: i'V_ Y_
o ,,,
,c 0. 3
iil
4 ,5 e d,,Z )1:7°4 're/. .5.4'9 - 8 3 9 X
.-:-
05% „s.--,-:, ----- (-) .'••
9.c.;
1
°9 j PV,------- .9- I- -- - -h." - - -4 C11 It 5 Ci ic:7-----C.)1,_.k. L A /otyk- k2.Ir., , t-77:). --D1717;7.7:,7,7317.-------
TEST HOLE STAMP
il
//, ,57'4",,,t4i3O„5"k/-
SC419/.- 1
if : 4-0 = /"
._4. .1
, •:., 'fl
rAtro."=/innt.p..,..
:1[;i1. iv : Z 1,, 9 11 SQ Q . ic--. r. 84.1.111.,sisr-ve.y slur,rt,,t7,^tv,t1,
e64-lerre iii.M.I•yo.??In.k,Net
'Itl
ernk:v&cod WM 011,I.,•2 Lr-,3 csrrrrpi41x,- -
Iv/err/e valil Iron oir,-,y.
.s!
Gurrontrseo Iriftnse-i i`strc‘tn rtY)::r-
I (-5 6'a nro!Y t3 the ptv Pon 8-z issi-,Trn e-4)r,ss---,
is!rowed.end on hiss ts4-,iltn t'''s
."-i-e-,,,s 4:7,„.., 11
I
.c:r 745,4/ tts-comp,..ny.em•orrannntrA
4ansilrxs intistion 65,Asei horoan eiro
A cl-',7'
I
A4 a 7,6;) to*so&atones of&ha forseim}now-
tution.%tiro:noon oro meg is anoff.p,:Ar,,,,
1 tl 044nittrtel IrsortioVienz or eakisict.4-/-i'
own=
I
, SEAL
I .
-
of NEti,
..
Li.1 .7-; ..'","i 6 ti urn e :If ,- • , .
p.._,..3
.
• rr 0„.„ '0' .1 r-
,
ROpERICK VAN TUYL, P.C. 5 NA, ' `1'•
/
s 2
t6bel'itk"'
. ....4., ,.0
LICENSED LAND SURVEYORS
41LAND'
GREENPORT NEW YORK
• , ,
_______J,
._....... , ,— , , ,, , -
POST N81329 j
_
,
_____________ _ ______ _ __ _
-c,-