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Town Hall, 53095 Main Road
?e '" P.O. Box 1179"/ � ,��I Southold, New York 11971
JUDITH T.TERRY �l 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. 616 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : LISO CONSTRUCTION CORP.
Address 1 : HERRICKS LANE
City St Zip JAMESPORT NY 11947
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 ON 9/11/89.
Name Of Owner WEST, ART AND MARION
Mailing Address 1 25 EAST CHESTER STREET
City St Zip VALLEY STREAM NY 11580
Property Address 1 DELMAR DRIVE
City St Zip LAUREL NY 11948
Tax Map No. section 127.00 block 4 lot 8.000
Cross Street JOSEPH STREET
Building Permit Number Cross Reference:
Issue Date: 5/30/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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P.O. Box 1179
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JUDITH T.TERRY +�����R,l e'o TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK � ° %� '"'-
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771
TOWN OF SOUTHOLD 9i IC
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MAY 2 1 1990
To: Southold Town Code Enforcement Officer 4
U UL
From: Linda Cooper, Southold Town Clerk's Office s
a_...�., !�'..nor!$ SOryO-a'b'�A
Dated: May 21, 1990
Transmitted herewith is a copy of application No. 631 for a Cesspool/
Septic Tank Construction Permit submitted by:
Liso Construction for Art and Marion West
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: — ti � , � � �
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Kopytfocw�. oar L
Signature
NAY 241990 q b
Dated
1 .
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OFFICE OF THE TOWN CLERK C�� FO(/�'
Town of Southold Qom. . ;� Application No. 5(
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road Construction
P. O. Box 1179 �. Alteration
Southold, New York 11971 ,'y�,l
Telephone 01 t NA' Residential 4
(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 r
DATE T.1 1-1. I I ET
APPLICANT NAME: S o Gv r _ P.m? .
APPLICANT ADDRESS: {�� ,�i� � � �d ey 443 ci
d-^ sPO � N .• 1( tSii4-0 •
SEPTIC CESSPOOL v
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
("► L 4> !a !ry G,
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: R 1 A rt kg-P.4.
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OWNER MAILING ADDRESS: EA./5A C..NrC., gt a-12-. i •
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OWNER PROPERTY ADDRESS: GL hit �a 2 t Vim.
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TELEPHONE NUMBER OF CONTACT PERSON: 1),a— qEe,57/- 1,4a.a. ' Li SO
TAX MAP NO. : Section 1a--) Block '-f Lot g
CROSS STREET: \, o S Ls P t4
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signat re of plicant
RECEIVED BY :Nprignem �,
Town Clerk' " flt�
DATE: 1 MAY 211990
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SURVEY FOR
ARTHUR WEST & MARION WEST
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICE!: LOT 13 "LAUREL COUNTRY ESTATES°
s
AT LAUREL DATE . AUG II, 1989 _
FOR APP•6VAL OF CONSTRUCTION ONLY TOWN OF SOUTHOLD .
SCALE I, = 4d; %
DATE cf./</ 1, /HS;REF. .O.Sq-SC) _ �_ SUFFOLK COUNTY, NEW YORK NO 89-0953
*UNAUTHORIZED ALTERATION OR ADDITION TO THIS
4
SURVEY 6 A VIOLATION OF SECTION 7209 OF THE
/. NEW YORK STATE EDUCATION LAW
APPROVED f . ' ` N COPIES OF THIS SURVEY NOT BEARING THE LAND .APSE OF NE_
C� .2)."_?-39 �4 — NOT BEsuNvE YCONSIIDERED TOL BE A VALOR LIID TRUE COPY OSSED SEAL HALL `Q
/ *GUARANTEES INDICATED HEREON SHALL RUN ONLY TO �jck. EI. '�,�
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY IS PREPARED p O�
AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERN- * .r, ..46kl, .+-
N NEAREST WATER BAIN_MI . $SOURCE OF WATER PRIMATE_PUBLIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED $
M BUFF CO TAX MAP DIST 1000 SECTION 127 BLOCK 4 LOT e HEREON, AND TO THE ASSIGNEES OF THE LENDING ';F, Ij fe
INSTITUTION GUARANTEES ARE NOT TRANSFERABLE i t i
$THERE ARE NO DWELLINGS WITHIN 100 FEET OF TENS PROPERTY TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT {. 41 ^
OTHER THAN THOSE SHOWN HEREON :
N THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE OWNERS i^� '
WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT *DISTANCES SHOWN HEREON FROM PROPERTY LIME! �, /'
TO EXISTING STRUCTURES ARE FOR A SPECIFIC2-'1--
r
or HEALTH
SERVICES, LISA CONSTRUCTION CORP. PURPOSE AND ARE NOT TO DE USED TO ESTABLISH ,��� ��¢ 9 ��'O ��-
PROPERTY LINES OR FOR THE ERECTION OF FENCES �Eplq .(O
e�• = '`�AID Wit`-
ADDRESS P.O. BOX 4S9 n 400 _
X. .„...7:kir--. James ,, N�._11947_ ',' :.'°', ,Ii, ' sYQ. NG a YOUNG RivERH Ao�NEW YORK
DER I�UE
NOTE': ■ = MONUMENT .1v.,- ',,V ` 1. j
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF 7,4,t ALDEN W YOUNG,PROFESSIONAL ENGINEER
SUFFOLK COUNTY ON JUNE 22, 1970 AS MAP NO.5486 ,y ' ":.ir - AND•LAND,SURVEYOR N Y.S UCENSE NO 12845
' HOWAfiti W YOUNG, LAND SURVEYOR
5 0 TIE LOCATION OF WELL(W),SEPTIC TANK(ST)S CESSPOOLS(CP)!MOWN HEREON •- N Y 5-LICENSE NO 45893
a ARE PROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS
BRANDIS A SONS INC. A.C.