HomeMy WebLinkAboutGroll, Mary Jane C)1
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Town Hall, 53095 Main Road
•1 OBox 1179
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10'.00. Southold,P.O .Southold, New York 11971
JUDITH T.TERRY -� "- i/ TELEPHONE
TOWN CLERK (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. 359 R Residential X Non-Residential
Fee $ 10. 00 Septic Cesspool X
PERMIT ISSUED TO:
Name : GROLL, MARY JANE
Address 1: 300 WILLOW POINT ROAD
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS PER SUFFOLK COUNTY HEALTH DEPARTMENT
APPROVAL.
Name Of Owner GROLL, MARY JANE
Mailing Address 1 300 WILLOW POINT ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 665 SUTTON PLACE
City St Zip GREENPORT NY 11944
Tax Map No. section 33 . 00 block 5 lot 5
Cross Street MCCANN STREET
Building Permit Number Cross Reference:
Issue Date: 6/17/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
•
57
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-� )*%' :it\♦ Town Hall, 53095 Main Road
BLDG. DEPT. % .;� 1;;,'
TOWN OF SOUTHOLD - 131 . P.O. Box 728
�1 ` �r�� Southold, New York 11971
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JUDITH T.TERRY TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
. TOWN OF SOUTHOLD
•
June 17, 1988
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk •
Transmitted herewith is a copy of application No. 362 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by Mary Jane Groll
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.
•
etreoet
%woe, awed
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 - ,c
DISAPPROVE. - �� JJ n
COMMENTS: (0...e ���..Lc � "V., �A CYIP dL
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Signature
(Of / ry/ YY
Date
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OFFICE OF THE TOWN CLERKSUCfU1A'
Town of Southoldn Clerk • � ; Application No. 31p
Judith T. Terry, Tow
Town Hall, 53095 Main Road a Construction -�
P. O. Box 1179 ��J Alteration
Southold, New York 11971
01 ' '. Residential
Telephone
(516) 765-1801 "' Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1 2--
Fee $ //)
DATE - V Ne \-7 q
APPLICANT NAME: Hk2 ,(. - -\ g-i' (3-. (-1—
APPLICANT ADDRESS: oo Q o \ N
DU-CO-6 L.- N
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
O(\( vJ it L-(, t tIJ Gr-
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ` l
OWNER MAILING ADDRESS: 306 V\1\ 14„-e) ,,/ Qp t r.Jt Ce-b .
601-050c__ N' �lct
OWNER PROPERTY ADDRESS: ((5 `} oNL_
TELEPHONE NUMBER OF CONTACT PERSON: l(oc- 3t 7O
TAX MAP NO. : Section 3 3 Block Sl Lot
CROSS STREET: tie- CPI-NN
BUILDING PERMIT NUMBER CROSS REFERENCE:
Si nature of plicant
4110
RECEIVED ' _ �, .; �
Town C rk's Offic
DATE: JUN 17 1988
Town awit Southold
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(VACANT)
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S-UT TON P
ACE IN STserr
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420.00' Bor Or 30••r•
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b. F a -`"CONKER Y 1.FO'N
C < sEK 37 89' ` w FENCE �-- r __--
.S 76'37'40"W C 071��—E�—'/ rrW 22.2 SET
STK
Zt zl_9 mo 82.91' S68 18 40
N/O/F SCHNEIDER �ao MON
. 2 0/L SIP
' (VACANT) �bS- 3010(DWELLING)
• I ' - N/0/F TASKER TV -1_,S
3C 0'Au-o 430\.' s- a-0.
• S CAITVAOLb\ VS/•-(''.
Prepared In accordance with 1h.. minimum I14-tt
standards for line surveys as established
by the L.I.A.L.S. end approved and adopted
for such use by The New York Stale Land
SURVEY OF
Tills Association.
/��(//^'�� The water supply d sewage disposal sys-
L O T V V tams for reSuffceolk
will conform to the
standards of the Suffolk County Depart-
ment of Health Serv'- s.
--.1r
MAP OF
EA S TERN SHORES ;.
The locations of wells and cesspools shown hereon are from fie.l • ••` ;
FILED APRIL 27, 1964 FILE NO.4021 observations and or from data obtained from others. .*
TOWN OF SOUTHOLD .
CERTIFIED ra 46
SUFFOLK COUNTY, N. Y FIRST AMERICAN TITLE MVS -ANCE 110
1000 - 33 -Scale �r05 - 05 COMPANY MARY JANE GROLL ;c,o SAM��G9L w�P ac OFA
May 2 4, 19880r c� Fo C --�w
9 H
AREA = 13,803
to i..I>. 44.0, 8*)/ .S. LIC. NO. 496/8
•
PEC enr'F '3' 1'-7 ORS, P.C.
(5/61 7- �C20
P. 0. BOX 909
MAIN ROAD
SOUTHOLD, N.Y. 11971
t
88 - 354