HomeMy WebLinkAboutPatchell, Gregory %S�FFO(,�c
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ELIZABETH A.NEVILLE ��_ y�: Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER �i *. Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER �_ R! 44.„.0 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ��� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2803 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : GREGORY PATCHELL
Address 1 : 575 E LEGION AVENUE
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-02-0001
Name Of Owner PATCHELL, GREGORY
Mailing Address 1 575 E LEGION AVENUE
City St Zip MATTITUCK NY 11952
Property Address 1 LAUREL TRAIL
City St Zip MATTITUCK NY 11952
Tax Map No. section 126.00 block 7 lot 1 .000
Cross Street
Building Permit Number Cross Reference:
Issue Date: 5/17/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE 1'�1•. G# \ Town Hall, 53095 Main Road
TOWN CLERK t o ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS % v' i Southold, New York 11971
MARRIAGE OFFICER :0 ,fi ����
# 0 Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER ;_Wel 001 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER /�� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
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TO: Southold Town Building Department ”: ` +ti i
' a Z 20 02 t--I
FROM: Linda J. Cooper, Southold Town Clerk's Office ..-
DATED: April 17, 2002 , , 414'4 ''1
Transmitted herewith is a copy of application No. 2907 for a Cesspool/Septic Tank Construction
Permit submitted by:
Gregory Patchell
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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: "1-e,•-%_074,Zierriet"-*".1,31.ore"... .,_ ���C..a.
Signature /(4/:.' )'-
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Dated
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OFFICE OF THE TOWN CLERK �� AF{ WirC
TOWN OF SOUTHOLD �� 1 Q,I�' Application Nom 9�J 7
ELIZABETH A.NEVILLE,TOWN CLERK
P.O.BOX1179 O !4 Construction V'
SOUTHOLD,NEW YORK 11971 _ •
^' Alteration
Telephone ,j� Q $10.00 - Residential
(516) 765-1801 �.� l b, $25.00$25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE '—/ 7 ")-
APPLICANT
APPLICANT NAME: Cl/ 6-eV 2-7
APPLICANT ADDRESS: 674—
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SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
,va ' thvier
LOCATION MAP: Must k, attached hereto before permit may be issued.
LOCATION OF PROPOSEt) CONST UCTION OR ALL RATION:
OWNER OF PROPER`I Y: - 77,:sN c, �j'��'Ti2,�dZ L
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OWNER MAILING ADDRESS: 6-7Sr . •Zr/O'✓
q-i Ti 77/c /C
OWNER PROPERTY ADDRESS: ...s 2F oLc-Z ici„/, g—
Akt- T,7dam 'c /Ly
TELEPHONE NUMBER OF CONTACT PERSON: e3 ���1�'�-GPI/2-6
TAX MAP NO. : Section 7itglego Block O ? Lot /5o
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REF RENCE: Aft,
/11,1 •
Sign:ture of Applicant
RECEIVED BY: (t�`
Town Clerk's Office
DATE: y/f -77.0
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PROPOSED eS.T. Io
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AP d- Lot 11
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A'4, F.E. ® ; Subdivision — "Laurel Links"
4090 0, i
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Young 48i' Young, Land Surveyors °
400 Ostrander Avenue, Riverhead, New York 11901 v"
631-727-2303iin
Alden W. Young, P.E. & L.S. (1908-1994) ` 8
Howard W. Young, Land Surveyory
Thomas C. Wolpert, Professional Engineer ga
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Robert C. Tast, Architect
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HEALTH DEPARTMENT USE
COUNTY �F
SUFE® OF,'a`c' Ip a;* wr-
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PERMIT FOR A^^^ 3 r11.1
A , atslSRI.:►Iv v Fe,;
... .,a li�ta, iv+::F CE ONLY Foo
DAI°71 it!)_.)- r.!.* ,:7, ."' ---.°K.....12.2...2.12..z....0...241
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NOTE
AREA = 31,910 SQ. FT.
• SUBDIVISION MAP "LAUREL LINKS" FILED IN THE OFFICE OF 0 -
THE CLERK OF SUFFOLK COUNTY ON NOV. 23, 2001 AS
FILE NO. 10712.
• VERTICAL DATUM = N.G.V. DATUM (M.S.L. 1929)
8