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HomeMy WebLinkAboutKiernan, Patricia ,, SlFFOL 1 •' �0 CpG ELIZABETH A. NEVILLE �i••• y ; Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 ti ZSouthold, New York 11971 REGISTRAR OF VITAL STATISTICS '* t MARRIAGE OFFICER `� ° �e Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER �-�O1 . '0l� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER ,s�� 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. 2831 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : PATRICIA KIERNAN Address 1 : PO BOX 479 City St Zip CUTCHOGUE NY 11935 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 #R10-02-0089 Name Of Owner KIERNAN, PATRICIA Mailing Address 1 PO BOX 479 City St Zip CUTCHOGUE NY 11935 Property Address 1 4785 STILLWATER ROAD City St Zip CUTCHOGUE NY 11935 Tax Map No. section 137.00 block 3 lot 10.000 Cross Street PEQUASH AVENUE Building Permit Number Cross Reference: Issue Date: 6/21/02 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) f_� o,o� sFFo�„ aco; ,, ELIZABETH A. NEVILLE e# V Town Hall, 53095 Main Road TOWN CLERK ; o - % P.O. Box 1179 C4 2 Southold, New York 11971 REGISTRAR,OF VITAL STATISTICS • t MARRIAGE OFFICER `. 4,, ������ Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER -'10/ -0„.0 i Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER _,, .••,, southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD IN 12 2002 ,_. TO: Southold Town Building Department .r _._. FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: June 11, 2002 Transmitted herewith is a copy of application No. 2935 for a Cesspool/Septic Tank Construction Permit submitted by: Patricia Kiernan 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: vy- - i/� . 244-'4/p4:. Signature © /'2 ai Dated .. 1 OFFICE OF THE TOWN CLERK i'"",•,,,,,,••••,,, Fr.rrnB> OWNOvrr.r owrrcllxx ►`'s ��E�OtK��TF SOUTHOLD �/ Application No AS P.O.BOX 1179 Z .G . Construction L- - SOUTHOLD,NEW YORK 11971 'e 1 C • til yc Alteration Telephone oA, �iri . $10.00 -Residential ✓ (63 1) 765-1800 -;1. 4�,0 $25.00 -Non-Residential .,,,o... TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION RECEIVED for JUN 1 1 2002 CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Southold Town Ct Permit No. Fee .$ DATE 6 ( i 1 i G --- APPLICANT APPLICANT NAME: .i 7 jZ1C-i q. 1(1ij ,-') APPLICANT ADDRESS: )(rj f�� )76 4-i ' ( VCESSPOOL fir,SEPTIC 9ESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION lJ€C.0 S ' 1 A L/ t ►. LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: ?Al'el c i 14- ( 67Z f`i A ,.v OWNER MAILING ADDRESS: Pd P aiC 41-7 CI CL(,-(-ri,�'L. AA-E, l I( CI-3 I i t OWNER PROPERTY ADDRESS: LI-7 8 S , C &-f-e y- A-11 e TELEPHONE NUMBER OF CONTACT PERSO r 57 -- ? 7 � 383 73 TAX MAP NO. : Section /.3 7 Block 6_3 Lot /6 CROSS STREET: S(� 672-,244..i4, Jf(ll `1 ll 4pf✓/p / O * l( � U BUILDING PERMIT NUMBER CROSS REFERENCE:, 6r14/t- i Sign ture of Applicant RECEIVED BY . �� � Town Clerk's Office"- DATE: fficeDATE: . _ . . , . •. . .. .. ., , , , . ,ft Er"stkirlatiRAION20 well, , ArP4DirlstiTayamrti4SIOrflutY 41,444614 °N At (IC suittner, _ OP 141.0. :1v,, Rry, ExCEPT 45 PER rION Ten'lLIONVISITIR e i Ctgarteorms rt ptolvc4iiiiresraLriHrt°,4041fAscrtPli.t7Mrt;vitCoN , . , 1440SE SIGNATURE APPEARS HEREON V 4Pc, A 7 •,,s TOWN OF SOUTHOLD • 15 ,._:,_ •.,... ,,,, , - t...PARTME..*N-, 11,-,:°' "iZaii..'"ii, '.`S'ZRV1C''•',.9- PEIMI'T FOR APPROVAL OF CONSTRUCTION SINGLie FAMILY R MDINCri', ONLY 1...;ORA " DATE(31S- ")...r..-r• . . SUFFOLK COUNTY NEW YORK 137- 03 10 1000-_ _. - _....- SCALE: 1 "=40' . APRIL. 17, 200p April 19, 2,041- revlsw-isi .-- APPROVirt FOR MAXIML/M OF 3r0ROOMes C4°CdC8t'Cl ' ' YEAR3 FROM DATE OF APPROVA1 .._ 0- , . . .. . - — - - - - - 407,4tC , / . . \C ,z 4/ 611 I eis W,;1k,il'e . . /./ IA j 14,. 0,- ,4% (' V /- ii• 4104t. * t 04 sie0y, 4et ._ 44. . ft° A ,,if c fa Ile V) \- At i's,v \ cr` ihviirk .c.•-'c 4fP , ,,,.. \ e ' \ Test Borltig S.Iii‘ Sim&ow Lowy 11PF (14°:* cilt 779,,esi ,., i ....4,. % Ce • Irt% i ce ,,,,, ftfiric 91" 4- ..?;t «. -If I . , // x 14.1 • i itt ,'..J 4447000 4 ,,,," .0,-- ,,'ls , \ . -------- • . ' tt. * Geamorl *thy \ 1:446, er *'''...k I Z„ ‘ \ , ,, te,4917. i t GCZA , fl 11? S \ \al ‘411°.-1C ‘1114 . 4" 6stiOs 46 to- t- IA. • ,, 69 1- S1 ----....... 4 ,, ..ks SOSit \.11.1° ' •,..v m familiar with the STANDARDS FOR APPROVAL 4- 4 Sitli, IFC.0."4 -•\''' 1 mt kqP • •sr ...‘ cv \ (Dv •,......3 ..,.., • T.e.,., ,,(... ) CONSTRUC HON OF SUBSURFACE SEWAGE "Ze‘, -v.c.1„,7,W" / 1 POSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES 7.-..', A .:;. , i Witt a lo i ote by the conditions set forth therein ai-,d / •\ vf4 *..;',';'' the permit to construct - ' 1 Aitt '1 4- \ . „ ? -14catiovpf wetts and cesspools shown hereon are 'Itt,c4,.. •..„- . - ,....,/./ ,,, .. << YS LIC. NC. 49618 ... >m Fletd 6.t*ervoons and or ciat.04, olotNnr-o4n. Q,Att)i e r s. ^C, PEtf3NIC jr:1" ORS, ... . (A'41) 74 - -5riPil FAX:(A' t) 7A -179-7 . .a-: . " . . 1