HomeMy WebLinkAboutCiaglo 4,�®OFFOUr
ELIZABETH A.NEVILLE �� Town Hall, 53095 Main Road
TOWN CLERK ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER �� ejs b��I,, Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER � �® �®0' Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICERmit
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OFFICE OF THE TOWN CLERK
SOUTHOLD infAUFMATCEIRT MOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2638 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : QUALITY CRAFTED HOMES INC
Address 1 : 175 MONTAUK HIGHWAY
City St Zip WATER MILL NY 11976
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 #R10-01-0095
Name Of Owner CIAGLO JR, CHESTER L
Mailing Address 1 95 HIGHWOOD ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 9785 MAIN BAYV I EW ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 88.00 block 1 lot 1 .006
Cross Street JACOBS LANE
Building Permit Number Cross Reference:
Issue Date: 8/13/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
„ ,,,,,,,,,,,,,,
3,3'
•
ELIZABETH A. NEVILLE ie d• Town Hall, 53095 Main Road
TOWN CLERK ; P.O. Box 1179
era $
REGISTRAR OF VITAL STATISTICS , ,tSouthold, New York 11971
MARRIAGE OFFICER : �g' Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER � �®I ��ss22,, l��-il°� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ GLs' IS”
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: August 9, 2001
Transmitted herewith is a copy of application No. 2726 for a Cesspool/Septic Tank Construction
Permit submitted by:
Quality Crafted Homes
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:
ignature vn
81101 pi
Dated
'
OFFICE OF THE TOWN CLERK 11. ��cl
TOWN OF SOUTHOLD O.•
O �oG Application No. ,77
ELIZABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 .
�'F. Construction ,/
SOUTHOLD,NEW YORK 11971 p • r-rt , Alteration
. u1 �.
Telephone -O,��O ��O�ttt $10.00 -Residential (/
(63f) 765-1800 - 1 00' $25.00 -Non-Residential
TOWN OF SOUTHOLD •
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION R E C E I V S D
for AUG 9 20W
CONSTRUCTION or ALTERATION PERMITta,.. ihtpWin
Clerk
SEPTIC TANK or CESSPOOL '
Permit No.
Fee '$
DATE q && o /
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APPLICANT NAME: O?k • , . I kw,
71,___,
APPLICANT ADDRESS: /7S G1-ic
. 0t7 eiWY //97C
. SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
Ku, hod,6„,j,
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CON TRUCTION OR ALTERATION •
' OWNER OF PROPERTY: C , c / :,C. OS jL , ` -
OWNER MAILING ADDRESS: _�4 A .ilai / ,
Økeite-ezefOWNER PROPERTY ADDRESS:,7j 142-- • -j(
TELEPHONE NUMBER OF CONTACT PERSON: ZZ ‘ 93oo
TAX MAP NO. : Sect•n Y4? Block D / Lot 1' 6
CROSS STREET: 6 'I 7
' Lt.„...,-
/
BUILDING PERMIT UMBER CROSS REFERENCE:
�i ! - / • / c�
Signatur of Applica
RECEIVED BY: •
Tow Clerk's Office
DATE: '
N.,,
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•
JOB No. 01-18
ALL DISTANCES TO WELLS AND CESSPOOLS
ARE BY LOCATIONS FROM HOMEOWNERS,
FIELD OBSERVATIONS, AND EXISTING
SURVEYS. SINCE MOST ARE NOT VISIBLE
THESE DIMENSIONS ARE NOT CERTIFIED.
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No. 3610300166 G ,4,1:,,,,,,X, , �
(T�ELeV`+!-4 9 ' FIRM MAP ><z._ - , ,fi '.zw''';'x
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SUBJECT PROPERTY FLOOD ZONE X ,; ' �z ' z
NOV LOAM • -- ,',,''.;*4...'"-,, -k..
;AND ELEVATIONS REFERENCE TO ''�:,,s'"' tipC
,, fir' v',,";
FIVE EASTERN TOWNS TOPO MAPS :'
COURSE ' Re;
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Unau tioneed alteration or addsbn to this document b a violation of Section 7209 . ;.,,,,;,,,,,,,,,,,,„45,q-
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,;:Yw?; &' "t
OP the New York Stage Eduatiomtaw. - ,°' , *- `' ;,
SURVEY OF: LOT 4. . F ,r y� F$ ;,
0 COURSE Certification Indicated hereon stlal6 run only to the person for whom R b red „%-„,.-,_,..-:,--,.-i.°, --”z't ,x-1.;
6ehehto the Tine Com ti MINOR ;, ; ' „%'_.
yEl anti on hb parry Tlse Agenq and Lending Instlodbn Ilsrod SUBDIVISION ',a' ,,,,,,:`,64,4e4.„../A,... ;',,,,,i"y2' ,4":"
hereon,and to tiie rlen Ohm t Institution or subsequert owners _ i�•�,;:` n�����""�Y
Copies otthls document riot bearing hie professionalb Inked seal or embossed DE ERF.IELD—FA ' ' Z'"kis"",,,,,,I"'1```` 'i
seal shall not be orisktered vel -. �'.: e t ,b,:1
eyelid iy ' ,`,a
The onyeb(ordtmenalorrs ehovm tret'eon from structures to the tines ,7-ti0YYF1�` veri�a ajo pe4'iR''74
fora specific purpose and use and therefore aro not intended to side the erection of F !j J✓
fences,retaining walls,posts,Patios,planting areas,addition to braidingsora other f ,,,' ,, 'Lii,r : . l-'-LN` '`'kr"'' '';
construction m �/ �4�d:��'t i�
SUFFOLK C O T` �` a +:�' �,,:.. �z„ s'r
The edateneeof right of warrand/er rients of record,atony,nPslrwnr are not • '�`• • '1 r a a Y CT,'-T 1 -, -';, '..-''r`t4'3,;: -X"t+�"15.4+4*,
guaranteed
DATE: 8/26/0 :'�;'= ',-, „..r. ,,,,,,,,,....,.,1-_, v`�',',,q
SCALE: *u :-,:',. `:x , ; ,rr "}-
CERTIFIED ONLY TO: - e,),
>< `',;,A,4,1,::-.1*–,,,,,,,,,,,,
SAMANTHA PERRY , . M� ri< �,f,,.
QUALITY CRAFTED,HOMES ga'4'2 � � ` r:`
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