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ELIZABETH A.NEVILLE 4 Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER �o ��1°�, Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER =__ liNg
® �� 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. 2731 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : GREGORY PEPE
Address 1 : 127 ST. MARKS LANE
City St Zip ISLIP NY 11751
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 #R10-01-0267
Name Of Owner PEPE, GREGORY
Mailing Address 1 127 ST. MARKS LANE
City St Zip ISLIP NY 11751
Property Address 1 650 CEDAR DRIVE
City St Zip EAST MARION NY 11939
Tax Map No. section 22.00 block 1 lot 6.000
Cross Street SOUTHERN BLVD
Building Permit Number Cross Reference:
Issue Date: 2/20/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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r ���,®SUFFO��� 1
ELIZABETH A.NEVILLE �o 0 * ; Town Hall, 53095 Main Road
TOWN CLERK y -' ; P.O. Box 1179
REGISTRAR.OF VITAL STATISTICS % Q rrt i Southold, New York 11971
MARRIAGE OFFICER `� �,i. ���� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER =__-'/®1 . ,� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER��,,.�'� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD 1---
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TO: Southold Town Building Department I f-t{ 1 5 +L'..�''
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FROM: Linda J. Cooper, Southold Town Clerk's Office �aa c• y'7
PoLo
DATED: January 15, 2002
Transmitted herewith is a copy of application No. 2825 for a Cesspool/Septic Tank
CONSTRUCTION/ALTERATION Permit submitted by:
Gregory Pepe (Contract Vendee)
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: Maintain required setbacks from adjacent wells,buildings,property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED.
:
Signature (
D///670 2-
Dated
OFFICE OF THE TOWN CLERK $1 s', �'—•
TOWN OF SOUTHOLD ,'��J CQG Application NoKo
ELIZABETH A.NEVILLE,TOWN CLERK i Construction
P.O.BOX i179
SOUTHOLD,NEW YORK 11971 0 •
ctr Alteration
Telephone O,� �Q�i/1 ' $10.00 -Residential
(63•f) 765-1800 �11. �;,,'' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
•
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee •$ J
DATE JJl.�1O2
APPLICANT NAME: G.P /c).
APPLICANT ADDRESS: 1 2 7- �' '17, YVk ocv ,( s L ck h
-1si7 •) vu,Y, / i ? sl
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
ziA/ / Fig's 14 F i,,t4
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: G Y e y®r y Pt j Q (VQ 2
OWNER MAILING ADDRESS: 1 2 7 Sr Ylil a v -
9 : p 1/V l e [ 7 S- 1 - `{ I3S
OWNER PROPERTY ADDRESS: 6 c—Q Ce c Y �r ✓ Q.
IccST YYl qr o' - IAJ >1 , i l4 2 R
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section 2 2 Block ® I Lot
CROSS STREET: Som �h e r h t V ,
BUILDING PERMIT NUMBER CROSS REFERENCE:
•
(glature of Applicant
RECEIVED BY: •
Town erk's Office
DATE: //0 ?� •
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N/O/F NIKI MANGOS ,
N/O/F ANN DAVIES . (DWELLING) ,-,-
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(VAC-ANT) vELL.k..\ „ 4 .
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U4SPVsySTEM BUILDING
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FILE NO, 5621 FILED JULY 30, 1971
LOT 7 'MAF' OF AQUAVIEW PARK'
LOT 9
8' 0;00' EL 38.6Z,OS
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(DWELLIN
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SUFFOLK COUNTY DEPAR7MENT OF HLTh SERViCES
UT FOR APPROVAL,OF CoDoTEUCTZON FOR A
50' RIGHT OF WA y
CIFIc.ux FmlliLY Eln,.,DENC7J-:ONT12( 1 .
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(VACANT) (VACANT)
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..- \ TEST HOLE
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. 120:noneirci)_____ _ ._.
7 - BROWN SILTY LOAM OL
40tEsl • I' c-Toa f,117;::-.17.ii.5m.Oi-T ; 35.:13olvis
45;k-Parn,iliar with the STANDARDS FOR APPROVAL ---___L- BROWN LOAMY SILT ML
li,IP...ti3N$TRUCTION OF SUBSURFACE SEWAGE 3'
DIS- bP' g-AL SYSTEMS FOR SINGLE FAMILY RESIDENCES SOUTER/IV BLVD. PALE BROWN FINE TO SAND SP
,
lrld wiik dkiiide by the conditions set forth therein
Dn -the. permft to construct, . •
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ihte Yt'Otti,t,lon., of wells and cesspools shown hereon are BROWN SILTY SAND WITH 5X-10% GRA VEL SM 4•1, / / A' 1.
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Fr‘qiii.-- f,et4 51b.servation and or data ,Olotained f rorn others. Ali',N,Y. ...-t._- NOIArg4*618
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