Loading...
HomeMy WebLinkAboutHollowel A 011' 0AF F644 o ELIZABETH A. NEVILLE �k # Town Hall, 53095 Main Road TOWN CLERK o - P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Ply i Southold, New York 11971 MARRIAGE OFFICER ® �� Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER ma "'/Ol Yioe 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. 3011 R Residential x Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : CHICK THOMAS Address 1: PO BOX 877 City St Zip JAMESPORT NY 11947 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 #R10-03-0010 Name Of Owner HOLLOWEL, TIM Mailing Address 1 1280 SMITH DRIVE SOUTH City St Zip SOUTHOLD NY 11971 Property Address 1 1280 SMITH DRIVE SOUTH City St Zip SOUTHOLD NY 11971 Tax Map No. section 76.00 block 3 lot 11.001 Cross Street MAIN BAYVIEW ROAD Building Permit Number Cross Reference: Issue Date: 4/17/03 Elizabeth A. Neville Southold Town clerk (TOWN SEAL) �' ®c.uFF®` SO r ELIZABETH A. NEVILLE / GZd Town Hall, 53095 Main Road TOWN CLERK % c= - % P.O. Box 1179 cia REGISTRAR OF VITAL STATISTICS % d® PP, i Southold, New York 11971 MARRIAGE OFFICER ..® °F �� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER ���® ®�i��, Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER '_1 ��� southoldtown.northfork.net r,_ ' `, \ OFFICE OF THE TOWN CLERK \ , _ C. ' TOWN OF SOUTHOLD 11, 1 ,1 � RND -` \_ z , ' TJ O: Southold own Building Department L - FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: March 7, 2003 Transmitted herewith is a copy of application No. 3134 for a Cesspool/Septic Tank Construction Permit submitted by: Owner: Tim Hollowel -Agent-Chuck Thomas 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: Z. APPROVE DISAPPROVE 1 Comments: ► - , ,..2144.A....,v ,Z,, ) Signature a. /0 7/7, Dated IN OFFICE OF THE TOWN CLERK ,r rirrr••r..���I I *TOWNOFSOUTHOLD :"� SOalrc Fr WABETH A.NEVII.i.F,TOWN CLERK ��• ' P.O.BOX 1179 '►'O Application No. 3 / 3 SOUTHOLD,NEWYORK11971 Construction ►►.� Alteration Telephone - ,f 47►• $10.00 - Residential ----- Telephone 765-1800 '_��/ At 0 „.,,,,.r' $25.00 -Non-Residential TOWN OF SOUTHOLD 6 • SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION • for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee .$ DATE /v r ', 1 v7 APPLICANT NAME: Ch-Lic- ' • sok-7,...x.. • APPLICANT ADDRESS: U SEPTIC ✓CESSPOOLS i lti • 1 DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION 1�- 9C� LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: i vvi 47:41),(x,ve.-L. OWNER MAILING ADDRESS: SY1-44:1A4 Q•� ---s- A a OWNER PROPERTY ADDRESS: Q4.,,.,.., Ia ' O 5 1-E-In -b -S TELEPHONE NUMBER OF CONTACT PERSON: (63 `! i7'/ 7Z7 -7'713 TAX MAP NO. : Section 76 Block 3 Lot J/. / CROSS STREET: 144 a)1‘,1 .:L ,,ga. , •, _ • BUILDING PERMIT NUMBER CROSS REFERENCE: ‘IIIIII'Si• a u of Applicant RECEIVED BY: sk . T°wn Clerk's Office DATE: 'J ( U Th Or r 'IL;...\., - nr---,,,--- , si „... ,„,.4.,.,,,,,..„,:„.,„,. e5vesict /1,,••: • ,- , . '''';',..,!,\ i'IIiUC WATER I.AMAam SVIMMO A TO PLANA ILMOM 114Lek; w DAn ' " ^(, /� (,O ," L MDTO TO MO YM 10R TOT ICU DATA. - t I I Y 1_ SOW." `_' �� S.1 T�IYuw NP1 TAW CIPACI IOA A 1 TO 4 SOON NOUR t 1�MOR C.?: - `e� 1 TI - R- R' 4 1�MY 1r*O11M0 ITIT /OO A 1 10 4 8000011 NOM t A0001 A RRMIk ARA !;•} S1 Y` 0� IO 1.121 ' pg.to" wTs fSa�fq•n.OlArcm r NON 1lwn OOIRJSIS l(AOM 810 �5:' •,,, ,,,.30100'E 41111132; r00feRD mANROII 1oOl :' 1 r ,'�; J 7Ta// \ j; rinoo uAww roa(q r x r rrN a, K Q__-;""`[._ilj�;.pl" ®/1180o OIK TNS(IT 180 ML awn maw caw.OVIC TMOI r' �I ,�- f \ 0.Tl[LOCATION a RUA NO COIPOO10 Y1000 1a[ON am 100Y MD .` 1 C (. \ ORQVAICNS ANO/011 DATA PRAM 100N ONOL , r3,. :0210 )".',/0‘1,{ dS, '''1,-...•• REStt7ENCE .. 4 4*.------OF - \ % PIDLIc NATE I, wt7T - ~s— �/ 401111%e, A ••' � ROw1N an SAID 61?( -0 101 \ .Ali R01TY 11N[TO 11[D SAND .:� ✓ ($) • , / .` ��� \ T, TATO N PALL ROOM PlC TO WOO SAND t • !) \ TATO DI PALE ROVN 11010 SAID RrrDENCE u FAA:'/riER M % ,r _�prl.9P WATT"DICOUNTESED S.1' KLAN SWAM PLEASE NO`6'E as �e nsrFaeat�KOMkcc�o" n>� *4 DA?e 11/21/02 San taryr Yi 'l.•l p tiled ' , unc e-driv ycom rowoAloN �. ' °�' � .$ CRA1M `f' c cLclr 6.25 ���� d FIRST(LOOK CLOY 9.25' SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES .• ' r I'Ei�.Y�'f'�' ��.,OF-CONSTRUCTION FOR A % 4 \-;".- ��� SINGLE kIAM:LV RESIDENCE ONLY l� \ '..� DOM.___ �w DATE, 2 r�i CSS REF.NO R l©-03-00 iO -- • .No I rill Kr . ...... APPROVED.�._ • � ` ji...i ' Nt ICJIb41 • r�Z,6 FOR MAXIMUM OF 'e 'ROOMS . . se,•olevA , SLN‘ EX PARETHREE YEARtiitFROMIDATE OF APPROVAL _ f1mTrI0 01111, 0' �� , rnvlwa A—H 1.uJu MOM wlllu n YAM MOUNT=LI'%OW WUOiACE C 46 T 1 .v v(_�2S 12 L 1/, ON s. r a-vt ( a d; --f_ i>(, IS. yeer30 SEPTIC SYSTEM CROSS SECTION I is • Abandonment of existing sanitary system e -- to be witnessed by Health Department. � LOT: 47 $ 4S /114'• • MAP OF: GOOSE NECK FILED: NOVEMBER 22, Igefl 48 NO. 1663 CO.GO5- T - SUFFOLK // SOUTHOLD SOUTHOLD, TOWN OF TE FL_A DIST. 1000 SEG. 76 BLK.3 LOT 11.1 SCALE: I11 = 401-0° L SITE PLAN OF THE Charles M. lamas arGhit ' c-- RQL.1.QI"1 LL RESIDENCE PO BOX 87, JAMES- T,Mfr U4l co ,--,r- SMITH DRIVE SOUTH, SOUTHOLD NEW YORK (631) "127-1 , ;