HomeMy WebLinkAboutNegermiller ,,,,/Iii,,,`
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ELIZABETH A.NEVILLE ;,II_P �d; Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS r
Southold, New York 11971
MARRIAGE OFFICER �,iL A,. if Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER � vfn, ANY iii Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ill 4 O. 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. 3020 R Residential x Non-Residential
Fee $ 10.00 Septic x Cesspool
PERMIT ISSUED TO:
Name : AGIESCZKA DROZDOWSKA
Address 1: PO BOX 93
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 #R10-02-0229
Name Of Owner NEGERMILLER, ROBERT
Mailing Address 1 73 CHESTNUT AVENUE
City St Zip FLORAL PARK NY 11001
Property Address 1 INLET POND ROAD
City St Zip GREENPORT NY 11944
Tax Map No. section 33.00 block 2 lot 44.000
Cross Street GREENHILL LANE
Building Permit Number Cross Reference:
Issue Date: 4/17/03 Elizabeth A. Neville
Southold Town clerk
(TOWN SEAL)
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•'LIZABETH A.NEVILLE 1il 02 �4Town Hall, 53095 Main Road
TOWN CLERK % p - % P.O.Box 1179
2 $ Southold,New York 11971
REGISTRAR OF VITAL STATISTICS ;O ��, Fax(631) 765-6145
MARRIAGE OFFICER
RECORDS_MAANAGEMENT OFFICER ;_y�f 0-10 Fax
(631) 765-1800
FREEDOM OF INFORMATION-OFFICER =o'�
---•-.....01'* ' southoldtown.northfork.net
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MAR 3 i ` i , OFFICE OF THE TOWN CLERK
s-, i TOWN OF SOUTHOLD
- , /
- y
TO: Southold Town Building Depailnient
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: -
Transmitted herewith is a copy of application No. 3143 for a Cesspool/Septic Tank Construction
Permit submitted by:
Robert& Joanne Hegermiller
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- -_ _ i Air— i
freGa .'; .
Signature
D° ma– v.3
' Dated
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OFFICE OF THE TOWN CLERK ��,, ,•••••••,,�'
TOWN OF SOUTHOLD x.11 IHILk' . ' y
ELIZABETH A.NEVILLE,TOWN CLEtuc ��� C� Application No.'��
P.O.BOX 1179 •
SOUTHOLD,NEW YORK 11971 Construction
C=JrTi
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Alteration
Telep hone =1� �4 7. ' $10.00 - Residential
(631) 765-1800 - �,�•� ,� •
� $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION •
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
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Permit No.
Fee .$
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DATE (1.4 LS/
APPLICANT NAME: t?c70.ii7A �12� �
APPLICANT ADDRESS: i3 - L RID P.O. Zbx 9�J•
SEPTICS CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
+1,r✓co 03117 3 o Emu CT I O L3 1 Si P &L ♦`Pr 1u I l-"( 02 im RL J L/ 0'Z RI
5-To RU- am GAR .327U I LDI A3(4.-
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Ro is t1/4.) Naos I1_LE�
OWNER MAILING ADDRESS: .73 04-1 - 51-=-001-- hue
LORf�L pktp_k j 1100)
OWNER PROPERTY ADDRESS: -27. 1..)t-E-1- looN.D P.D.
Gi- N•PO x
TELEPHONE NUMBER OF CONTACT PERSON: 631- 0298- 11.2c -
TAX MAP NO. : Section 33 Block a Lot )I
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CROSS STREET: 6-12--e0A.D•4-I I LI. LIj-t
BUILDING PERMIT NUMBER CROSS REFERENCE:
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!1ii.Z�C.(.� � it 1i(��Ct�1:6JG�9SIL�—
Signature of Applicant_
RECEIVED BY': 1/1-1.414-----'
-Town/Clerk's Office
DATE: (6 3 ,_
Juv4' OF LOT # I2-7 N
'MAP C►i5EGTION FIVE EASTERN SHORES"
FILLD'DEG. 51, I%i68 AS #5234 W ,/,SITUATE: GREENPORT
/'
TOWN OF SOUTHOLD F
SUFFOLK COMM NY
�SUFFOLI:COUNTS'DEPARTMENT OF HEALTH SERVICES
SURVEYED OS-16-2002 ! PERMIT FOR A..PPLOVAL GOI,7THIJ PION FOR 4 i
SUFFOLK COUNTY TAX# baNGLE FAMILY RI;SH)ENCE ONLY
1000 - 3 o; - 44r
�_ iv DATE I 2-4 3 HS REF.N0. ••-0- -o . _ 7
>v W Q APPROVED Iwo •_:.&
GERTIF& N FORMA.° mum ROOMS HOLE
U 'Oa
ill C.
Loom
Robertade ni l l� EXPIRES THREE YEARS FROM DATE OF APPROVAL 3
JoAnn H ill°.
AR5 Abs oat Ltgg
N
Lot* 128
grovel
DWELLING WITH
PUBLIC.WATER
1f
Inlet p,o, 11 ,d l " !.ad
(asphalt roadway)
N69°02'10"E 130.00'
o
el=2q el=26
e1=28 17
(J-I O
o
CJI
tz..) Loc# 127
LA
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LA
LA I 1
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rri- CD
C11 i O p prbposed driveway
Ia o 0 II - b
r 24' 9- Xw <
CrO 13 proposedw water n ❑
(7 e-* I U- service y
# I E� l' '
-I 1
A= 35' I ° ' coo 55'
LUQ � 0...-4,
30•
test
Cil ®hole F
O I 1 9\ ,o) O P
building envelope as per
pre-existing non-conForming
Qfarce
sr O r,
Lot # 100
e1=25 "" N69°02'10"E 130.00' e1=29 e1=26
VACANT
VACANT
Lot # qG
"Map of Eastern Shores" L®L# 126
Section Three
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NOTES e� .,.......;;`:".;,. ..r.., ..,.,
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• REBAR FOUND :C1p ,�� J „���f
yrfr
O PIPE FOUND *4' ;L /iff . .". ..,
LAN• OP o'
HEDGE T ��7 ""
AREA = c1,500 SF or 0.45 ACRES J OH1 1 C. EHLERS LAND SURVEYOR
6 EAST MAIN STREET N.Y.S.LIC.NO.50202
GRAPHIC, SCALE I"= 30'
RIVERHEAD,N.Y.11901
ME I 369-8288 Fax 369-8287 REF.—TIGER\PROS\99-300A