HomeMy WebLinkAboutEdson (2) ELIZABETH A. NEVILLE 1,/���® t; Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
CIO
REGISTRAR OF VITAL STATISTICSi Southold, New York 11971
MARRIAGE OFFICER s�s 1', Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER =__ ® 46,60 Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER r�� southoldtown.northfork.net
OFFICE OF THETFTOWN CLERK
SOUTHOLD IIT WK r��URTSCWSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2862 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : GOLD CREEK BUILDING CO.
Address 1 : 77 STEPHANI AVENUE
City St Zip EAST PATHCOGUE NY 11772
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 #R10-02-0106
Name Of Owner EDSON, LOUIS
Mailing Address 1 MAIN STREET
City St Zip CUTCHOGUE NY 11935
Property Address 1 DEPOT LANE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 102.00 block 2 lot 6.008
Cross Street MAIN SREET
Building Permit Number Cross Reference:
Issue Date: 8/22/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
oil Of FOidt ".... 02 4&6 2..'
ELIZABETH A.NEVILLE ''���,,® *,; Town Hall, 53095 Main Road
TOWN CLERK ; 00 .. % P.O. Box 1179
REGISTRAR OF VITAL STATISTICS � • ) Southold, New York 11971
MARRIAGE OFFICER �, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER \4 ilt'le. / Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER �.����,,r�� southoldtown.northfork.net
n OFFICE OF THE TOWN CLERK
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TOWN OF SOUTHOLD
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LTO: T, .,..._.�.0Athol Town Building Department
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L__.—IFROM:ti---Linda Linda J. Cooper, Southold Town Clerk's Office
DATED: July 23, 2002
Transmitted herewith is a copy of application No. 2965 for a Cesspool/Septic Tank Construction
Permit submitted by:
Gold Creek Building Co. Corp •
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: �i =4 .c. r., <,„ , ( .....:
Signature
677A/9 Z
Dated
1
•
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- OFFICE OF THE TOWN CLERK ll,%IFOL ' -_ r
TOWN OF SOUTHOLD
FrWABETHA NEVI'T.F,TOWN CLERK � °G Application No.
P.O.BOX 1179 1 j
Construction
SOUTHOLD,NEW YORK 11971
v
Ls, Alteration %
Telephone _ ,� ., .,� $10.00 - Residential i/
(631:) 765-1800 ,��'
•
$25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION .
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE '?l'Zvt,y go
APPLICANT NAME: Goup efle\ ,,yam egUi eA.36 03-ep
APPLICANT ADDRESS: 77 ,'`Trpl.b4.10 c vibe_
E. i71A-r-c. ue, it-)Y // 77
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
/V&A.) IpincNge
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Lead 1cSe�
OWNER MAILING ADDRESS: «-i - / rc/-1j .- y
OWNER PROPERTY ADDRESS: Pon- Uv / CUTCt-Ie CCTe
•
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section 10,2 Block ER Lot
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFiRENCE:
@nature of App icant
RECEIVED BY: •
Town Clerk's Office
DATE:
' ,SUR VA' (F
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-- LISA AMcQ UILKIN LOT '
MAS' OF
LAND SURVEYING . DEBORAH EDSON
102 MAIN STREET Fly, -N° ,8537
WEST SAYVILLE, NEW YORK 11796 AT CLITCHOCIIE' CLUB INC•
PHONE: 631-563-4952 TOWN OF SOUTHOLD, E ,LY MgR1AN COLUMBUS 458.75+
STATE OF NEW YORK Nom T Ax LOT' S
CA,
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CERTIFIED TO: �9s r AT ISN T THE s�
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' LIBERTY SAVINGS BANK �� } URE DEDIE — — — ` c.
MKM ABSTRACT SERVICES RESERVED 0.52 AcresO
' FIRST AMERICAN TITLE INSURANCE CO. QP y54 Sq. F t. = — , — s
COLD' CREEK BUILDING CO. CORP. I m o 459.43
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TEST HOLE I
AS PER FILE MAP "' e' 'F
Er'6RE� a ,E�:ta YEAR01�li pA°� CSE APPfZ®V
TOP SOIL v ..,.4, ,....?„,,,, r
I I y 460.26'
LOAM • I S 51" 00' 30" W o V
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ADDITION TO THIS SURVEY IS A TO EXISTING STRUCTURES ARE FOR A SPECIFIC
. 1:,'.,1 L- ; 11� ,C � AjN RppDVIOLATION OF SECTION 7209 OF THE PURPOSE AND ARE NOT TO BE USED TO ESTABLISH
NEW YORK STATE EDUCATION LAW PROPERTY LINES OR FOR ERECTION OF FENCES
• L �`
n V-Ar( --1•-.jc=v COPIES OF THIS SURVEY MAP NOT BEARING CERTIFICATION INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY
S.C.T.M. �{ 1000 - 0102.0g 4-`I -i',EreI'
-, 00 THE LAND SURVEYORS INKED SEAL OR IS PREPARED'AND ON HIS BEHALF TO THE COMPANY, GOVERNMENTAL AGENCY, AND LENDING
�' EMBOSSED SEAL SHALL NOT BE CONSIDERED INSTITUTION LISTED HEREON. AND TO THE ASSIGNEES OF THE LENDING INSTITUTION
-1, ''"-
�! DATE: 5-24- 02 TO BE A TRUE VALID COPY CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS
REVISEbr FILE NO. Q380-02 SCALE.1"= 50' .