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-:ELIZABETH A.NEVILLE t '�d; Town Hall, 53095 Main Road
TOWN CLERKOci3 - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS
Southold, New York 11971
Fax(631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER `=�*®� i0 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ��� southoldtown.northfork.net
OFFICETTOF TTFH��EppTOgWNLLDDCLERK
SOUTHOLD WAGS WATERUDISOPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2881 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : ROBERT LEHNERT
Address 1 : 698 FRANKLIN AVENUE
City St Zip GARDEN CITY NY 11530
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 #R10-02-0058
Name Of Owner MICHAEL DROBET
Mailing Address 1 PO BOX 545
City St Zip MATTITUCK NY 11952
Property Address 1 STILLWATER AVENUE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 103.00 block 7 lot 10.000
Cross Street DARTMOUTH PLACE
Building Permit Number Cross Reference:
Issue Date: 9/24/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
0-0171-••=401' CP 8-2. I
ELIZABETH A.NEVILLE 11�_� G��; Town Hall, 530•- ain Road
TOWN CLERK ` y ; P.O. Box 1179
REGISTRAR,OF VITAL STATISTICS
l3 $ Southold, New York 11971
MARRIAGE OFFICER O �, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER `=y�01 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER r �� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK I ---r'-- ---•�`--
TOWN OF SOUTHOLD 1 tj
L I AUG 2 6 2002 ;r_`
TO: Southold Town Building Department —� Pt_oc DE�,T
.rwv OF ;:'U BOLD
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: August 23, 2002
Transmitted herewith is a copy of application No. 2996 for a Cesspool/Septic Tank Construction
Permit submitted by:
Robert Lehnert
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
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Signatureazi, .2--6
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Dated /
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'OFFICE OF THE TOWN CLERK '. c4FULkc - _
TOWN OF SOUTHOLD � Application No. �
FIT7ABETHA.NEVIL.T.F,TOWN CLERK
'OO G. PP
P.O.BOX 1179 Construction
SOUTHOLD,NEW YORK 11971 : •
Alteration
Telephone
‘VO4
$10.00 - Residential
V
(631) 765-1800 =��.1 /111>','�.
$25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee '$
DATE
APPLICANT NAME: p j.e� teh n er /
APPLICANT ADDRESS: 6'6,, -4 -A Pin pia n��� GCt 5`]'` 'C
98 frAsi k/ i Ave- , c ,-6t , G; ,ti //53
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
Pry vSe l/ew lden ce
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
• OWNER OF PROPERTY: MI4a 1 l•2 i.e7
OWNER MAILING ADDRESS: Pr Dr ' O X 545-
,Nr , 1/952
OWNER PROPERTY ADDRESS: 571/))INA7 -e - Ave
CLiGA(fve r /f/7TELEPHONE NUMBER OF CONTACT PER✓SON:
TAX MAP NO. : Section /03 Block 7 Lot 1 0
•
CROSS STREET: Dari ®t/-, Pia c e
BUILDING PERMIT NUMBER CROSS REFERENCE:
I
Pa
RECEIVED BY: or rnat�
I � Town Clerk's Office
DATE: � �
SANITARY SYSTEM - - - - - -"'.:#1.---172----," --m - -- --- <' ! .\\
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PROPOSED SANITARY SYSTEM MON 'S 7 / � P I -`�` i i i` z PROPO E Wa
'EE ATTACHED -Emu. CONDITION USE 1200 GAL. SEPTIC TANK -- , / -
�r �t (3) 10' DIA. x 4' DEEP CESSPOO ;�y t� � J - ',''
GRADING_P AND/OR PLOT PLAN
`\y / ,S/y 11 r-- Sea 9, 't'►• \ -- '/%'/-
ti `� --- k A'o• PRO '��
°� 'c' -., , do s stn �-- ''
WELL TIONS A p� C>I'� X 15.7 ��` ,� '
AS PER OWNER
yGoo S \ y / ---
iAP
%�� s - ‘ PROPOSED
SANITARY SYSTEM \` �\`pti syq�, \\ �t1$E ` i / / i, R-
SUFFOLK COUNTY - / 1 /.' `LO�j•
DEPARTMENT OF0 ° v; I
HEALTH SERVICES ��>. I�i 2r / `._,'
PERMIT FOR APPROVAL OF CONSTRUCTION FOR A ��`�
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SINGLE FAMILY RESIDENCE ONLY
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71 C, �4
!SATE;'� O�-
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APPr:OrI '
Or ?y
BEDROOMS p,�
EXPIRE: ii1;,". _'RS FROM DATE OFAPP rA •
IllfU SOW UNE ..•+.+. F.rr \®�.A ���O���t•`°>• O�.
EXP.PAW, D•LPIL mm. �C,�<}Y
In\-7CV—\ A /� p 0°4 MON.
LEAPING
I
1.000 cu. ri POOL 1 ^� WELL
�y�,'
SEM TANK 1 �„/
10'MI,. I
S 1kp4.1
9 1 / WELL AND SANITARY LOCATIONS
NS I .�J� AS PER OWNER
P.
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SANITARY SYSTEM
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TYPICAL LOT LAYOUT
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MINIMUM SYSTEM DEPICTED, ��
s
REVISED: MAY 20, •• ��� ) � 0
REVISED: FEBRU•r �¢� y ;. ' "
SURVEYED: AP' 0Q w� PLAN) .p-
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