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ELIZABETH A.NEVILLE 1' =�® -** ; Town Hall, 53095 Main Road
TOWN CLERK cm, ; P.O. Box 1179
co,REGISTRAR OF VITAL STATISTICS M i Southold, New York 11971
MARRIAGE OFFICER : Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER = '/®1 �b'�1� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ��� southoldtown.northfork.net
OFFICETTOF TTFHgEppTOWHN DDCLERK
SOUTHOLD WAGS WATERUDISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2903 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : STEVEN HOELL
Address 1 : 239 OLD TOWN ROAD
City St Zip EAST SETAUKET NY 11733
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 #R10-00-0202
Name Of Owner HOELL, STEVEN
Mailing Address 1 239 OLD TOWN ROAD
City St Zip EAST SETAUKET NY 11733
Property Address 1 1925 GRANDVIEW DRIVE
City St Zip ORIENT NY 11957
Tax Map No. section 14.00 block 2 lot 3.021
Cross Street MULFORD COURT
Building Permit Number Cross Reference:
Issue Date: 10/30/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE A Town Hall, 53095 Main Road
TOWN CLERK ® = P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS Southold, New York 11971
; A,. 0 Fax (631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER ; ®1 �� �i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ���� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD 1j 1 Ir �� cF�g[ 1 � t `�
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TO: Southold Town Building Department J[JFP' 2,5 2002 ,
FROM: Linda J. Cooper, Southold Town Clerk's Office -t5FF
DATED: September 24, 2002
Transmitted herewith is a copy of application No. 302b for a Cesspool/Septic Tank
CONSTRUCTION/ALTERATION Permit submitted by:
Steven W. Hoell
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.
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Signature
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Dated
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OFFICE OF THE TOWN CLERK ,,,,,,,,,,,c
ELTLABETHA.NEVIf.iTOVVNi1FHOWNCLERK .`t.TOLD �oevFF�(/rC% Application No.OF LO°`6
P.O.BOX 1179 /
SOUTHOLD,NEW YORK 11971 z Construction �/
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c Alteration
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Telephone ����• $10.00 - Residential
(631) 765-1800 ®l * It ,r $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE 7/70.2-j,
APPLICANT NAME: �
APPLICANT ADDRESS: p9� q e(j 03N
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: l �� d +4 OELL
OWNER MAILING ADDRESS: .3 R L-A3 K\
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OWNER PROPERTY ADDRESS: 199,5 (,42, \J Q �iJ
TELEPHONE NUMBER OF CONTACT PERSON: rr--061k
TAX MAP NO. : Section , 9- Block Lot I
CROSS STREET: (Yl i L- C
BUILDING PERMIT NUMBER CROSS REFERENCE:
__ 11. t U .. áA )A.
gnature of Applicant
RECEIVED BY
Town Clerk's Office
DATE: ��-'
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I am faml/lar with the STANDARDS FOR APPROVAL
fD ,i AND CONSTRUCTION-OF SUBSURFACE SEWAGE
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES \ z._
SUFFOLKCOUNTY D PARTM NT OF ,HEALTH S �` and will abide by the conditions set forth therein and on the
FtVICSS permit to construct. 2
PERMIT FOR APPROVAL OF CONSTRUCTION FOR A .A
,
SINGLE FAMILY RESIDENCE ONLY el
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DATE (1-3tr-00H.S. REF'. \.;.- 1► b_ -• 0- Da o a sP,e �.,
APPROVED ic._ ,w..A. : ® 3!'891i
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FOR MAXIMUM OF' C..ROOMS .. . .LD1 r.:;• '`A� , v `''.
EXPIRES THREE YEARS FROM OA O APPROVAL JA�ANT ` L
• s�l.%d9`1A�6d� INSPECTION REWIRED P`Y ` 'w r �� Z�
FOR SANITARY SYSTEM Se . �
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BY HEALTH DEPARTMENT' si �� G _ .
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NOTE, LOT NUMBERS REFER TO " MAP OF \ .S " -
GRAND VIEW ESTATES FILED IN,,
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by 20,00' t1 ,kg
THE SUFFOLK COUNTY CLERK'S..
OFFICE ON JUNE 8, /982 AS N ‘ 66®46'AC �, „ L. 31.42 tip"
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SUFFOLK COUNTY, N Y. �07, z \,
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SCALE 1" = 40' -
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ANY AL TERATI ppN OR ADDITION TO SURVEY/S:4 VIOLATION I '<F-�� yG� . - -
OF SECTION vas OF THE New YORK STATE EDUCATION LAW. -A, el 'lJ�• ,Q. . Vii•Merzc� y _ _
EXCEr AS PER 1CTION 7246 -stJeplVfS/ON2. LLtcATJONS o? ,t "'HEREON VALFOR 7 MAPAND•,COPIES" 7� QNLY ESAID: OER GO3 ;� Tt1E IMPRESSEDSEAL OF TNII:,SIMVEYOR ��� ;��'!�.. . LIC. Na 496/8
�ONAILIRE APPFiARS-tEREOA,� . A �' d�'�l,
ADDITIONALLY ro Y WITH SA(� W,THE "AL. BY' r11i,G ,. '� j.. Oft•r> C
• :The-=l,opotions ;o1 wells and c_e, spopit 1': s2 F !63/1 765 - /797
- ,l4.1,S BE VE'Yo��YR. ntra5 As�i � sl ri► e%.a�'e trim' Reid ottservallans P. 0� o -b`� '�` X
�o�i TO DATE"ARE n or N cotivANcs WI' NIS,, -
` , 'a► 4-:&&w,*R ata" det-10 obirtfrred fro* others. t� F :�.J REST
AREA =49,91:? sq. ft or 11390 acres Sftl fJ.' 3 Illi -