HomeMy WebLinkAboutFredenberg Kurt ELIZABETH A. NEVILLE
T~OWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
/0
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
· F~x (6~1) .765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
Residential ~ $10 or
Non-Residential ~ $25 __
Application No. 3/6, ~'
Permit No.
Applicant Mailing Address
Septic Ta~ or Cesspool~_
Brief Description of Pronosed Construction
Location of Proposed ConstmctioWAlteration:
Owner of Prope~y:
Owner Mailing Address:
/lq ?/
Name and phone number of contact person
Tax Map No: Section _ ,//~7/
Cross Street
Block 7 Lot ,~. /
NOTE: LOCATION MAP MUST BE SUBMITT~,I~ WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY ~VI~}I ItEA~DEPARTMENT APPROVAL
~-~fi[ure ~fApplicant Date
Received by: ?¢~-
NOTE
AREA = 22,875 SQ. FT,
· VERTICAL DATUM -- NG.V. DATUM (M.S.L. 1929)
· ZONING USE QISTRICT - R-40
~ THE FIRM ZON~ BOUNDARY SHO~ HEREON AS CONCIDENT
~TH THE 1~ CONTOU~
~ R~F~R TO FLOOQ INSURANCE ~A~ MAP ~ANEL NUMBER
PROPOSED WELL
& WATER SERVICE
EASEMENT
PROPOSED WATER S~'R,,~CE
EASEMENT ACROSS RIGHT.OF WA
REPUTED LOCATION OF W~LLS
AND CESSPOOLS AS INDICATED
BY MB, DANA FOX
PROPO~ED~
N
S
HEAl], S,_R¥1g S
TEST HOLE
DATE: 07/11/01
:33
HEALTH DEPARTMENT USE
ENGINEER'S CERTIFICATION
· I HEREBY CER]IFY THAT THE WATER SUPPLY AND SEWAGE
DISPOSAL SYSTEMB FOR THIS PROJECT W~RE DESIGNED BY ME OR
UNDER MY DIRECTION,
HOWARD W, YOUNG, N.Y.S. L.S. NO. 4589
THOMAS C. WOLPERT, N.Y.S, P,E NO. 61483
SURVEYOR'S CERTIFICATION
INSURANCE COMPANY OF NEW yol~l( (TITEE
ND. 641 SO13130) mAT THIS SURVEY WAS PREPARED IN
ACCORDANCE WlI~l ~HE CODE OF PRACIqCE FOR L YS
ADORNED BY mE NEW YORK STATE ASSOC~A~
~ ~g~'"~' '~PROFESSIONAL L~ND ~UR~YORS. ~~
SEPTIC TANK
300 S.F.S.W.A.
LEACHING POOL
SANITARY SYSTEM DETAIL
SURVEY FOR
KURT FREUDENBERG & JANET R. LATHAM
At Mottituck, Town of Southold
Suffolk County, New York
BUILDING PERMIT SURVEY
GENERAL AMENDMENTS OCT. 8, 2002
GENERAL AMENDMENTS AUG. 15, 2002
GENERAL AMENDMENTS FEB. 6, 2002
GENERAL AMENDMENTS NOV. 27, 2001
GENERAL AMENDMENTS OCT, 1. 2001
GENERAL AMENDMENTS JULY 24. 2001
GENERAL AMENDMENTS JUNE 7, 2001
MAP PREPARED MAY 25, 2001
JOB NO. 2001--0154