HomeMy WebLinkAboutMilner, Fred
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 153095 Main Road
P.O, Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork,net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
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Southold Town Building Department
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FROM:
Michelle 1. Martocchia, Southold Town Clerk's Office
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DATED:
January 12, 2006
RE:
Cesspool ConstmctionlAlteration Application
Transmitted herewith is a copy of application No, 3557 for a Cesspool/Septic Tank
Constmctionl Alteration Permit submitted by:
Fred Milner
Please review the application and location map and advise if this office may issue the permit.
Please complete the form below and return it to me. Thank you.
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I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
~
DISAPPROVE
Comments:
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Signature
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Dated I' /
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EUZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
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_> Town Hall, 53095 Main Road
P,O, Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown, northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$lOL or Non-Residential @$25_
Application No.35S 7
Permit No.
Applicant Name FR E!) tv! ; \ t'\<L
Applicant Mailing Address-3 8S \\Lh I k
~Au tel it). j \ \ q Lf ~
Septic Tank X- or Cesspoo L-
Brief Description of Proposed Constmction or Alteration
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Location of Proposed Constmction! Alteration:
Owner of Property: G-I\I" ~ Df15 (0) "
Owner Mailing Address: /J RIZ 1 -r 0 I.f.} rJ
I L( 5H'
Owner Property Address: / 0 5' 0 C
Block 0 l-O.U..,
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Lot ---1.'l-
Name and phone number of contact person
Tax Map No: Section g' ~
Cross Street --.-J~4A "I' f.J"..) Au e......
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NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
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Signature of Applicant
Received by: ~ ~~
Date
LOCA nON MAP
TEST HOLE DA TA
PERFORMED BY McDONALD GEOSCIENCE
27 AUGUST, 2001
EXISTING GRADE
BROWN SIL TY LOAM OL
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PALE BROWN LOAMY SILT AfL
3'
BROWN FINE TO COARSE SAND SW
B'WA TER
WA TER IN BROWN FINE TO COARSE SAND SW
14'
FOR S.C.D.H.S, USE ONLY
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TM 1000-089-02-05.002
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GUARANTEES INDICA TED HERE ON SHALL RUN
ONt Y TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED, AND ON HIS BEHALF TO THE
T1Tl.E COMPANY, GOVERNMENTAL AGENCY.
LENDING fNS71TUTlON. IF LISTED HEREON, AND
TO THE ASSIGNEES OF THE LENDING fN$777UTlON.
GUARAN~ ARE NOT TRANSFERABLE TO
ADOlnONAL INsnTU710NS OR SUBSEQUENT OWNERS.
UNAUTHORIZED AL TERA nON OR ADDITION TO THIS
SURVEY IS A WOLA nON OF SECTlQN 7209 OF
THE NEW tQW( STAlE' EOUCAnON LAW.
RESERVED LOT
CEDAR BEACH INN
N/F GENERAL WA YNl
PUBLIC WA TER
150'+ TO SANITARY
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CEMBER, 2001
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DnDI"'U CTI:"DC'
SURVE:Y OF'
LOT 27
IN
SUBDIVISION MAP OF
CEDAR BEACH PARK
SITUA TE
BA Yv/DV, TOWN OF SOUlHOLD
SUFFOLK COUNTY, N,y'
SURVEYED FOR GREGORY D'ASCOU
DENISE D'ASCOU
SURVE:YED 27 SEPT., 2001
SCALE 1"=30'
AREA= 20,000 SF
OR
O. 459A CRES
ZONED R-40
SCDHS f1R-70-01-0227
ELEVA T/ONS TAKEN FROM EAST
END TOPOGRAPHICAL MAPS AS
FILED IN SUFF CO. DEPT OF
PUBLIC WORKS
THIS PARCEL FALLS ENT/REL Y IN
THE 'X' ZONE AS PER FEMA FIRM
NUMBER 3610JC0167G DATED
MAY 4, 1998.
SURVEYED BY
STANLEY J. ISAKSEN, JR,
P.o. BPX 294
NEW SUFFOLK, NY
631..J734- 83
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