HomeMy WebLinkAboutRobertson, Christian
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ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREErINFORMkTION OFFICER
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FFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
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TO: '---'-'" '.' S"ou!hord'ToWif'B ilding Department
FROM:
Linda J, Cooper, Southold Town Clerk's Office
DATED:
Town Hall, 53095 Main Road
P.O, Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown,northfork.net
Transmitted herewith is a copy of application No. 3612
Alteration Permit submitted by:
for a Cesspool/Septic Tank Construction or
JoHns Zinl!er
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.
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Linda J, Cooper
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I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
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DISAPPROVE
Comments:
Signature
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Dated
ELIZABETH A. NEVILLE ...,
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
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Town Hall, 63095 Main Roa
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P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
sou tholdtown.northfork. nel
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential@$lOLr Non-Residential @$25 _ Application No.~
Permit No.
Applicant Name S /"Curl.O--- 21'~ - . ~-eG-..A'Y~
Applicant Mailing Addre I bGf) ~4\()ur) ./l/~~ LiYvV....
Septic Tank_or Cesspool_ . , , r.fill
BriefDescriptio,n of Pro osed COIJ~truction or Alteration bUild; (j B-D"\ Q):JL/ (,
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Location of Propos
nstruction/ Alteration:
Ch ()\~"ClY1 ~bQ/v1C:;Din
1 (" G, <0 -J-",d.J().y, . A/ e.eL.
Pu..Dn;L If'7C<f'
Owner of Property:
Owner Mailing Address;
Owner Property Address:
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Name and phone number of contact person ~ I ,'~~ J;~ . /4.U 9<7 0 t, 6l?-b .0"-J'-)
TaxMapNo:~73~ Section of?0 Block (Jon LI Lot OOG,@ (
Cross Street "/00.- (, / '1 P- k '2-,)1 4/\ /,'(. ~ \
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
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I turi9' App icant (Date
Received by: ~Q:
'ATIONS ARE REFERENCED TO AN ASSUMED DATUM
,XISTING ELEVATIONS ARE SHOWN THUS: JQJ)
:R TO FILED MAP FOR TEST HOLE DATA.
LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON
FROM FIELD OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS.
{IOUS S.C.D.H.S. REFERENCE No. R10-96-0030.
TING SEPTIC TANK TO BE PUMPED CLEAN AND EITHER REMOVED , r_
FILLED WITH CLEAN SAND AS PER S.C.D.H.S. SPECIFICATIONpZ :Z d 1't<:l.::""J
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EXISTING
6' DI"-. 6' DEEP CESSPOOL
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s' [)[(P CESSPOOL PROPOSED 5096 FUTURE
. EXPANSION POOLS
PROPOSED B' DIA, /...;/, '..
b' DEEP LEACHING POO~~: '.. /.;/ ,
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LOT 1
MAJOR SUBDIVISION MAP OF
r:. p WILD OA T3
\.\ ~.." C'._....rI.Lt:.:~X 9331 FILED MARCH 9. 1993
I\~J\ - 0,,'0 ITUATED AT
J\~ 1. 'l. c~.0\ PECONIC
\... . .~~;;;::;~c~-i-fQw .. OF SOUTHOLD
LK COUNTY, NEW YORK
S.C. TAX No. 1000-86-04-6.1
SCALE 1 "=20'
FEBRUARY 7. 1996
OCTOBER 30. 1997 FINAL SURVEY
JUNE 28, 2001 ADDED WOOD DECK
APRIL 24, 2006 ADDED PROPOSED SANITARY SYSTEM
AREA = 39.999.76 sq, ft.
0.918 oe.
UPGRADE
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SUFFbLK COUNTY DEPARTMENT OF HEALm SERVICES
PERMIT FOR APPROV At. OF CONSTRUCl'ION FOR A
.iINGLE FAMILV RESIDENCE ONLY
DATE b-7-Ob HSREF NO, fit cs"-
APPROVED
FOR MJ\XfMlJM OFh BEDR S
EXPIRES THREE YEARS FROM DATE OF APPROVAL
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UNATHORIZEO ALTERATION OR ADDITION
TO THIS SURVEY IS A VIOLATION OF
SECTION 7209 Of THE NEW YORK 51 A IT
EDUCATION LAW
COPIES OF THIS SURVE'l' MAP NOT BEARING
THE LAND SURVEYOR'S INKED SEAL OR
EMBOSSED SEAL SHALL NOT BE CONSIDERED
TO BE A VALID TRUE COPY.
CERTIFICATIONS INDICATED HEREON SHALL RUN
ONLY TO Tr1E PERSON FOR WHOM THE SURVE'i
IS PREPARED. AND ON HIS BEHALF TO THE
TlTLE COMPANY, GOVERNMENTAL AGENCY AND
LENDING INsmuTION USTED HEREON. AND
TO THE ASSIGNEES OF mE LENDING INST1-
TUnON CERTIFICATIONS ARE NOT TRANSFERABLE
THE EXISTENCE OF RIGHTS OF WAY
ANO/OR EASEMENTS OF RECORD. IF
ANY, NOT SHOWN ARE NOT GUARANTEED.
PREPARED IN ACCORDANCE Wlll-t THE MINIMUM
STANDARDS FOR TITlE suRVEYS ~ ESTABUSHE
Erf TrlE L,I.A.L.S. AND APPROVED AND ADOPTED
FOR SUCH USE BY THE NEW YORK STATE lANr
TITLE ASSOC ON.
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N.Y.S. lie. No. 49E
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Ingegno
urveyor
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Title Surveys _ Subdivisions - Site Plans - Construction Lay,
PHONE (631)727-2090
Fox (631)727-1727
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MAILING ADDRE>S
P.O. Box 1931
Riverheod. New York. 11901-
OFFICES LOCATED AT
1380 ROANOKE AVENUE
R1VERHEAO. New York 11901
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