HomeMy WebLinkAboutBMA
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATIOJ:l OFFICER
r,';:-'
\\
,
\
\
SEP 2. \ ~S
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
i :--'~_
'I
\--1'0:
,
_.~
, Southold Town Building Department
FROM:
Michelle L. Martocchia, Southold Town Clerk's Office
DATED:
September 19,2006
RE:
Cesspool Construction/Alteration Application
Town Hal!, 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. 3631
Construction/Alteration Permit submitted by:
for a CesspooVSeptic Tank
Theodore Petikas
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.
*
*
*
*
*
*
*
*
*
*
*
*
I have reviewed the application and location map of the project cited above and make the following
recommendations: /
APPROVE V
DISAPPROVE
,,~~?CY_$.(?~J;::;'~1~L ~
Comments:
~
?U-/'~4.
Signature
/ohAt
Dated / /
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 53095 Main Road
P,O, Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
sou tholdtown .northfork .net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10 t/ '1[ Non-Residential @ $25 __
Application No 31.03 l
Permit No
ApplicantName -~~.r;o="'17-C. (7e'\\ "M C ~,.a f\ .)
Applicant Mailing Address f) ~ r- ST'-O<!jJ'".Q- ~
~-::?,~ p<i:~L / f (VI .I Illy
Septic Tank_or Cesspool_
Brief Description of Proposed Construction or Alteration
r).e \ J C t'i'0"Y'\ },ti~
Location of Proposed Construction! Alterati~ 151./5
Owner of Property: 1\ fJ'(\ . ~ ,N Ollf J f-f\ ~R 'i .I) lL(tt\J~ fo IIJ 1
Owner Mailing Address: 'QQ r ~:\--f'vJiCk"J 90 " ...:~ _,_
(~.e.....-\-~ r -0,\.\ Q rv'i, I I i'/v
Owner Property Address: I S tQ 5.- GO\ -tt, ~ D ( I '~
orient- N'-I i \ q51)
Name and phone number of contact person (lfFo p GT I ~A--\ .06"'78/-12 cf l
Tax Map No: Section i) Block c: Lot :2. b
Cross Street ~f lL <r' ,1'\ 'ill-A. L- ~ V \;:_
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
~~;~A;;li;ant '1~:e9- () (;
Receive~C( ,e;h c~
)l)RVEY OF LOT 81
"lAP OF ORIENT BY THE SEA, SECTION T\I'IO
,El' C~C TOBER 26, 1"161 fiLE No, 3444
_c:
JITUA TE: ORIENT
-OI^lN: SOUTHOLD
)l)FFOLK COUNTY, NY
~~k'('::' .
."e' S
~) . ,.,' 'c-. ,
jRv'ETED OGl-II-02
'cAe TH DEPT UPDATE f)-22-2000
,JFF-r~)Lk COUNTY TAX it
-;':~_ I S-- =)- 26
N(Q)rtlh Sea Drive
: J:'~: ~ i FI t :.. ':~'.)
.HA CONSTRUCTION
8
) "f'?
~
~
11
FY]
~
r
~
!GJ
.
MONUMENT fOUND
PIPE fOUND
l-ot
54
-REA
q no Sf OR 0.45 ACRES
1',"1'
ARCE~ RESIDES IN ZONE DISTRICT R-40
LEv A TIONS REfERENCE SUffOLK COUNTY
oPO NAPS
"j":
I"" ,."-,,
'ROPER n ZONE R 40
,ETBACK5 BASED ON NONCONfORMIN0 LOTS
F ,_ESe, THAN 20.000 Sf
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
PERM;T FOR APPROVAL OF CONSTRUpION FOR A
SINGLE FAMILY RESIDENCE ~
Pe'(M i + RfM",,,-,><"A q-~,+-o0
DATE \ 1_ \ ~ -02 H.S. REF. NO. R 10 -o?-o ;;lOI
~
AFPROVED
TOTAL MAXiMUM BEDROOMS ~ V R
5/)( ~
EXPIRES T~YEARS FROM DATE qF APPROVAL
EXCAVATION INSPECTION R"EQUiRl::P]
FOR SANITARY SYSTEM
8Y HEALTH DEPARTMENT
E1..EASE N-QIE
Minimum distance b::Av.F3Qn If,'(::]
and cesspool is to be 150 'fJ,s.L
-'
-'/ ~
I,,'
..
"kAPHIC SCALE
- -
..-.---
1"=lf2
..
NoB'
"tj
z
C)
~
~
c5
C)
'i
"h
. 35'
~
C)
b
C)
SBB'
-------..------------- -...-
.
JrtLhi
,O"E I, BIIO'
'?'
'! (:J-D\
I --, ::: '
, <: -D I:
i" " ~ 9
, '2;'1
~::...
'J<
s.
;c, .)posed
r '-1~)Use
4S
ie/'V'! Blbl'
Pl\\llIDffi
______n __.______________~--.-.- ---
- ---------
-~.
N
~
wyE
,_ct'
~
s
- " (- - - ! ~'-) -
I 0._
UI. "'''ty
L-O<>'"
r~i ' ~',~:,'"
-'"', '-:~,~.';;,
-~
~-,
~..
1.,-
"',;
'J<
(5\.
A'
,^, '1f??-
O'ly'"
Ao ?-0,''3
0'1
_0':-
00
..
~
~
-..-...,.-"...<"t.o<a1""''''~'''Q........,
...", ......""l a ""-,, '..... ----r'. .->' .. ~
"""~ o' .-1"'" ~..,..,~_. '" 0>00
_f_-..f_-~-'
~ 'r,~:~::':1:' ~ ~y-:;-~
......---,,~...,..,.--..."'-""'''''''''''
"""'....
~,~;"~;~~~:...
...t~.....,...."'Pr<d""""''''''''''''''''''''~
Dj....._,,___""""'O< ...."'...""""
L6><l~_<I'\.'-'--""""""
",-~,,,,_................~..,,....-,wj
:;'~';;:"~~~~c::-,.:,
~e JOHN C. EHLERS LAND SURVEYOR I
li ~\?IJ.& 6 EAST MAIN STREET NYS. Lie NO 50202 "
RIVERHEAD, N.Y 11901
369-8288 Fax 369-8287 REF._\\COmpaqserver\pr~2-257.pro
o"j{X~'" ,,'._,."" ,~ .....vr .""".,.-...;,-, ;'"