HomeMy WebLinkAboutTole, Kathleen M
ELIZABETH A. NEVILLE
TOWN CLERK
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFJ:l.CE?
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO:
J
Southold Town Building Department
FROM:
Linda J. Cooper, Southold Town Clerk's Office
DATED:
October 11, 2006
Transmitted herewith is a copy of application No. 3636 for a Cesspool/Septic Tank Construction
Permit submitted by:
Kathleen M. Tole
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 1. 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
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Signature
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Dated r I
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ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 63095 Main Rol
.~ P.O. Box 1179 .
Southold, New York 11971
Fax (631) 765-6145
Telephone (681) 765-1800
Boutholdtown.northfork.ne
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $1 0 /or Non-Residential @ $25 _
Application No. 3b 310
Permit No.
ApplicantName J~-n-\LEew M c 'OL.-t=:
Applicant Mailing Address :oq4{) ~ E 1. =,..,) c.. vvPM
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Septic Tank_or Cesspool_
Brief Description of Proposed Construction or Alteration <; \ ~a... Lb ~\L-'\
~RS\be.N<'~ .
Location of Proposed Construction/Alteration: /
Owner of Property: \.Lh\""lt u,:E. "-l N\ <. '0 L..E _ N\ p,. R-Y ~}jIJ~Jl
Owner Mailing Address: "3q ~O ~r\E \ oJ a.. LV"'....,
E: MA-~o~ \t C\ ~j
Owner Property Address: ~ \ A-
Name and phone number of contact person i.~ ~l E E~
Tax Map No: leoe Section ;;0 Block 0 2-
CrossStreet~~~ () c <""> S S'w.~""\
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVIJ:Y WITH HEALTH DEPARTMENT APPROVAL
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Signature of Applicant Date '
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Lot ~
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Received by:
.
SUFFoLk COUNTY DEPAR
TMEN'rOF REALm SBRVlCES
PERMIT FOR APPROv A1. OF'" P
.))NGLE FAMILv RES~N3Tkl)('TION FOR A
DATE ~-?#....(!)f2 RBP ENCEONLY
APPROVED
FOR MAXIMUM OF '#- S
BXPIRBs l'HRBE YEARS FROM
. , . DA APPROVAL
III:i .. A./IgNRl:QuIRED
. _u,:~ ~94,90':&2"~ \11
SURVEY OF
LOT 62
MAP OF
BBLE BEACH RARMS
FILE No. 6266 FILED JUNE II, 1975
SITUATED AT
EAST MARION
_TOWN OF SOUTHOLD
F K COUNTY, NEW YORK
,C, x No. 1000-30-02-99
SCALE 1"=40'
OCTOBER 2, 1998
JULY 13. 2006 UPDATE SURVEY &: SET STAKES
THE LONG WAY
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1. [LEVAnoNS ARE R[F'[RE:NCED TO AN ASSUMED 0AT1JW
EXtSTIMG El,EVATIOHS .4,RE SOOWN THUS: ':;Q.Q
2. JfU'ER TO nu:o IIIAP FOR TEST HOLE DATA.
3. WINMJW SEPTIC TANK CAPACITIES FOR A. 1 TO .. BEDROOW HOUSE IS 1,000 GAU..ONS.
1 TANK; a" LONG, 4'-3. wtDf, 6'-7. DEEP
.... WINIlIUIIl LEACHWG SYSTEW FOR A 1 TO 4 8f:OROOW HOUSE IS 300 Ml ff SI[){WALl AREA,
1 PClOl< 12' DEEP, IS' dSa.
e PfIOPOS[D DfOAN$lOt\I POOL
@PIlOfIOSED WCNlMO POOL
~I"ROPOS[D srmc TANK
S. THE LOCATtON or WEU.S AND ctSSPOOlS SHOWN HEREON ARE FltOW nELD
OISlRVAT1ONS AND/OR DATA OBTAINED F"ROW OTHAS.
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UNo\UTHORIZED ALTERAllON Oft ADOlTlON
TO THIS SUR'.'EY IS II '<tOI..ATION OF
SEC110N 7209 Of THE NEW YMl< STATt
rou"",,,,,,,, L<W
COPIES OF THIS SlJRVE'( w.P NOT BfAAING
lHE UHO s~'s INKED SE'AL Oft
EYBOSSm sv.L SHAlL NOT III[ CON5IOEREO
TO E!I: A \W.JO 1RUE COPY.
c:EImF1CAnoNS INDICATED HEJlfON StW..L RUN
ONlY 10 THE PERSON fOR WHOM THE ~
IS f>REPNlm. NCl ()fll HIS BeW.f 10 THE
1JTl..E COWP.tHY, GOIERNWENTAL NJ8lC'( AND
l..DIl*G INS1TMlON US1fJ) tERfOH. NI>
TO TK.: ASSIGNEES Of' lHE I1JrIlING INSTI-
l\lTJON. CERTlFtCA'OONS ME. NOT TJWfSf'UWLE.
THE EXISTDIC[ OF RIGHT or WAYS
AND/OR EAStNENTS or RECORD, IF
IMY. NOT SHOWN .4,11[ NOT GUARANTEED.
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AREA = 32.053.16 sq. fl.
0.736 oe.
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lUll JUL 2 4 2006 ~
By
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Cl
CERTIFIED TO:
LJ.ND AMERICA COMMONWEALTH
TITLE No. RH0630586~
KATHLEEN M. TOLE
MARY ANN DURKIN
N.'f.S. lie. No. 49668
T'dle Surveys - Subdivi$ions - Site Plans - Construction Loyoul
PHONE (631)727-2090
Fax (631)727-1727
......., ADORfSS
P.O. Box 1931
Riverheod, New YOI1< , 1901-0965
omcfS LOCATED AT
322 RON<<JK[ AVENUE
RlVERHEAD. New YoriI 11901
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