HomeMy WebLinkAboutEngelke, Sandra & George
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIA(;E OFFICE/{
llECORDS MANAC;EMENT OFFICEI{
FREEDOI\fDViNFORMATION OFFIC"~R
, ; , ('; " ~r;l '- .'"
Town Hall, f).'3095 Main Hoad
P.O. Box 1179
Southold, New York 11971
Fax 16al) 765-614[)
Telephone 16:311 7(;5-1RIIII
southoldtown. north fork. 1Wt
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO:
South old Til\vl1JBuilding Department
FROM:
Francesea Quintieri. Southold Town Clerk's Office
DA TED:
Transmitted herewith is a copy of application No. 3643
Alteration Permit slIhmitted by:
for a Cesspool/Septic Tank Construction or
Sandra & Geon~e En2elke
Please review the application and location map and advise if the project has received Suffolk County
Hcalth Department approval and if this office may issue the pennit.
Please complcte the forl11 below and retum it to me.
Francesca Quintieri
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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: ~ ~~"':. ~ .......z:<:e.
:".9'-.;?/ ~~~&.<:~%~
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Signature
1//0>/0 C.
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Dated
.
Telephone
(63-1) 765-1800
Application No.
Construction
Alteration
$10.00 - Residential ........-
$25.00 - Non-Residential
omCll OFTBE TOWN CLERK
TOWN OFSOumOLD
ELlZABETII A. NEVIU.E, TOWN CLERK
P.O. BOX i179
SOUlllOW, NEW YORK 11971
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No~3.d--t3
Fee $ In.cO
DATE lV, /0 \...p
I ,
APPLICANT NAME: ~ ~..G'ljO_ r..n{J.D~
APPLICANT ADDRESS: 'fl:J,tu~Jlfn.V'1. ~ 'i1~
SEPTIC~SSPOOL
DErCfRIPTIOtl OF PROPOSED CONST~~~~ OR ALTERATION
NW vtoUb€- W 6uU ~ ~0AA-'
LOCATION MAP: Must be attached hereto before permit may be Issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY:~ "f (''7-~~
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS: 570~ J:MJ;CJAA (\~c.k.~
Q~V\~~__
TELEPHONE NUMBER OF CONTACT PERSON: 73V-(Pf../01""'
T AX MAP NO.: Section j ~ Block OS Lot l'f< <>
CROSS STREET: ,~\ ivt&ol.-t laMe
BUILDING PERMIT NUMBER CROSS REFERENCE:
RECEIVED BY :"(:'~
Town Clerk's Office
DATE:ll1UCiD
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
PERMIT FOR ApPROVAL OF CONSTRUCTION FOR A
S=~T~: N6 SINGLE FAMILY RESIDENCE AND
REMOVED ~E:~ l-k!>uS E
DATE &;JiJ.Dtn.-l.8. . ~lO-ob-COJ. \
APPROVED
TOTAll>.1AXIMUM BEDROOMS
~1~S THREE YEARS FROM DATE OF APPROVAL
.
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- eull.PIN6 HAW.. .... EL I'I.&S
/ ~ LINE ELEVATION 1"1.2 FT. 205FT. ,
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~ LINE ELEVATION 1"1.2 FT.
I' MIN. 2' MAX. 4'MAX. I' MIN. 2' MAX. I
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BOX I
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NEI"l 5EPT1c. SYSTEM
FOR !5 ~ FtE51DENc.E
ANI:) eEAc.H SHED, 1500 6AL
SEPTIc. TANK (ST) I'IITH (1)4' PIA
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HOG NECK BAY
SITE DATA
SCTMII
PROPERTY:
ADRESS
OWNER:
looo.oS.o5-14.3
5704 Indian Neck Lane
Peconlc, NY.
SANDRA AND GEORGE ENGELKE
83 CHELSEA ROAD
GARDEN CITY, NY. 11530
130,414.28 SQ. FT. = 2.9939 ACRES
R.SO
PECONIC SURVEYORS P.C.
P.O. BOX 909
1230 TRAVELER STREET
SOUTHOLD, NY. 11971
LICENSE II 49618
DATED March 11, 2005
SITE:
< ZONING:
SURVEYOR:
LOCATION MAP
PRO..EC,T SITE
BY MARK McDONALD
TEST HOLE GEOSCIENCE
SOUTHOLD,
NO SCALE NEW YORK 11971
TEST HOLE DATA 1127106
1.0 FT. DARK BROWN LOAM OL
.
OF BROWN SILTY SAND SM
PALE BROWN FINE
TO MEDIUM SAND SP
NO WATER ENCOUNTERED
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