HomeMy WebLinkAboutHurtado, John L Jr
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
sou tholdtown.northfork. net
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICE.!.L------1
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JUN 2. 1 :;( " '""OWN OF SOUTHOLD
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l~tholdT()W'I1~:[lding Department
TO:
FROM:
Michelle L. Martocchia, Southold Town Clerk's Office
DATED:
June 21, 2007
RE:
Cesspool Construction! Alteration Application
Transmitted herewith is a copy of application No. 3717 for a Cesspool/Septic Tank
Construction/Alteration Permit submitted by:
John L. Hurtado Jr.
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
v
DISAPPROVE
Comments:
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Signature
tJcGft7k
Dated I /
., .;.
EUZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
.....
Town Hall, 53095 Main Roe
.., P.O. Box 1179 .
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown .northfork.nel
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Lo,:It 1-
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $1 0 ~ or Non-Residential @ $25 _
Application No.3, J J
Permit No.
Applicant Name ::)c:JHiJ L-. I-IUf{TADo -;Jr<..
Applicant Mailing Address f. (). t3 () '?< I 'J .;15
, 5ou7!10LJ) N,,!. {fen I
Septic Tank ..; or Cesspool_ /
Brief Description of Proposed Construction or Alteration j/'(!;V ~(f)I.frVC&
Location of Proposed Construction! Alleration:
Owner of Property: JOffl./ L. H(/1(7Af)O :I'll.,
Owner Mailing Address: I. o. /; () '(<. /1.:1 S
5ou1uuJ.. /) ,P.r, /1'[71
/
RICO FAIA/I./ I'.cJA{)
5ov1110LJ) ,N./, !ct7/
/
Name and phone number of contact person ;TOil/./' t. Hu/L1AOD
Tax Map No: Section 7 ~ Block D,)" Lot
Cross Street AI oll1f1 I3A'7 tit (Jw /l. 0 A D
NOTE: LOCATION MAP MUST BE SUBl\fiTTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
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gnature 'Of plicant D&te
Owner Property Address:
'J f(.. 7(;5 -{;, .J-:20
7,f
Received by:
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NOTES
AREA = /:>5,44.2 SQ. FT.
. 5U6DIV1510N MAP - "FORE5T6ROOK AT 6AYVIE~" FIl.ED IN
THE OFFICE OF THE Cl.ERK OF SUFFOl.K COUNTY ON JUNE 15,
2004 A5 FIl.E NO. 1111'1.
. VERTICAl. DATUM = N.I!..v. DATUM (M.5.l.. 1'12'1)
[!I- ~!leT' . . MON.MS<rr I'"ClUND I!. STAKe !leT' A. "TAKE l"GlL.tfD
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By
Young & Young
400 Ostrander Avenue, Riverhead, New York 11901
631-727-2303
Howard W. Young, Land Surveyor
Thomas C. Wolpert, ProfeBsional Engineer
Robert C. Tast, Architect
Ronald E. Pj'uhl. Landscape Architect
Douglas E. Adame, ProfeBsional Engineer
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HEALTH DEPARTMENT USE
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SURVEYOR'S c.ERTIFlc.
. JI'lE HERESY CERTIFY TO HURTADO
INC. THAT THIS SURVEY I'lAS PREPARE
V'll TH THE CODE OF PRAC TI CE FOR. LA
6'1' THE NEV'l YORK STATE ASSOCIATION
LAND SURVEYORS.
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PLOT PLAN
HURTADO DEVELOPMENT INC.
LOT 4 "FOREST6ROOK AT 6AYVIE~"
At 6a~vlel'll, TOl'lln of Southold
Suffolk c.ount~1 Nel'll York
c.ount~ Tax Map Olol,;clIOOO Secllon 1'1 Block 02 lol 1.4
I BUILDIN6 PERMIT PL.OT PLAN
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MAP PREPARED
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MAR. :2, :2006
SGAL.E1 Ill_SO'
...JOEl NO. :2006-0100
DV'l6. :2ool_0145_0004_:2006_0IooJlp
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