HomeMy WebLinkAboutRogers, Robert
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ELIZABETH A. NEVILLE, MMC Town Hall, 53095 Main Road
TOWN CLERK p ~•t P.O. Box 1179
W Southold, New York 11971
REGISTRAR OF VITAL STATISTICS p • .F Fax (631) 765-6145
MARRIAGE OFFICER 4 0\ Telephone (631) 765-1800
RECORDS MANAGEMENT OFFICER www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK D E C E M F
TOWN OF SOUTHOLD D
MR 1$ 2013
TO: Southold Town Building Department
DEPT.
BLDG.
FROM: Carol Hydell> Southold Town Clerk's Office
TOWN OF Of SDL'THOLD
DATED: March 15, 2013
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4206 for a Cesspool/Septic Tank Construction
Permit submitted by:
Robert & Maureen Rogers
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
DISAPPROVE
Comments: Final approval required from the Suffolk County Health Department
Signature
Dated
1 o~~S~FFO(,(-~O
ELIZABETH A. NEVILLE Town Hall, 53095 Main Road
TOWN CLERK p P.O. Box 1179
h Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS 1 yf
MARRIAGE OFFICER `F Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER 'y - Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER # southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
I
Residential @ $10 or Non-Residential @ $25 _ Application No.
Permit No.
Applicant Name R0 J- NaureM Rocs
Applicant Mailing Address Aa 1 WafCr5 4 d e_ DrI?e
Toms River , NJ 08753
Septic Tank_j,-' or Cesspool
Brief Description of Proposed Construction or Alteration CDl)5jn cc Al u* -4 000 ,aai-
Sep~_o 4w* and *v49 C21 81 dia. h~, 67 e,fyc dea{A lea' 7hlD P0015
Location of Proposed Construction/Alteration:
Owner of Property:_ Ro be_-v'1- gol 1 aur2c/? ~oyc~s i Cb~ lva ~/eoJd ee
Owner Mailing Address: ;2al Wate_5 EceQ-e .DriV2
_TOms Ri ye*- , /V .T 0 8 76 3
Owner Property Address:665- SCfr),imd- Lane
asf Marr'On , NY l l 9 3 9
Name and phone number of contact person ThOma5 0, WO 626L~4 P. E. % YM415 f X94eA5
6:31 -?Z7.
Tax Map No: /000 Section 35- Block 8 Lot 5 2! 2303
Cross Street !`Marina LGrne-
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
Si tare of Applicant (~ywrr ,w- Date
/ f I~~~3 ~ootlcrrr'lf)
Received by: {lam ' 'J - 3 I
NOTE Young & Young OR.
AREA = 31,771 SO. PT. 400 Ostrander Avenue, Riverhead, New York 1Igo I
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/ 631-727-2303 p
N • SUBDIV1510N MAP '50MMIT ESTATES, SECTION 2" FILED IN Howard W. Young, Land Surveyor b6~8
Lot I I THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON MAY Thomas C. Wolyert, Professional Engineer Ee s
Subdivision - 21, 2002 AS FILE NO. 10168. Douglas E. Adams, Professional Engineer
"Summit Estates, Section 2" / • VERTICAL DATUM = N.G.V. DATUM (M.5.L. Ig2q)
\ (Dwelling YV Public Water) Robert C. Tact, Architect
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HEALTH DEPARTMENT USE
13 \ ~ti_8
\ w SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES i?E
S PERMIT FOR APPROVAL OF CONSTRUCTION FOR A tY
SINGLE FAMILY RESIDENCE ONLY
FEB 1 9 2013
= o'
DATE
CF. No.
/2/(>-13 R a
Lot 10 N APPROVED -~p
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/ w ca For MAX u F ~~=g
1,~ ~.\pn~ y\~+ rA Subdivision - U~ BEDROOMS
\y\0 ~u$ "Summit Estates, Section I Q EXPIRES THR" YEARS FROM DATE OF APPROVAL
s
"o 0&a Suffolk County File No. 1426 W o
\ up Q~ 0 (Dwelling W/ Public Water) c-4
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of 4 yam, Uj C= ~£5"
SURVEYOR'S CERTIFICATION
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C\~~ +11.11 4146 gyp, 17., ly V
10
Lot 13 { ~s N55 V }X qq
~.°p HONIARD W. YOUNG, .5. L.S. . 458013 1iC, ;
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°u ~ 10.1110. 9.86 9~` QA ~m
SURVEY FOR °
\y , +10.95 ) s 9++14D1
L, o p o TEST HOLE
O, \ 12541 +14b4 14. \46 jcm
ROBERT R SOM ~
1 '7 \ S EL=14.0 0.01 MP N RO6ER5
4, 6 o 01,01 `°pp TOPSOIL LOT 13 "SUMMIT ESTATES SECTION 2" spy
1.01
At East Marion, Town of Southold ~g
LOAM
be c "i ` `OS f'a , ' Suffolk County, New York 0=g 10 D4gj County Tax Map obtrwt10005G t10N 55 151 ckO5 Lot 5.21 t
0
J O S' .0 IN , p(\ry SAND 3 ~ gS o y~ ow \p< Gv\ ~m<~ ` GRAVEL BUILDIFkS f'EiMIT SURVEY egg
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6~9+ P MAP PREPARED
\ \ ~Q JAN. 31, 2013 e
SCALE 50' set's
= MWUMENi SET MONUMENT FWND =STAKE SET STAKE FOUND
JOB NO. 2013-0016 OF 3 abbe
DW6. 2002_02"ICN2013_0016_lop 3