HomeMy WebLinkAboutLong Island One Real Estate
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ELIZABETH A. NEVILLE, MMC Town Hall, 53095 Main Road
TOWN CLERK G P.O. Box 1179
w Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS p • .F Fax (631) 765-6145
MARRIAGE OFFICER Telephone (631) 765-1800
RECORDS MANAGEMENT OFFICER www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department D
FROM: Carol Hydell, Southold Town Clerk's Office MAR 2 8 2013
DATED: March 27, 2013 BLDG. DEPT.
TOWN OE SOUTHOLD
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4208 for a Cesspool/Septic Tank Construction
Permit submitted by:
Lone Island One Real Estate Inc.
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
o Y is
Dated
„ o~gUFFO(~-co I
ELIZABETH A. NEVILLE Q G
To
TOWN CLERK O Town Hall, 53095 Main Roa
y- P.O. Box Box 1179
REGISTRAR. OF VITAL STATISTICS ze Southold, New York 11971
MARRIAGE OFFICER 'F Fax (681) 765-6146
RECORDS MANAGEMENT OFFICER 44f0~~ Telephone (681) 765-1800
FREEDOM OF INFORMATION OFFICER #1 southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TNOLD T TOWN OF SOUTHOLD
gUll01 P.O. Bo PAt 99MESOUTHOLD WASTEWATER DISTRICT
N.Y.
goUthold,
APIPLICATIO
N
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$10- or Non-Residential @ $25 _ Application No.
Permit No.
Applicant Name w -f - - - r-l'"
Applicant Mailing Address /3 isms
Septic Tank or Cesspool
-Brief Description of Proposed Construction or Alteration Cd c-S g u d
Location of Proposed Construction/Alteration:
Owner of Property:_ l_st f5 ! C9 yp 1p
Owner Mailing Address: j'Q , d / .r s f- YI / `Gp~ / w Z l CI 3 c,
Owner Property Address: I ~7 I O h„ tL C74s ~~7 0-,~L 10 ~
Name and phone number of contact person 3 Rz-1 /r"' 7-C -7:2
Tax Map No: ( D 00 Section 0 yd " Block O L Lot Q) / ! .
Cross Street t^ ` S ~Q-
NOTE: LOCATION MAP MUST BE S ED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVE HE DEPARTMENT PROVAL-
Signa a pp (cant ate
Received by: _ d J/
SUFFOLK COUNTY DEPARTMENT Of HEALTH SERVICES Survey for:
PERMIT FOR APPROVAL OF CONSTRUCTION FORA \ ~p~ 91 toy°tl BRYAN VILLANTI
~b\lc
SINGLE FAMILY RESIDENCE ONLY i \ lave\pn9 W~P p-, Lot 89, "Eastern Shores, Section 2"
DATES At
H.S. REF. No. R) f) 3 -(D01 Creenport
APPROVED "AA.0- Town of
e FOR MAXIMUM OF `P i U BEDROOMS\,0'~B o`eT 15QOQ =A2,3p Southold
~b<Lc
EXPIRES THREE YEARS FROM DATE OF A" W*AL N Suffolk County, New York
S 0 O Cn
T11 N S.C.T.M.: 1000-040.00-02.00-017.000
k -.r\ 0 i ..v 30 0 30
° CO 7 I
r1 \Q^~ vol $9 2
bl5 g0 p O SCALE: 1"=30'
PPOPO ao w~ ~pvooonq $ co NOTES:
i- 1 CS
U') 1. AREA = 20,250 S.F.
y h \ C~ w n 2. ¦ = MONUMENT FOUND, • = PIPE FOUND.
r2 N w A yt"a aj \ A= STAKE SET.
B~ aµsl V~PRCPOKa 7 3. SUBDIVISION MAP "EASTERN SHORES, SECTION 2"
° o cP i of.o FILED IN THE OFFICE OF THE CLERK OF SUFFOLK
COUNTY ON AUG. 10, 1965 AS FILE NO. 4426.
\ 9~s -A _ 4. ELEVATIONS SHOWN HEREON ARE REFERENCED
TO APPROXIMATE N.A.V. DATUM (1988).
N \ II S~aN'e A~
0
\ PRGPOSE ,'y' \`1EWPy 'm. \ O.
L Oap0. i
o DATE: JAN. 29, 2013
JOB NO: 2013-041
\ Z EL~\99
\ ) \ CERTIFIED TO:
o O \ Q QQ BRYAN VILLANTI
TEST HOLE DATA 2 \ Z~Q•w Evc>E / A\,
TEST \ ~~s\5~ 569Q r~ 1
I HOLE FILED /2AP
/ MpW \
EL=15.0 TO SOIL \ / ,NpSE0.
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&P LOAM _ A~ laWy\\nPE R YPRaI 0-1
~y\N , ca \ DAVID H. FOX, L.S. P.C. N.Y.S.L.S. #50234
~00s
3.0 FOX LAND SURVEYING
\ 64 SUNSET AVENUE
SAND & ET' \50 WESTHAMPTON BEACH, N.Y. 11978
V
0
GRAVEL 631 288-0022
`b\W
WIP JNAjTLORIZEC
SOALTeann ON OR AD~HHQN TO THIS IS AUR~Y
STATE
NY a\\`~`~' A UOL O O 7209 OF THE NEW YORK EL1N TION ATL ITAE COPIES ES OF MIS SI-ROTY MAP NOT SEARING
1E
r. LRNT SHE VEV.E OR's E SEAL
BE oR :.n TRU O 1E1-
G.W _ sHA,L Nor HE roNSIOEEE D TO BE < vAU~ rauE =oR-
EL=1.0 14.0 \
\ CERP.-I<ALFH INDICATED HEREON $ HALL AIN ONLY TO TYE
RS~N 0K4 THE TLE-Y -RE E9 ON H15 FTS
~EF R LF C nTLE COMPAN' cR ME T AGENCY
IJ OLO"l~ \ \ECEIVED Arv0 LE"D 15'1Nn0 LISTED RE- D E
455 ONE OF 7AR _ENLIN~ 5 TL FC-ER TIE.. pS
ARE NO' Rt ANSFERABLE TO ADCIIICNAL IS TI nOU
OR 41B1F3L/ENT OWNERS.
DWG: 2013-041