HomeMy WebLinkAboutDeFrese, Robert JUDITH T.TERRY o• Gy1 Town Hall, 53095 Main Road
TOWN CLERK ` y • P.O. Box 1179
REGISTRAR OF VITAL STATISTICS O
i Southold, New York 11971
MARRIAGE OFFICER
# �! Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER OI s/4 00. Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER �- r
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1525 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : NORTH SHORE INNOVATIONS INC.
Address 1 : 135 BELLEVIEW AVENUE
City St Zip CENTER MORICHES NY 1193
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #R10-06-0069
Name Of Owner DEFRESE, ROBERT AND LISA
Mailing Address 1 P. O. BOX 503
City St Zip AQUEBOGUE NY 11931
Property Address 1 INDIAN NECK LANE
City St Zip PECONIC NY 11958
Tax Map No. section 98.00 block 1 lot 1 .004
Cross Street ROUTE 25
Building Permit Number Cross Reference:
Issue Date: 8/21/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
it i 09;C;F., 0 4::'s
0 % * %
JUDITH T.TERRY - % Town Hall,53095 Main Road
TOWN CLERK t 03 Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS # Southold,New York 11971
MARRIAGE OFFICER "IL 0. / Fax(516)765-1823
RECORDS MANAGEMENT OFFICER of * `�►a�11 Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER • • "'-
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
G
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: August 14, 1996
Transmitted herewith is a copy of application No. 1591 for a Cesspool/
Septic Tank Construction Permit submitted by:
North Shore Inovations Inc. for Robert & Lisa DeFrese .
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.
Thank you.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments: JC%> , ' 1/>L l0 _ 6>Z706
7.
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S g tures
Dated
it
OFFICE OF THE TOWN CLERK "" "--
Town of Southold 0111.K
Judith T. Terry, Town Clerk Application No.
Town Hall, 53095 Main Road 11 „At Construction
P. 0. Box 1179
Southold, New York 11971 Alteration
ay,
Telephone
$10.00 -Residential
(516) 765-1801 .1 1�,7 $25.00 -Non-Residential
•TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE i'1/43/fit
APPLICANT NAME: /f/o,,,-"X S�i-f ,r/o,/,y J` s c. ¢..ii,.�,yvuc�#7£Tn¢S
/"s/
APPLICANT ADDRESS: /3
�'t•-/�'i, ,moi:' 1 •"› /7 '`7
SEPTIC k CESSPOOLY
DESCRIPTION OF PROPOSED CONSTRUCTION OR
ALTERATION ,t/'u-'
C0'4%57",- tr' . / S r /.0 fr //yJ
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Zobe, (24- 4:54 fTeS.
OWNER MAILING ADDRESS: At /3or �3
/17 . 'ec5 yy,
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 82-75 -9-75-2--
TAX
-9-73ZTAX MAP NO. : Section ?Er- Block p/ Lot /. Y
CROSS STREET: /6 . 5
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY:/
Town Clerk's Office
DATE: 8A-3/
AREA • :,1.6072 Acres ,
N/O/F M. 4 E
MCKEAN �. Si
o ,-_ _
N/O/F JOHN PONTINO .h` i /
I a`frg�2
S. 80.45.00.E.
375/' Z
30* E N. 79.p6"40' E. /
S 85.1200` 65'12 _ I 11
48.19'____:,-.../-
30.4/' E, N.5j - ___
LOT NUMBERS ARE _ /� (ie lines along �t of Buller
REFERENCED TO ' MINOR M of Richmond's Creek "rn
SUBDIVISION FOR THE O'KULA O ..,I
FAMILY"
o Ai Lenny ? /an�s.0--ji
sa �. of rvP!_ N
��p e _
Qak 14/.Ff9e en _ _ "
f„ aw
G. y�
sn _ _ _ , __ = LOr n m3{
' r
Z
,o- ° Dov
SUFFOLKr6 ft
��DEPARTMENTel ,..: ' -' ` STI 2s
hie .g'
PERMIT FOR APTEOVAL Q♦ ^
"MLR)1rAMQ,Y R1aa11D)Li�s ONLY POD A / oC� � ' it'll..
-I.'�\ 7.M C) Re
APPROVED��, ,. ,. ��; � ..- "`
FOR M/CJC t dR•.. . bib*,, , •„ ,o" -----
1 IPIRP+S TN R SQRS iiteIH BA7 i Arnta , ? 4 ——
N s ID Ree
L 0�
SURVEY FOR �;,a
178'oe' 1):6-nrri
ROBERT L. & LISA M DeFRESE ,s. 78.44'°°' W. i
AT INDIAN NECK
TOWN OF SOUTHOLD o c)
SUFFOLK COUNTY, N. Y. ; 6a2
1000-98- 01-P/01.1 1 O ZysO
Scale. 1"= 50' ,1
July 31,1996 k
_ - O _ ( N
II
WATLR SUPPLY AND SIUNAGE DISPOSAL
MUST !� 1i
cONVOSM WIEN NEW STANDARDS DATED NOV V , ' IX,1995.
N
CERTIFIED ro. is
ROBERT L. DeFRESE
SE
REPUBLILISA Al. C CORP. Q
FIDELITY NATIONAL IITLE INSURANCE OF NEW YORK PLEASE NOTE N
i iimum distance between well F=
a id cesspool is to%e 150 feet. mof Pte`
•
S.
?0 '44.00" W.
1275.58 a In. 05
AND CONSTRUCTION OF AAVAS RFACE APPROVAL ROAD ,,
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESVENCES NEC -�'
and wit abide by the conditions set forth!herein and on the INDIAN CZE 4F Nffy :,,,,,
;
pernal to construct. S,�t'ti T Mr,. /�� nit'
0 1-
n,
The locations of wells and cesspools r l„i,' .ifi I}. a C.4:,;:-
end
shown hereon are from field observations - = -.s (I 1 "'t
ANY ALTERATAW OR A0 1 W TO nos SUPYEY/S A VIOLATION and or from data obtained from others. �I`*A. ' J �5�' _ � J
Cr SEC1Ul 7209 OF IRE NEW, STA lE EDUCATION LAM ,!.. �t0 r ',I.*. (: kt, NO. 49618
WEPT AS PER SECl17N 7P09-SUWAISI W L ALL OERTI�icA �9'}
LLCM ARE VALD FOR HIS IMP NO COM THEREOF OILY f
AUL.
IMP AR COPES BEAR THE DIMWIT SEAL OF TIE SUPVEVOR - CONIC"�f17►I- , P.C.
MARSE 910K4 TIRE APPEARS HEREON CONTOUR LINES d ELEVATIONS ARE 0161 765 - 54 0
AaanawLLr TO COMPLY NTH SAD LAW TIE TERM'ALTERED or REFERENCED 777 THE FIVE EASTERN P. O. BOX 909
MUST BE USED BY ANY AND ALL SURVEYORS MUDD A COPY TOWNS TOPOGRAPHIC MAP 1230 TRAVELER STREET
of A*11 SUPVEYOWS IUP. TEN SUCH AS?maw APD SOUTHOLD, N.Y. 1/97/
DRolit it r0-0ATr AL NOT M COIPLLINCE MIN THE LAW.