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HomeMy WebLinkAboutGrant, Roland r t oFFU( l, eo JUDITH T.TERRY ��_ Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 1 Pry , Southold,New York 11971 REGISTRAR OF VITAL STATISTICS ` �, Fax(516) ?65-1823 MARRIAGE OFFICER �0� RECORDS MANAGEMENT OFFICER :_ �.( * '1►��d�1�� Telephone (516) 765-1800 FREEDOM OF INFORMATION OFFICER .•,,,,,•��� OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1433 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : ROLAND AND KAREN GRANT Address 1 : P. O. BOX 126 City St Zip PECONIC NY 11958 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. #R10-95-068 Name Of Owner GRANT, ROLAND AND KAREN Mailing Address 1 P. O. BOX 126 City St Zip PECONIC NY 11958 Property Address 1 1775 INDIAN NECK ROAD City St Zip PECONIC NY 11958 Tax Map No. section 86.00 block 5 lot 9.001 Cross Street SPRING LANE Building Permit Number Cross Reference: Issue Date: 1/10/96 Judith T. Terry Southold Town Clerk (TOWN SEAL) ,jo, 000•14,,,...... / y3 ,,••,oS�FFO(4-SDG. e°0 y : JUDITH T.TERRY % o= r4 % Town Hall,53095 Main Road TOWN CLERK k ti Z t P.O.Box 1179 0 o Southold,New York 11971 REGISTRAR OF VITAL STATISTICS 1 Fax(516)765-1823 MARRIAGE OFFICER y2 *0�11/ RECORDS MANAGEMENT OFFICER VI * �0d Telephone(516)765-1800 FREEDOM OF INFORMATION OFFICER . ,,, ,i01� OFFICE OF THE TOWN CLERK '.1 l - p - -.,, TOWN OF SOUTHOLD JAN - 91996 TO: Southold Town Building Department _ BLDG.DEPT, FROM: Linda J. Cooper, Southold Town Clerk's Office TOWN OF SOUTI101 r3 DATED: JANUARY 5, 1996 Transmitted herewith is a copy of application No. 1489 for a Cesspool/ Septic Tank Construction Permit submitted by: Roland and Karen Grant • 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. ;-G--r ec Linda J. Cooper * * * * * * * * * * * * I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE v DISAPPROVE Comments: _ _ , Q 4„1 O - 44017.600, Signature /7924— Dated 6 , OFFICE OF THE TOWN CLERK ,,,'""""' Town of Southold •'�, c.41fD1.xI'� = Application No. /c761 Judith T. Terry, Town Clerk ��' �� Gy Town Hall, 53095 Main Road �� = Construction -- P. O. Box 1179o ` •,=T, Southold, New York 11971 y 4',•• Alteration Tele hone O,y �t • $10.00 - Residential p (516) 765-180101 �, ' $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 Cy ( qt APPLICANT NAME: ROL KYD v-AROJ GCQPNT APPLICANT ADDRESS: p,Q , ©( r atm Co e 1 Ny r kq�-'Z SEPTIC CESSPOOL X DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION C dN ST RUC oc Sue, Su R c kcE uJPaa DISPo c SvIsTurn Foc ScNGLLE F A mt L/ G,cc t DcICC LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: ROLP D C QANT OWNER MAILING ADDRESS: P•©. bOX r ab • ROOK\ ke VIS% OWNER PROPERTY ADDRESS: \-1 lc) \ NOIA ) CZO .t2 PCOOK) Ny k‘qS� TELEPHONE NUMBER OF CONTACT PERSON: TAX MAP NO. : Section QS( , Block 6 Lot 9 , I CROSS STREET: 1-400 c T cI -nt of S 2R6. LA Q c BUILDING PERMIT NUMBER CROSS REFERENCE: Sign ture of Applicant RECEIVED BY: Q��[� Totts G s Office DATE: y'J 5 Sz9 fawn e!e.k Sir P-G '' ®; - `' 'U 3 5 io,3 ,-,�J,, F?�g3. } r ''''.---.........-_______p..-- " 6`2�,f . ,.. \ �\ N ,n04 4 T„, m A *46546i4 tao � L�0 Z, 7:. \ i I I lot i 1 I / / iti) \ A. by e \ \ /14 1 1 = CDPc.c?1 \ \ i lk litioiiiriiii vviiir e ) \, ten• ll **bl O ti� 0 d \ . o LpT (-) 4 o- n G Va • SURVEY FOR ROLAND & KAREN GRANT AT PECONIC TOWN OF SOUTHOLD SUFFOLK COUNTY, NY. 1000 - 86 - 05 - 9.1 Scale: 1” = 60' Mar. 16, 1995 APRIL 4, 1995 (revisions) April 6,1995 (revisions) May I, .1995 (revisions) I A. OUTER 1r�. P y ^1 ANY ALTERATION OR ADDITION TO THIS S RVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCA raw LAW `i� at * .Y.S. LIC. NO. 49618 EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS A\1,4. 4 # .: / HEREON ARE VALID FOR THIS MAP AND COPES TII REOiF OIC Y F "s" ''►�•-',-*17 ARS P.C. / SAID MAP OR COPES BEAR THE *PRESSED SEAL OF THE SURVEYOR P .\\ n; •,, � 'MOSE' S* NA TIME APPEARS HEREON. (5516) - 0 ADDITIONALLY TO COMPLY WITH SAID LAW THE TERM ALTERED 8Y' P. D. B• 909 MST BE USED BY ANY AND ALL. SURVEYORS UTILIZING A COPY MAIN ROAD OF ANOTHER SURVEYOR'S MAP. TERMS SUCH AS *INSPECTED'AND SOUTHOLD, N.Y. 1/971 *DROUGHT-TO-DATE'ARE NOT NV COMPLIANCE WITH THE LAW.. 95- 133 . pscitIVED • hse. c//3 An f/j. e//5.5 fin, q,, e//3.5 MAID /ml^, . ---.4 1:0.;.,.��..i, r Vfl)c- L..P,. \ I.E / 5 T IEII� re. 0 " 4 to.5 Y S.C. DEPT.YiCF.� 3 .__ _ 1 Z—— 'e — HfJLTH- = y, Wa-tCr 3i / CROSSECTIO SEPTIC SYS t o' P NO SCALE �P _______,_____________7 �� I DG \ PRS rr, yie 11 r'Q. e • I o IesK) n°1 O 1 69�ZQ0°LA iennl�re� ll -Z. ° �f^�• Pro p 0 21:.1 4=6. ' 0d-( "?- !XriVEV/ o- 3. 24' O 0111111111111111110 h n 504 �I I yo 's.. e /ta" Tit 2 / OM ) 0 69.- Test Boring a/ test Soihig 509195 4/2/95 S. 0 o mor'. • SANDY SANDY 2' - LOAMY LOAM* SAND Y Z ss 2'CaltRa- V\ SA D a ' SAND 10' GRAVEL VEL • SAND I LOT NO.. ARE REFERENCED TO • MINOR SUBDIVISION FORIlEAVY PECONIC BAY GARDENS, INC.-FLED M/ Ti* OFFICE OF //5, GRAVEL THE SOUTHOLD TOWN CLERK WH/TE ll. --- - ELEVATIONS ARE REFERENCED TO N.G.V. Dawn. /2SAND SND ' PALE VEL AREA = 2.6069 Acres to tie lines /63----- GR. WA TER ORANGE b':. Pr:2 i ,e r:.'-iJEL11,2 ONLY F k SAND I am familiar with the STANDARDS FOR APPROVAL AND ON OF ZUBSURFACE SEWAGE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES DSPOSALSTRUCTISYSTEMS FOR SINGLE FAM/LY RESIDENCES FOR APP VAL F CONSTRUCTION ONLY and ,will abide by the conditions sel for/h therein and on the ermil to construct. DATE HS. REF. NO.` `io -15-o��0 2 '`