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SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1729 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : ANTHONY ALFANO
Address 1 : 630 MONTAUK HWY.
City St Zip SHIRLEY NY 11967
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-97-0124
Name Of Owner LIBERATORE, ANGELO & ROSARIA
Mailing Address 1 C/O ANTHONY ALFANO
640 MONTAUK HWY.
City St Zip SHIRLEY NY 11967
Property Address 1 NEW SUFFOLK AVENUE
City St Zip NEW SUFFOLK NY 11956
Tax Map No. section 117.00 block 6 lot 16.005
Cross Street GRATHWOHL ROAD
Building Permit Number Cross Reference:
Issue Date: 9/19/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
ow
FFOUr
co
JUDITH T.TERRY It _ %y1`� Town Hall, 53095 Main Road
TOWN CLERK • y P.O. Box 1179
n' Southold, New York 11971
REGISTRAR OF VITAL STATISTICS • a
1i
MARRIAGE OFFICER Fax(516) 765-1823
� � � /
RECORDS MANAGEMENT OFFICER0,( & .000 Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER -••„ ,•s'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: September 15, 1997
Transmitted herewith is a copy of application No. 1802 for a Cesspool/
Septic Tank Construction Permit submitted by:
Anthony Alfamo for Angelo and Rosaria Liberatore •
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:
RECEIVED
SEP 18 1997
3, 3O Pf t Signat t
Southold Town Clerk VI 1(4'7
Dated
1:1(211 OE I IIE .1 OWN CLERK eq\VIII/A-
C
low' of- s
Application Flo.
Judith olithold. Ferry, Town Clerk .
I own Hall, 53095 Main Road 8 4 Construction
P. O. Box 1179 • n
' ".Y
Alteration
Southold, New York 11971 • • • •
oe.phone Oi
• Residential
_ . .
(516) 765 11101 Non Residential
ToWN OF SOUTHOLD
SOUTHOLD WASTE:WA I.ER DISPOSAL DISTRICT
APPLICA1 ION
CONSTRUCT ION or ALTER AT ION PERMIT
SEPT it: TANK oi CESSPOOL
Permit No...._.
Fee $
D A 1 F.
APPLICANT NAME.: 7--/.4„tiy
APPLICANI. ADDRESS: 30 AloAix-9,,,( /WK.
Si hie tEr /447
Dr:scRIPTIoN OF PROPOSED CONSTRUCT ION OR A 1..TE RA I ION
LOCATION MAP: Must be attached hereto before permit may be Issued.
LOCAL ION OF PROPOSED CON ST RUC HON OR A LIE RAT ION
OWNER OF PROPERTY : AUC:797.0 .XO4SAie/A 1.1 Berg/4-7-04E
OWNER MAILING ADDRESS: C/0
•
OWNER PROPERTY ADDRESS
TELEPHONE NUMBER OF CONTACT PERSON
TAX MAP NO. : Section 1/ 7 ItiorIc (49 Lot
_ . .
CROSS STREET : -dX64-644,-(/L. .le-e(- - - • '• • --••
BUILDING PERMIT NUMBER CROSS REFERENCE :
•
•
r)6°
Signature of App icant
RECEIVED DY :
(.:•W -
DATE 9 -
- ra , ' . ..N LOT 5IANK
\J
DWELL/NG 4��� \ POOL DWELLING
WELL & SEPTIC l 0DWELL I G
WELL & SEPTIC \ VACANT
OVER 150' / :i
FROM PROPERTY Q. ,/ * OVER 100' FROM PROPERTY
S78'34'00"E L 245.00'
/ (28.0) o
IA
TEST HOLE N.T.S.) 1 o w w
_6. TOPSOIL LOT 4 a.0 c)til0
Lau, 49,838 S.F.
-4 SAND ca
N jl O O 1. 144 Ac. 1, 0u_o i%
GRAVEL 1 op ? �4
-17
et oK x fu 0) OlJil(?�
o in
Q MIN. 100. 1 (26.6) - (27.0)
PROPOSED 1�i
0 WE,.,. 1N78'34'00"W
33' \\ 25.7• . �z6.o� 5.3. 95.00'
LOT 3 H \ PROPOSED
VACANT 1 h DWELLING 0
1 ' F.F.-28.0 ;,)
fo.r
\3o.a '' LAND N/F OF
'3 (24.9) A�RCN ^ - N OUIN/uFNK
Z 26.5
1\
O (25.5) SEPTIC IN REAR
' EXACT LOC. UNKNOWN
\\ 1
1 \
L
IPROPOSED 0 ; ,R O 607 INLCELLAR
O pp
Q 21
I
368. 14'] \ ---
�` LP= t Ilii 1 "Nrr�17 150.OQ'-- \1
18.60 79.81 20.8 21.34 22.67 24.1/526.72
19.45 20.57 22.33 23.67 275.30 27.21
1
\
o s
CV N
.
.� " ..2-F t -0 L-I< A V E N U E
SUFFOLK cowry D A`�b:` ir91.�`W:" t" liSl-ALT SURFACE
PERMIT 7)11l APOSIOVAL ON COPITRUC"T'ION i'0R A
a» LULU AMLLY RILSIORN ONLY
GA; �� 5 (Sq.INi RIF.NO. D- I,-),. Del
AtPRO r 4i) ' —
THE WATER SURPLY, ; �89,g } SURVEY OF
FOP TH�1 c liF 4 S lf'�R9�5 "I�'1CNl� YIE� R OVA)' LOT 4
STANDA MAP OF
OF 4Tigv L ;IG . KOUROS ACRES
SITUATE AT
SUFFOLK COUNTY DEPT. OF HEALTH NEW SUFFOLK
SERVICES FOR APPROVAL OF CONST. ONLY TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
SCALE 1" = 50' JULY 28, 1997
REF. NO.
APPROVED BY; s.c.T.M. DIST. 1000 SEC. 117 BLK. 6 LOT 16.5
JOB NO. F792 �,>r �,
MAP I1 A 6692 — ���`--`-"' YQ9 T -� o
FILE 6 2 ed `" gc� ��fi '� , �►1 '=.) r A
n s�
5 ounry
REVI IONS. }, . Rti I, '� �
/NG
AUG 0 6 1997 P.O. Box 309 " • I ontauk Highway
. a Sayville, N.Y. eo. ;2 H. pton • :4 , N.Y. 11946
Dept.Of Health Services �1 ,e t'" a°b aQ' (516) 589— 637 (51•) 728-5330
•iffice Of Wastewater Mgmt. , J c,tr os6, With the records of:
sFD LAND Sk/ Paul T. Canalizo, L.S. Robert A. Kart, L.S.
• license no. 050149 Good Ground Surveyors, P.C.