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JUDITH T. TERRY 1' 4 Gy� � Town Hall, 53095 Main Road
TOWN CLERK ; y -'� P.O. Box 1179
T t Southold, New York 11971
REGISTRAR OF VITAL STATISTICS O
MARRIAGE OFFICER � y �1 Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER =�0,( , ;01,�� 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. 1614 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : SUSAN AND JAMES ORIOLI
Address 1 : 51 HEARTH LANE
City St Zip WESTBURY NY 11590
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. SCHD REF. #R10-96-0090
Name Of Owner MAGG, SUSAN
Mailing Address 1 51 HEARTH LANE
City St Zip WESTBURY NY 11590
Property Address 1 495 HALLS CREEK DRIVE
City St Zip MATTITUCK NY 11952
Tax Map No. section 116.00 block 7 lot 4.000
Cross Street NEW SUFFOLK AVENUE
Building Permit Number Cross Reference:
Issue Date: 3/20/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY � _� y1\� Town Hall, 53095 Main Road
TOWN CLERK y i P.O. Box 1179
v► P i Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER ys •S Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER �lsigg `1►a� ���� Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER '—.�� 081.
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: February 19, 1997
Transmitted herewith is a copy of application No. 1671 for a Cesspool/
Septic Tank Construction Permit submitted by:
Susan and James Orioli
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
MAR 2 ') 1997 Signatur,/
Dated 3/`///2
OFFICE OF THE TOWN CLERK , ' ""•,, •
Town of Southold 1`'1. \VOLke ✓l
cJ Application No. Le,
Judith T. Terry, Town Clerk
••••
.: G�
Town Hall, 53095 Main Road , • Construction
P. 0. Box 11790 _ _ —
Southold, New York 11971 : t�t� �; • *-A Alteration
Telephone
1:•.%V.° • V � $10.00 - ResldentialW/o. Oo
(516) 765-1801 =:-► r $25.00 - Non-Residential
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TOWN OF SOUTIIOLD
• SOUTIIOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION M11,1144, ,4
Z._ il•
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL `T r
d�� ,Snr
Permit No.
Fee .$
DATEL/y 7'17
APPLICANT NAME: 5/37 / 47/.es ,7x.�oQ- O r' / 4_
APPLICANT ADDRESS: /Ufi
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: • Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY : `�(./.5A/t/ f7?/aG‘- (aaG 0
OWNER MAILING ADDRESS: 5/ /./g.4/2r/(‘-/ /2/E--
.
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OWNER PROPERTY ADDRESS: 401:_< ji?tS C 'FA IZU�
rfri utx1 1/ff‘C2—
TELEPHONE NUMBER OF CONTACT PERSON :0(S) //1//-3(3/ _ ^�
TAX MAP NO. : Section //(o Block 07 Lot 01/
CROSS STREET: /2/f41
BUILDING PERMIT NUMBER CROSS REFERENCE:
RECEIVED
4
. FEB 19 1997 Signature of Applicant
RECEIVED BY : �� o _
TatFi�'if f1?e
DATE ; •
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WATER SUPPLY AND SEWAGE DISPOSAL MUST "' I ^� J I, /
i
/5.5 / / ) 1 f "! Ay �Q?CONFORM.WITH NEW STANDARDS DATED NO 13,1995. I / 6 j f ¢N, 8707$0' W, J1a._. . �.._..._ .... .. . / CD
l 3/8.27�� LOT 28 0` . �) .,1 . y `'
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• PERMIT FOR APPROVAL O?CONSCRUCTION FORA ` \� v`z ` �' f
•
AREA = 55,352 sq.f t. FAMILY RESIDENCE ONLY
to tie lines . DAT$ � 18 ..... -, ., :/0 6/6->_170
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APPROVED , �•
� `��-� j SURVEYOF SUSANEMAGG
`" S FIDELITY NATIONAL TITLE INSURAN,
1�.� „ "V�� ,,"r;; OF NEW YORK
The locations of wells and cesspools FOR _ L Q T Y9
shown hereon are from field observations EXPIRES THREE YEARS FROM DATE OP APPROVAL `HA Off► VIEW A T MA TTITUCK 201 32q 3
and or from data obtained from others.
- - . . FLED AUG. 2X1987 FIE NO. 8377
:,/A r 4 T MA TTITUCK
I am familiar.with the STANDARDS FOR APPROVAL TOWN OF SOUTHOLD
AND CONSTRUCTION OF SUBSURFACE SEWAGE
• DISPOSAL SYSTEMS FOR SINGLE"FAMILY REp( S - U '7FOLK COUNTY, N. Y.
and 'Ii abide by the conditions set forth therein n on *a#er lines�. be inspected by the ; woo- 116- 07- 04
permit to Yconstrucl. d1 Health Services. �� = 4t NEly
Suffolk County Dept. Scale: 1" 40 �� )'
Call 852-2100, 24 hours In advance, - 5 �� MEr?��-P�.
9-7- to schedule Inspectlan(s). May 15, 1995 �° 4,
G- ;R^ Aug. 31, 1996 (contours) S A, ,
ANY AL 7ER.4 T/ON OR ADDITION TO THIS SURVEY IS A VIOLATION i _
OF SECTION 7209 OF TIE NEW YORK STATE EDUCATION LAW C ,, d
EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTF CASI17►NS /L_ , -$/vA S i,
HEREON ARE VALID FOR n-es MAP AND COPES THEREOF ONLY IF • i U .74..,4 r r -
a:-*-' SAID MAP OR COPES BEAR 77E IMPRESSED SEAL OF TIE SLRVEYOR - PECO/C 414'44L• "
WHOSE SENA TURF APPEARS HEREOrtiC • • FILL, AFPROX. 300 cu yds. for backfill B grading (516) 765 - • • w+
ADOMONALL Y TO COMPLY Y WITH SAID LAW THE TERM 'ALTERED er P. O. BOX 909
MUST BE USED BY ANY AND ALL SURVEYORS UTIL12 IG A COPY 1230 TRAVELER STREET
OF ANOTHER SURVEYOR'S MAP. TERMS SUCH AS ASPECTED'AND CONTOUR LINES AND ELEVATIONS ARE REFERENCED TO N.G.V.D.
'BROUGHT-TO-DATE"ARE NOT NV COMPLIANCE WITHTHE LAW. SOUTHOLD, N.Y. 11971
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