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Home My WebLink AboutPatchell, Scott 1 low/APO � OfFOtco - • JUDITH T.TERRY _ 'yJ► Town Hall, 53095 Main Road TOWN CLERK co, :.e P.O. Box 1179 _ Southold, New York 11971 REGISTRAR OF VITAL STATISTICS O �, Fax (516) 765-1823 MARRIAGE OFFICER �=y RECORDS MANAGEMENT OFFICER =�,( * `��00. Telephone (516) 765-1800 FREEDOM OF INFORMATION OFFICER ' % ,,s"�� OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1613 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : JAMES E. FITZGERALD, JR. Address 1 : P. O. BOX 617 City St Zip CUTCHOGUE NY 11935 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. #R10-97-0003 Name Of Owner PATCHELL, SCOTT Mailing Address 1 P. O. BOX 81 City St Zip SOUTH JAMESPORT NY 0000 Property Address 1 1075 WEST HILL ROAD City St Zip SOUTHOLD NY 11971 Tax Map No. section 70.00 block 4 lot 24.000 Cross Street WELLS ROAD Building Permit Number Cross Reference: Issue Date: 3/20/97 Judith T. Terry Southold Town Clerk (TOWN SEAL) 11 0 W j JUDITH T.TERRY � GZJ FGD 9 vi-}titan, 53095 Main Road TOWN CLERK ; y P.O. Box 1179 r'A > hold, New York 11971 REGISTRAR OF VITAL STATISTICS � BLDG.DEPT Fax c516) 765-1823 MARRIAGE OFFICER O RECORDS MANAGEMENT OFFICER O! **to" W !'elepFione (516) 765-1800 FREEDOM OF INFORMATION OFFICER 'vim•• •� OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: February 18, 1997 Transmitted herewith is a copy of application No. 1670 for a Cesspool/ Septic Tank Construction Permit submitted by: James E. Fitzgerald for Scott Patchell • 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 recom ations: APPROVE DISAPPROVE Comments: • RECEIVED /44'7/ MAR 21 1997 Signature 3//02 Dated Southold Town rr.�M" • OFFICE OF THE' TOWN CLERK ,,,, Town of Southold ,, Judith T. Terry, Town Clerk ;' K Application No. /6 -7e) Town Hall, 53095 Main Road P. O. Box 1179 ; a - Construction Southold, New York 11971 tA Alteration Telephone .y ��' $10.00 - Residential /G (516) 765-1801 y 4j • $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 't-4 /9 jgg7 APPLICANT NAME: VLig6 t . f irmAll r-JE. f/ AO/ / APPLICANT ADDRESS: tillajk 47 SEPTIC L/CESSPOOLIZ DESCRIPTION OF PROPOSED CONST UCTION OR ALTERATION Se" 611s rCht4r kig.0 LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: 0o OWNER MAILING ADDRESS: •�_iil> 411.k�. OWNER PROPERTY ADDRESS: (+ WVf /, j . 4 Ate/ TELEPHONE NUMBER OF CONTACT PERSON: 75q5-ge° - TAX MAP NO. : Section. 7© Block r' , Lot C9YCROSS STREET: 'Ue(IS RL-' BUILDING PERMIT NUMBER CROSS REFERENCE: YIP .�rri ,..�_1 /44(bi i Signature of/'pp ica t ' RECEIVED BY: RECEIVED Town Clerk's Office DATE: FEB 1 g 1997 Southold Town Clerk A ''''t VQc P. l V d64,e///n9 /p,b/'c rare: .•IV WEST j',. HIL LgQ? i ROAD .!/ - FAI ti=4 Favb/c wo-/aw -^ 5 r s J S. 85'52'4 . v; 61 110.00' .* 256.00' o i :1�: 61 .moo,+. /s/r ,ter r z • ,o o u� �o a • i LOT ^ r`; 0 0 P `1 \Ln_ < " it 6 T � qq} 7y) r`, tXCAVATLON IIi TT ,�7 /e, `�% LOT 9tr :�,-oG 05/y "" r,LOT C) S'' '*y' 1111M1dwe/i,g9 C.1 (P"/.c ware, I am familiar with the STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE SEWAGE a/- as. DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES ri$ and will abide by the carnations set forth /herein and on the N 3 permit to construct N /J h The locations of wells and cesspools 0 0 ^ p fr.rera.,i�� shown hereon ore from field observolions 'e a^/ . -. h .• J/ eC /0.1 y.,e,, and or from dola obtained from others. wa/f ^� � tw 3•'rtt en.6 • Ej'''''''' -----N-.f--------'6743'44:::25. N. 86a43'b40tW p 717 W8 344q 'i _eaNw 11,1 SId65,,,,,e, ,, .Or•/ 4,.. wo/rn..a/ . ,'a /ma „/o,„ 9 eo4 b,/kq,,,,. CERTIFIED TO' vim.'• IP PA �� ' Dredged SCOTT AYLE P. TC ELL t I Canal GAYLE PATCHELL u h PECONIC ABSTRACT, INC. a, I h NORTH FORK BANK / e LOT LYES PER FLED UAP Test Boring — l WOO OO A.M, N. 86'5/5 A7---- ' O' , 0.3 Or.Br.Lorin OL Sumo K cot'ig44'i>rlARt� Lhl r[01 iiARams r'g;:ter Pm Af'!AOlAL M100ltlfftlM T ON Pat A 1.5' Ory 1Al�.T OIB.T ctr sa�,srck and SCs-CL r GATT: . 47 70 -97-o00-, 2: r. Fine to coarses Sand SW SUR V AY OF FOR MAXIMUM O! ±i °C.11 Water h Pale Br. LO pIRFS THREE YEARS!ROM DAM O!APPROVAL• Fine to Coarse Sand J sw 19' "CALVE LA" FLED SEPT.9,1970 FILE NO.5673 AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000- 70- 04-24 Scale: 1"= 30' AREA = 16,818 sq.ft to tie line Nov. 7, 1996 .1 i Nov. /9, /994. (, ,opo5e..- hse ELEVATIONS ARE REFERENCED ro N.6.V.D. DEC. /2.,1996 I TEST BORING 8 REVISIONS) .sec Nn.