HomeMy WebLinkAboutRyan, Matthew e,gUf FOI
• ELIZABETH A.NEVILLE �h`1\ oGy�; Town Hall, 53095 Main Road
TOWN CLERK ; p - P.O. Box 1179
ti 2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS v'
MARRIAGE OFFICER ‘#41
� 1� Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER ��l **%�',, Fax
(516) 765-1800
FREEDOM OF INFORMATION OFFICER sal
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1901 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : THEODORE MARTZ JR.
Address 1 : 145 RYERSON AVENUE
City St Zip MANORVILLE NY 11949
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 #R10-97-65
Name Of Owner RYAN, MATTHEW
Mailing Address 1 1021 LOEBER CT.
City St Zip CHARLOTTE NC 28211
Property Address 1 BAYHAVEN LANE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 88.00 block 4 lot 14.000
Cross Street WATERSEDGE WAY
Building Permit Number Cross Reference:
Issue Date: 7/21/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE . h.7 ,y Town Hall, 53095 Main Road
TOWN CLERK ; p P.O. Box 1179
y Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS uu' rrt
MARRIAGE OFFICER "4.°4' �����,1� Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER : �� �0 Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: July 14, 1998
Transmitted herewith is a copy of application No. 1976 for a Cesspool/
Septic Tank Construction Permit submitted by:
Matthew Ryan
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:
SitJnat�
lit f 1
Dated
TICE OF THE TOWN CLERK 'CO'' UL"ti-
'
TOWN OF SOUTHOLD ,�' OG Application No. 1976
7(p
.ABETH A.NEVIILE,TOWN CLERK per'
P.O.BOX 1179 ; . Construction
SOUTHOLD,NEW YORK 11971 � n
ttt) Alteration
Telephone -�O,j �O./ . $10.00 -Residential
(516) 765-1801 '-_ 111,,,'' $25.00 -Non-Residential
•
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee '$ •, / 9
DATE
APPLICANT NAME: e."''
APPLICANT ADDRESS: Alai %641W /4/5 Pra-A4-, /4/"(-'
SEPTIC CESSPOOL
DESCRIPTION OF P SED CONSTRUCTION OR ALTERATION `f 7
CJI -=-
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONST UC7�ION R ALTERATION:
OWNER OF PROPERTY: It raZ 441
OWNER MAILING ADDRESS: GO --I Løe&
A
i't
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: -<►(O"C318 -
TAX MAP NO. : S ction 8 8Block 04- Lot I
CROSS STREET: �"4-t
BUILDING PERMIT NUMBER CROSS REFERENCE:
/i
Signature of A. .lica
RECEIVED BY: fA,44._
Town Cferk's Office
DATE: � ,NI 58
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N / "mo EXCAVATION INSPECTION REQUIRED
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NOTE
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`1��,y ,�....._. . ..,,.- .,__....• %s� �«Q�r,�o�{ A T SOUTHOLD
�� ALL TOWN OF SOUTHOLD
6; SUFFOLK COUNTY, N. Y.
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s� �� NOTE' JUL NLY�,p SUBSURFACE SEWAGE DISPOSAL ' DAT$ �9� 0IN_ g„, 'tss, • !,� SYSTEM DESIGN G S.. g930. 'vsc. _`�/ BYE JOSEPH FISCHETTI, P.E. AFFRpVEDvHOBART ROADN° /A� , ' �' SOUTHOLD, N.Y. 1(971 FOR IYUX MUM(xr3OOM3x Y, it �Y y \O (5/6) 765 - 2954'9 T��s ga 7fiREE YEARSFROMDATE:AFPItOVAL
Y_4 £0^ 2,9� APAroved inac�brdance�..,..� �� 3 wit i3oa d of
0 tietermination date 3 14 g °view
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all a 'cif /y �0 �5 'prop Con fo✓r a.�� vk 1Mi
y h. J .FLOOD ZONE A4 (E 8 _ •\'' •-MM°"$
�'5 �� COMMUNITY-PAPEL NO. _ 19°1” ,oa
b� s, 360813 0079 D ��fCT TC CJ�'e^NANTFi a.^,iBTFtt^''IOt PAG4 p1 •
:*s
AREA = 18,019 sq ft. �`
ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION / ami /liar with the STANDARDS FOR APPROVAL The locations of wells and cesspools ♦l .� cam,
OF SECTION 7209 OF THE AEW YORK STATE EDUCATION LAW r P �.,N,,,- °. 496 \1167.. LIC. Na 49618
EXCEPT AS PER SECTION 7209-SUBDIVISION 2.ALL CERTIFICA�JOWS AND C TRUCT/ON OF SUBSURFACE SEMAGE shown hereon are from field observations/r�i/
HEREON ARE VALE FOR THIS MAP AND COPES TIEREOF ONLY F DISPOS SYSTEMS FOR SPIGLE FAMILY RESIDENCES and or from data obtained from others. - ce —V7,70,1"-
HOSAID E S OR CRE A EAF_AR HE IMPRESSED EO SEMI THE SURVEYOR and will ide by the conditions set forth therein and on the (5/6! 76.5 - 5020 RC.
WHOSE SAbrUTrNPE APPEARS hEREAhI
ADIX770NALLY TO COMPLY WITH SAID LAW TIE TERM ALTERED BY' permit tMs construct. P. O. BOX V9E9
ANJST BE USED BY ANY AND ALL SURVEYORS UTILIZING A COPY /230 TRAVELER STREET
OF ANOTHER SURVEYOR'S MAP. TERMLs SUCH AS 'MNs1PECTED'AAD SOUTHOLD N.Y. 11971
ELEVAT1pNS ARE REFERENCED TO/4GKQ
WROUGHT-TO-DATE'ARE NOT N COMPLIANCE INTH THE LAM.
1 well .
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