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Home My WebLink AboutPalumbo, Anthony �o�SUFFoc�-�o ELIZABETH A. NEVILLE G'y� Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR.OF VITAL STATISTICS �y • �� Southold, New York 11971 MARRIAGE OFFICER O Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER �ol .�� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 3130 R Residential X Non-Residential Fee $ 10.00 Septic x Cesspool PERMIT ISSUED TO: Name : ANTHONY H. PALUMBO Address l: PO Box 309 City St zip NEW SUFFOLK NY 11956 Descripton of Proposed Construction or Alteration SANITARY SYSTEM FOR ONE FAMILY DWELLING. APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES. REF #R10-00-0155 Name Of Owner PALUMBO, ANTHONY ------------------------------ Mailing Address 1 PO Box 309 ------------------------------ ------------------------------ City St zip NEW SUFFOLK NY 11956 -------------------- -- ---------- Property Address 1 3550 GRATHWOHL ROAD ------------------------------ ------------------------------ City St zip NEW SUFFOLK NY 11956 -------------------- -- ---------- ,ax Map No. section 110.00 block 8 lot 3.000 ------ --- ------ Cross Street NEW SUFFOLK ROAD ------------------------------ Building Permit Number Cross Reference: ---------------------------------- Issue Date: 1/29/04 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) 1 � FF01/r OG 3130 ELIZABETH A.NEVILLE �� y� Town Hall, 53095 Main Road TOWN CLERK C Z P.O. Box 1179 REGISTRAR OF VITAL STATISTICS 0-0 Southold,Southold, New York 11971 MARRIAGE OFFICER Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER ��,( �a� Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net OFFICE OF THE TOWN CLERK DEC 1 2 M TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: December 12, 2003 Transmitted herewith is a copy of application No. 3265 for a Cesspool/Septic Tank Construction Permit submitted by: Anthony Palumbo 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. Linda J. Cooper * * * * * * * * * * * * I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE DISAPPROVE Comments: L41 ` Signature /.2 03 Dated ' FF01/r ELIZABETH A.NEVILLE �`Z` �G.y Town Hall, 53095 Main Road TOWN CLERK p P.O. Box 1179 co = Southold, New York 11971 REGISTRAR,OF VITAL STATISTICS MARRIAGE OFFICER O ,, Fax(631) 765-6145 . RECORDS MANAGEMENT OFFICER Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER O'� �a southoldtown-northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @ $10 or Non-Residential @ $25 Application No,,3o? Permit No. Applicant Name 1iq04.j .41V ;0 Applicant Mailing Address & t6c%c Septic Tank or Cesspool Brief Description of Proposed Constniction or Alteration S,i✓�/ -�„ Location of Proposed Construction/Alteration: 1 Owner of Property: �� ")��r y , /_Z-41, ,_ 1312 Owner Mailing Address: k, Owner Property Address: ) 6'L2 Name and phone number of contact person 4c4., PA Tax Map No: Section O Block � Lot 3 Cross Street lr,,,/4 /k NOTE: LOCATION MAP MUST BE SU TED WITH A PLICATION. NEW CONSTRUCTION REQUIRES SURVEY TH FAITH DE MENT APPROVAL ignature of ApplicantDat Received by: 5UR\/EY OF PROPERTY SITUATE: NEW 5UFFOLK a�p�a� ap°pat N TOWN: SOUT HOLD exsyt'te (� j� /y �� I ��,/ septic 9 .HJT FOLK OO ISIT 1 , 1`l 1 �a I °efq m Nor for m W e E SURVEYED 04-23-02 S72- 1` °`"E��N�9 st SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICBS amended II-1-02, o, e 1.95 , , wetlands f lags located 01-14-03 �' E PERMIT FOR APPROVAL OFCONSTRUCTiON FOR A S REVI5ED PER DEC 04-02-03 , SINGLE FAMILY RESIDENCE ONLY AMENDED 01-10-03-3ATED EXISTING SEPTIC 06-II-03 102.53. i /Q�� ti �'a� e�,�0 S a HS REF.NO, 'ro, SUFFOLK COUNTY TAX # i APPROVED 1000 -I10 - 8 - 3 CERTIFIED TO: O ��ui i FORN[�1XIMUMOF. BEDROOMS ANTHONY H. PALUMBO - 0 � MI MRE5 THREE YEARS FROM DATE OF APPROVAL I FIRST AMERICAN TITLE IN5URANGE COMPANY OF NEW YORK m � 6 REGORE? ALL SHORE A65TRAGT LTD. Q' �' 't `i s N Qocatlon TE5T HOLE C%t c"a , Q� ~ of existing NOT TO SCALE septic system86 yt EL=b' tri ^+ �� eNell 0 STNvr OP _ _ _ _- - -- aPprOx 2 01L r� Q� Pr9-ose uL ° ° ayl w rr 0 m ewe ..N 5AWY Q JC °� ° rmerly of: r \ ~ ' �� oP cation Qe e4 nd now or jz Bllgh LOAM Or �,flOiilol septi�Xsysi� e C� Lo JoDLLIN6 ern 4, ;o i test �� 0 hole a � .."+,� UAY N 1 B �� / � is+,In u r ith of Resew Y GRWPA d8E8!'� atlat03 ruga tban dated r O Q � 33 6' N80 ' 0 001 �c a • �y ldr Quo`` C� Q� X SOL--- 0`qop. aa,- 0 8 o opprox. !c location -;zz e OF existing i 0 035 septic system -+ i 0 , -y noor formerly of: Landw 4 \p ronci5 J.Tlaleski eWe N 30 o N pvAELLIN NOTES: ,y 6 S21bp, o° 00 �OF NEW 1, oPP MONUMENT a �'P 1Miwtt�ar4ed alteration or add�tkm Fe o wrvey map bear ny a Ilcensed mtl 5u-veyor5 seal fs o � . 1 aataly,a _n 1 .a:m:ath�e s�°Eaa�ow fthe o PIPE -9-1 or N. Al y ma ked with on or 9Mo ci M1e and seyor's nese S2 orry O \A . ( t s amped seal s on be oo sdered to ald U o PROPER EZAE IDE5 IN FLOOD 8 d ONE X" tim°2Qa f, e\' <.� � DESIGNATION ' ONE ;a°� a Fd°P L urve / Uy tM Nen York State At-of Proiesslorwl ��. o.w s,rveyors. soya ceruNca—y sron p oily PROPERTY ZONE R 40 SET BACKS FOR / X35 owo n��nair'r.�m�it elane�ey z�oeP�oa NON GONFORMING LOT AREA / ��,`� tal ogezy ow ie�d`g k�suwnaa Ilsted nerea..,i V- m ue ose�ees aF ero I.,di,g u.snwua. a ti ti o- uore are eot trmsFermle m addrtiorol msutouoas LINE OF HAYBALES PURI G CONSTRUCTION veli icis ner per wn oi' JOIN C. EHLERS LAND SURVEYOR t.= t Qpot on 6 EAST MAIN STREET N.Y.S.LIC.NO.50202 AREA = 23,025 5F GRAPHIG 5GALE 1 50 of Exi septic sys't9 RIVERHEAD,N.Y. 11901 �; 369-8288 Fax 369-8287 REF.-\\Hp server\d\PROS\20-166e.pro li . I 'ji