HomeMy WebLinkAboutNorth Fork Management, Inc 4
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ELIZABETH A.NEVILLE ��=� O4 : Town Hall, 53095 Main Road
TOWN CLERK y P.O. Box 1179
REGISTRAR OF VITAL STATISTICSSouthold, New York 11971
MARRIAGE OFFICER yj. ,. .of Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER �_��( jig , los 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. 3138 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : NORTH FORK MANAGEMENT INC
Address 1: PO BOX 696
City St Zip AWUEBOGUE NY 11931
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 #R10-03-0074
Name of Owner NORTH FORK MANAGEMENT
Mailing Address 1 PO BOX 696
City St Zip AQUEBOGUE NY 11931
Property Address 1 455 THREE WATERS LANE
City St Zip ORIENT NY 11957
Tax Map No. section 15.00 block 7 lot 11.000
Cross Street UHL LANE
Building Permit Number Cross Reference:
Issue Date: 1/29/04 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE Town Hall, 53095 Main Road
TOWN CLERK y P.O. Box 1179
v. t Southold, New York 11971
REGISTRAR OF VITAL STATISTICS O '�
MARftIAGE OFFICER y `. ,s Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ; �( * 40Telephone Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER . ,.�� southoldtown.northfork.net
JPA 2 0 200
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED:
Transmitted herewith is a copy of application No. 3275 for a Cesspool/Septic Tank Construction
Permit submitted by:
North Fork Management,Inc.
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: % -�-�
‘-‘`
Signature r7
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IO#,%Suff0L�c0
ELIZABETH A. NEVILLE ts `Z`� %4 Town Hall, 53095 Main Road
TOWN CLERK � p P.O. Box 1179
H Z Southold, New York 11971
REGISTRAR.OF VITAL STATISTICS i
O t � Fax(631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER ;_7 a' •' Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER =O'� * 1',,�� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
OPERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential@ $10 /or Non-Residential @ $25 Application No. 3n2
Permit No.
Owner Name /)p- y 4,4,e GLfr ' 'r //04
Owner Mailing Address /3 Bc k 676
Xouft3olof
Owner Property Address z --4'/ &5 71-11-te \kAeirs
Owner Telephone No. 7d2
15
Tax Map No: Section Block 7 Lot -
Cross Street (//L Zilit/t'
Please check each that applies: New Construction
Alteration to Existing System
Residential Non-Residential
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. (Locate
building and system; give north arrow and approximate distance in feet from system to building
and closest road. New construction may submit copy of survey with SCHD approval.)
1 Kt/L /O t
Signature of Applicant Date
/ —
Received by: _
UHL LANE • II
FOR SCDHS USE ONLY FOUND.
CM TEST HOLE BY
.MCiD_QtI4iD GEOSCIENCE
•WELL , r III-- h 14[?T',28, 2002 •
EXISTING CESSPOOLS I EL. 16 5' ORIGINAL SURFACE
CESSPOOL R JOSE AS PER RESIDENCE
OWNER: MR JOSEPH SAYWERS ,-
ON
ON 11 APRIL 2003- RK BROWN SANDY LOAM OL
N/F JOSEPH SAYWERS S W 1pp3 MAI -b P 3 1- -
„� , .j C,1 Ar _
m RESIDENCE 00 -056 1 6 LOT 40t0 65'TO WELL BROWN LOAMY SAND SM
j c S 88'57'40"E 125.00' D 3' •
K. D EL. 17 —
"99 £�— ,- I Hl 'O IS - FOUND
'-�iii F '� s m x) O IP 10�' ±-1
i'� "� 0
O 26 0' g 0 •
BROWN AND PALE BROWN FINE TO
O
2) B,DwMETERx o O COARSE SAND WITH HEAVY GRAVEL
, , EST
T --1 I p to w 5
, Qi. I pi Q Lor T as s DEEP y? IN LA YERS SW
III r I VACANT -10.0' LEACHING POOLS x_24 O,_� &Op
11. n 3 spfp PROPOSED PROPO r WA
y O o _ s is InINK
GARAGE DR 4 AY WATER AT 18'
-I b 0
1 O w
L 3 z z unm rdc•NO 509. E%P.
I .. .(.a.� �f 0 A A$NECCESSARY �� 35.0'
s = T A 191 I FOUND SPIKE Pr TEST D
.j = IN TREE BASE 64 0' HOLE • /y RESIDENCE
( I to PROPOSED
�� a i r LOT 147 EZ 3 BEDROOM
60
9 0 m r
VACANT
W RESIDENCE TO WELL
I T _) F- Q .0 400' +150'
C O w CV CV TO CESSPOOL
�, u W r -� y N o
NO
M0
GUARANTEES INDICATED HERE ON SHALL RUN
[vONLY TO THE PERSON
CTI I
Z 100' 35.0' —35.0' 1n IS PREPARED, AND ON HIS BEHALFBTO THEY
y z 10.0' TITLE COMPANY. GOVERNMENTAL AGENCY.
N 88'57'40»W I .25 00+ EL 16.1 LENDING INSTITUTION,IF IES/UTTO DIEASSIGNEESS OP THE�IDNGNTTION.
• LOT 42 Z GUARANTEES ARE NOT TRANSFERABLE TO
ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS.
RESIDENCE
EXISTING CESSPOOLS N/F HELEN SAKAPOS Pi UNAUTHORIZED ALTERATION OR ADDITION TO THIS
X SURVEY IS A NOLATON OF SECTION 7209 OF
I HEREBY CERTIF THAT THE WATER SUPPL Y(S) AND/OR SEWAGE DISPOSAL • rn THE NEW YORK STATE EDUCATION LAW
SYSTEM(S) FO'titPROJECT WERE DESIGNED BY ME UNDER MY DIRECTION
BASED UPON FUL AND THOROUGH STUDY OF THE SOIL, SITE AND GROUND COPES OF 7H/S SURVEY MAP NOT BEARING
THE LAND_SURVEYORS EMBOSSED SFAL SHACL
WATER CONDIT 'LL LOTS AS PROPOSED, CONFORM TO THE SUFFOLK COUNTYINOT BE COYSIDERED TO BE A VALID TRUE
DEPARTMENT • TH SER CONSTRUCTION STANDARDS IN EFFECT AS OF rr- , COPY.
�v-
THIS DAT p/1. F o 'o_
I'#4,° -
0
1.40
P A$CH .4.. • ` ' �OTo RESIDENCE
i • WrrSEPH SCHETTI, P.E o
1•* el * 1725 HS:ART ROAD Gc^ -
`• s
1'4-1' 1 �i% SOUTHOLD, N.Y 11971 SURVEY OF o SURVEYED: 28 FEBRUARY 2002
‘ 4.0.—([ W!� 631-765-2954 0
:::�,— c�2� LOT 41 SCALE 1'= 30'
s. A,4t 05251 �2 i' IN
"�'t> SS%O1'0Y FF EL20 AREA = 12,500 S_F.
— ��,- FINISHED GRADE MAP OF ORIENT BY THE SEA 0.2870 ACRES
EL. 17 SECTION ONE
EL. 17
SITUATE
Fm#DAT 2777 - 2 ORIENT POINT, TOWN OF SOUTHOLD SURVEYED BY
DATE FILED NOV. 21, 1957 ELV 15.0 INV. 1000 GAL `INV.
EL.14.5 SEPTIC TANK INV SUFFOLK COUNTY, N.Y. STANLEY J. ISAKSEN, JR.
TM# 1000-115-7-11 EL 14.0 EL.13.755' DIAMETER P.O. BOX 294
LEECHING NEW SUFFOLK. N.Y. 11956
ZONED R-40 POOL SURVEYED FOR: PATRICIA E. KREN 631-7,4-5835
ELLEN B. KREN /
EL. PETER W. KREN /
GUAkANILEU lU: ��� d
PATRICIAE . KRENICIE. KREN 3' MIN L ENSED •ND SURVEY/I't
ELLEN
PETERW.W. KREN GROUND WA TER 1 2. 11 APR 03 SHOW TEST WELL AND CESSPOOLS ON LOT j/40. YS LIC. IO. 49273
1. JO APR 02 Al WLLL LOC. LO1 40