HomeMy WebLinkAboutStulsky, Mark (2) los1FFoc,(�;
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ELIZABETH A.NEVILLE y� Town Hall, 53095 Main Road
TOWN CLERK % y Z P.O. Box 1179
rtyREGISTRAR OF VITAL STATISTICS 1,� Southold, New York 11971
RECORDS MANAGEMENT OFFICER -� ��,� .MARRIAGE OFFICER
�' � Telephone(63 Fax(631) 1)5-6145765-1800
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. 3150 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : RICHARD SAETTA
Address 1: PO BOX 2047
City St Zip GREENPORT NY 11944
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 #R10-02-0212
Name Of Owner STULSKY, MARK
Mailing Address 1 760 SEAWOOD DRIVE
City St Zip SOUTHOLD NY 11971
Property Address 1 1005 SOUTH HARBOR ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 75.00 block 4 lot 6.000
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 4/15/04 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
•
4) FFOL4.>.. 31 SO
ELIZABETH A. NEVILLE 1100 4 ; Town Hall, 53095 Main Road
TOWN CLERK o P.O. Box 1179
% Z
REGISTRAR OF VITAL STATISTICS Al Southold, New York 11971
MARRIAGE OFFICER `. 4; l��1�, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER �_��! #9....
FREEDOM
Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER .�, ��,,,9 southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department 41 I 1 in
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: March 10, 2004
Transmitted herewith is a copy of application No. 3289 for a Cesspool/Septic Tank Construction
Permit submitted by:
Richard Saetta General Contractor
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: ..,,_�.—` .. , '
2i/er. .‘,.. ,‘:4
Signature
21/1.04-ire--1r, .,2e0e)V
Dated
•
•
OFFICE OF THE TOWN CLERK ,,,,,,,i,,,,,�.,.
TOWN OF SOUTHOLD ,: S�FFOLkc
F!!7ABETH A.NEVILLE,TOWN CLERK .`� � �l/ � Application N o.�Al
P.O.BOX 1179 ,�J 1
SOUTHOLD,NEW YORK 11971 Construction
ctr3 Alteration
I op
Telephone __,f,, ����� • $10.00 - Residential
(631) 765-1800 /
�.0 $25.00 - Non-Residential
, ,0
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE MARCH 4, 2004
APPLICANT NAME: RICHARD SAETTA GENERAL CONTRACTOR
APPLICANT ADDRESS: P.B. BOX 2047
GREENPORT, NEW YORK 11944 '
SEPTIC x CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
NEW SYSTEM
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION
OWNER OF PROPERTY: MARK STUL SKY
OWNER MAILING ADDRESS: 005 SOUTH HARBOR ROAD
rj. NEW YORK 11971
OWNER PROPERTY ADDREBS: SAME AS ABOVE 1(PO tip 1r cu
TELEPHONE NUMBER OF CONTACT PERSON: 6•11_76c_t min
TAX MAP NO. : Section_75 Block 04 Lot 06
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
/, iic? ' 1 . .
My
Signature of •v
RECEIVED BY: 101
1�� Town Clerk's Office
DATE:
:10\- -
a n l aro famrtll+o, 444 to 8 '4? +b Al* VA .
ANC, C $ RUC 1O,1 S FA A$
Jul b15POSAL S "`S �'�`'POI swat Mtt,YS E ES
d will abide by the condifions set forth therein and of fke
N'j• permit to construct.
.,
fix .
"°': The locations of wells and cesspools
shown hereon are from field observations
I,. and or From data obtained from ethers.
i
N1p1�
HE
pWELLING
water
t P ;BE. EFt ��� i
c�
�_ " 81.68 m -`--
rn 1.,\ t 0+ Y N. 80'!4'30 E• �
r
1O1F 6
200 p
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IBA P K $235 _ ( I v
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ubfCL water J �.� OD- - - - -- d d e b r,s c,
1P t) -.4
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2.3'. DZ 185.01,
S. 81.38'30" W.
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' roars+i sand
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FRANKRO
1111
17" CERTIFIED TO,
MARK E. STULSKY
FIRST AMERICAN TITLE INSURANCE 1
COMPANY OF NEW YORK
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES TITLE NO. 151 - S - 44/I
PERMIT FOR APPROVAL OF CONSTRUCTION FOR A
SINGLE FAMILY RESIDENCE ONLY
DATEq—�2 -a' HSR .rra'C �o_o��o, Z SURVEY OF PROPERTY
APPROVED - AT SOUTHOLD
FOR MAX holm OF B:4 • ••MS TOWN ,OF SOUTHOLD
FxPiRFS THREE YEARS FROM DATE OF APPROVAL
SUFFOLK COUNTY, N Y
•
1000 - 75 - 04 - 06
Scale- 1" = 40'
1997
June 25, I7 I cerinled )
OCT. 23, 2002 (ao
AREA = 65,359 sgft ( 1.500 Acres ) Nov, 1,
oaC /7 y1 epif fy s) '
ANY ALTERATION OR ADDITION Tp THIS SLARVEY IS A VIOLATION ® ���
of SECTION x"18 9 Or 71iE NO YORK �rTA ICATiON CAMS E ./� / Y:S LIC. N0. 49
AS.f 'a
;T 11L 7 't 9iJ11 JON ALL CERT .41,70 1S , 1 i ` `h� �I ASd� T IFN�comEs MEREOF Ott Y f' / eSAID MAI' 0RS BES �"� SEAL OP THE. SURVEYOR �' ODI�L E = P:C.
WHOSE SIl3NATtJ E APPEARS ,< 1 (•31) 65
'�502s F, , (63I) 765 - 1.79
ADDI770NALLY, To COMPLY wmI SAS LAW THE TERM ALTERED BY" O
MUST BE USED Q1' ABY AND ALL SI�RV�YORS UT/Ll A COPY 1 _ a�,1_Tf AVcLE. • TREET
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