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HomeMy WebLinkAboutZevitz, Joe (2) ELIZABETH A.NEVILLE OA y� Town Hall, 53095 Main Road TOWN CLERK o - P.O. Box 1179 H Southold,New York 11971 REGISTRAR OF VITAL STATISTICSivy t MARRIAGE OFFICERFax31) RECORDS MANAGEMENT OFFICER ` 1' -0 .• 0',04� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER Ol_ ,��� 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. 3179 R Residential x Non-Residential Fee $ 10.00 Septic x Cesspool PERMIT ISSUED TO: Name : COURTNEY GALLAGHER 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 #R10-02-0017 Name of Owner ZEVITZ, JOE Mailing Address 1 97 BAYLOR AVENUE City St Zip HILLSDALE NJ 7642 Property Address 1 1300 WEST LANE City St Zip SOUTHOLD NY 11971 Tax Map No. section 88.00 block 6 lot 18.004 Cross Street LITTLE PECONIC BAY BLVD Building Permit Number Cross Reference: Issue Date: 9/01/04 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) I���o�Os11ff0�,�►�o,\ J ELIZABETH A. NEVILLE �� y� ` Town Hall, 53095 Main Road `1WN CLERK h Z P.O. Box 1179 REGISTRAR OF VITAL STATISTICS O Southold, New York 11971 MARRIAGE OFFICER � ��� Fax (631) 765-6145 � RECORDS MANAGEMENT OFFICER _ Oi �►a,�i� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER ��,,' ' southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department of 7 FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: May 17, 2004 Transmitted herewith is a copy of application No. 3319 for a Cesspool/Septic Tank Construction Permit submitted by: Courtney Gallagher for Joe Zevitz 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 `i Comments: -40 Signature '.24147 ?-10 Dated 4 • • OFFL "OF THE TOWN CLERK �,,,��"„r A° � � r� TOWN OF SOUTHOLD `�,: SVFOtK�► FraRBTHa.NEVILLE,TOWN CLERK .1a � Application No. 3317 P.O.BOX 1179 ; • Construction SOUTHOLD,NEW YORK 11971 • • c�t, r1-11Alteration = • (63)e eph765-o a _�Ol m. ����• $10.00 - Residential L/ ?r,. $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 May 17, 2004 APPLICANT NAME: Courtney Gal1aghPr APPLICANT ADDRESS: P.O. Box 2047 Greenport, NY 11944 SEPTIC XXX CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION . . _ _ _ New Construction LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: Joe Zevitz OWNER MAILING ADDRESS: 97 Baylor Ave. Hillsdale, NJ 07642 OWNER PROPERTY ADDRESS: 216() West Lane Southold, NY 11971 TELEPHONE NUMBER OF CONTACT PERSON: Richard 4900 TAX MAP NO. : Section 88 Block 06 Lot 18.4 CROSS STREET: /121,10 BUILDING PERMIT NUMBER CROSS REFERENCE:irr l� Sign_ -A e of Applicant RECEIVED BY: - W _ ow Clerk's Office DATE: S 7 T 0 ANY ALTERATION OR ADD:TION TO THIS SURVEY IS A VIOLATION l j�/�/}�/� Irl EX EXCEPT AS 7[09 D< TME NEV YpD STATE IVISION 2. ALL CERTIFICATIONS LAV. SURVEY L Y OF PROME7 �� EWPM ARE °.FOR HIS NAP AND COPIES mower I&T Ir v�gNT 'j e. WD NAV OR CONE'S/EAR TNR IMRESSED SEAL or TAE SuwEroR AT BA 1 I"L��T VNOSE SIGMATLRE ARS HERROK - DWELLI W ER TOWN OF SOUVIOLD WITH PUBLIC SUFFOLK COUNTY, NEW YORK P BLLiNGIC WATER 1000-88-08-18.4 TN t EL 9s. SCALE: 1"=30' jAY R NOV. 12, 2001 pEPARTMENT OF HEALTH SERYIC[S 04 i�, FEB. 6, 2002 f n prop. bse. ) SUFFOLK C0%h% f UCTroN Foa A , i JULY 19, 2002 ( reWslon prop. hse. 1 IT FOR APPROVAL OF CONSTR �O9 7 �H A©nJ FAMILY RESIDENCE ONLY I/ OD av 7 2 22?rCWSro') SINGLE EL 02• _ 00 UD p0' / A/4N/ 1 1 rr OR o 0}_ 00 l`1 rafer' /y,+ I j E._ .,3.r, w DATE `.) D R n 11y(" 87'35 20, E OYER M5 0 B V APPROVED 3EDROO qac' I e FOR M.XIMUM OF _ � oQQYAI ' EL.0 riww • "() k a \•- , EXPIRESTHREYEA1t`•-'��OATEOFhP f�®A� q, LJ . S iii \ i ® Q Av194_/oa�a g V I .o SUBSURFACE SEWAGE DISPOSAL SYSTEM DESIGN �� R ! Y �JTCAVATbN INSPECTION REQUIRED BY, JOSEPH FISCHETTI, P.E. s � /Tse' 43n O FOR SANITARY SYSTEM If HOBART ROAD t /* ) i gY SETH DEPARTMENT .t SOUTHOLD, N.Y. 11971 I� i +' �'* > g, (63/) 765 - 2954 Z Iatwe , y ( wall, 46 e'w"w.+M. • I.r. W `a O TEST HOLE IC War —11(tom, LEASj I j / Z M -1.---___`0nC '` Jt 2 i Irr DARK SAWN SILTY LOAN DL LE LIP 1 r r.! ►, B t /t•� _ J ems' +��_J1d► 1 • ZO r M ` 3, BROWN LOAMY SILT 11L ce+ear°° \ 4 pR'o [,�@� —36------- K Zw W bio i lk _ i i BROWN SILT ML h 2 b ti ®_prolpobeet figewc�Aon 6 4 ^ j *€.40 Z '#5$ ~PS </4A4 Mas N 4rlo3Co/60) G AMY 4;/196 F. ,1%� c�%s�re/ �!E'/ D -v c NOTES, `� �n -fr. ' BROWN FINE TO COAR SAND311;:. 2 .aiiie/.2.e. �..- 3. w I a familiar with the STANDARDS FOR APPROVAL �� ci �,� AND CONSTRUC7ION OF SUBSURFACE SEWAGE K" A. /�� OAR DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES 1 ( ��� ;)� WATER IN Y70VN n 'TO COARSE sfi+Fb SW and will abide by the conditions set forth therein and � ' ,� \c,pF'NEW rG ` �1-r 1 14' P T.NE P� on the permit to construct IISIOOS~ �r \ T14e location of wells and cesspools shown hereon ore ,,, Mif / I N.6 " I.+'9618 from field observations and or data obtained from others. N 'ECONIC 1: VMYOR'l s 4 (631) 765 - -; '4 A .(( ) 765-179 Elevations are referenced to N.G.v.D. ; Y P. 0 BOX 90' t'yS "' jq° : AREA=18,727 S.F. sitar 1230 TRAVELE' +gETfo S r III=MONUMENT TO TIE" LINES &� 01—it SOUTHOLD, N Y