HomeMy WebLinkAboutKunsch FOt� -
ELIZABETH A.NEVILLE �` Town Hall, 53095 Main Road
TOWN CLERK ti Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS v¶ .
Southold, New York 11971
MARRIAGE OFFICER �� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER :y�pl �a�•0' Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER - _ i '� 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. 3197 R Residential x Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : THEODORE C. MARTZ, JR
Address 1: 145 RYERSON AVENUE
City St Zip MANORVILLE NY 11949
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 #R10-04-0005
Name Of owner KUNSCH, ALFRED E.
Mailing Address 1 1213A MAIN STREET
PO BOX 504
City St Zip OAKDALE NY 11769
Property Address 1 275 WEST COVE ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 111.00 block 3 lot 4.000
Cross Street HAYWATER ROAD
Building Permit Number Cross Reference:
issue Date: 9/02/04 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVIi.i,E *� Town Hall, 53095 Main Road
TOWN CLERK ; Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ` rA Southold, New York 11971
MARRIAGE OFFICER 4, l� �, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER �_��( 14*�,.� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER '- ,•�,� southoldtown.northfork.net
JUN 2 2AO
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: —)
Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 22, 2004
Transmitted herewith is a copy of application No. 3338 for a Cesspool/Septic Tank Construction
Permit submitted by:
Theodore C. Martz,Jr.
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: + �-+ t ,.=� �•`.
Signature
aeflorta2- 61 )v)41
Dated
41 11
0,Oi OFFOL j
ELIZABETH A.NEVILLE ���ti� OGS<` Town Hall, 53095 Main Road
TOWN CLERK 8 P.O. Box 1179
% Va
REGISTRAR OF VITAL STATISTICS it 1
%bj. Southold, New York 11971
' • • • MARRIAGE OFFICER , w; t' Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER \4 Telephoneill (631) 765-1800
FREEDOM OF INFORMATION OFFICER -4 �a,ii 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 X or Non-Residential @ $25 Application No.333/
Permit No.
Applicant Name Theodore C. Martz Jr.
Applicant Mailing Address 145 Ryerson Avenue
Manorville, NY 11949
Septic Tank or Cesspool X
Brief Description of Proposed Construction or Alteration
new system
Location of Proposed Construction/Alteration:
Owner of Pro e Alfred E. Kunsch c/o Joseph LaCapra, esq.
A rty:
Owner Mailing Address: 1213A Main st. PO Box 504
Oakdale, New York 11769
Owner Property Address: 275 West Cove Road
Cutchogue, New York
Name and phone number of contact person (631)-878-8443. T. Martz Jr.
Tax Map No: Section 111 Block 03 Lot 04
Cross Street Haywater Road
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLIC• ION. N W .
CONSTRUCTION REQUIRES SURVEY WITH HEAiiibb DE ' •I: , APPR V
t�, l
Signature of Applica • /�/ Date
Received by: ,.Al/alke""---"J
S.C.T.M. NO. DISTRICT: 1000 SECTION:111 BLOCK: 3 LOT(S):4
LOT 12 \:\ 1
uU� ROAD EL 59.1 60 LS'S
LAST TOLE HAYWATER 2
29�/ 62 64 Ve•
e
LOT 15 �
ir------ 0.
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w
Wphp TO�Q
so.04'3
E 1i7
09:°~ 09: LOT ffi ELEV. 61.2
DR BROWN
W I. '4 0.5 y4.01 / 0• To SANDY LOAM T,
Q
Sr? 41�9 SILTY 3.5'
iti _ _ D Yn 3 PALE
0. 1 BROWN
lel.. 5 LOT 17 FINE
�o. II it"` Al '/1� Mone TO
,....4 Aja , (i mare. f rM1 4VV., MEDIUM
'.�� 4
U O ®' 68
Li
�O Q NS0 03o1
66
VOO W NO WATER
* t.062 17'
ot
.N v.4 ,; 60A +CJe p o
11-18-03
1415.s.° pU WA5°1 THE WATER SUPPLY, BELLS AND CESSPOOL
LOCATIONS SHORN ARE FROM FIELD OB RVA TIONS
COO)" AND OR DATA OBTAINED FROM OTHERS.
AREA: 26 701 S.F. OR 0.61 ACRES ELEVATION DATUM __._ AMMO
UNAUTHORIZED ALTERATION OR ADDITION 70 THIS SURVEY ISA ROGATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW COPIES OF THIS SURVEY
MAP NOT BEARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
ONLY'TO TIE PERSON FOR WOW THE SURVEY IS PREPARED AND ON HIS BEHALF TO NE DRE COMPANY,GOVERNMENTAL AGENCY AND LENDING INSTITUTION
LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING IN$DTUTION, GUARANTEES ARE NOT TRANSFERABLE.
THE OFFSETS OR DIMENSIONS SHOWY HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
`SuIMK OOUftTY DEPARTMENT OF HEALTH SERVICES NOT INTENCED TO MONUMENT THE PROPERTY LINES OR TO LADE DIE ERECTION OF FENCES ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS EASEMENTS
ANO/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON DUE PREMISES AT THE TIME OF SURVEY
?EZ*tPPR 4.PPROVAI,OFCONSTRUCTION FORA SURNEYOF: LOT 16 CERTIFIED TO: RANIERO DAVERSA;
SINGLE FAMILY r_rrrx;N ONLY NAP OF: ALONZO JERSEY REVISED GERARDO DAVERSA;
I OATt 2 17 0 usRBF.No,9IQ- 04-00 FILED:APRIL 28, 1930 AS #763
le AtPROVEDA��/.G/�/,r SITUATED Ai:NASSAU POINT
• TOWN OF:SOUTHOLD
!k MA EMUM OF BEDROOMS KENNETH Y. WOYCHUK L.S.
SUFFOLK'COUNTY, NEW YORK Land Surveying and Design
II/ARES THREE YEARS FROM DATE OF APPROVAL 6///f P.O. Box 3, Mattituok, New York 11952
• 1
FILE 923-133 SCALE: •.=30' DATE:NOV. 25, 2003 — PROMS(131)298-1698 FAX(MMI)298-1686
N.Y.5.UT N0.50227 maintaining M.record.of xobtt I.meaaee 7