HomeMy WebLinkAboutRodriguez, Roy •
ELIZABETH A.NEVILLE ; Town Hall,53095 Main Road
TOWN CLERK o P.O. Box 1179
y Z
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS V'
41
MARRIAGE OFFICER �i ��#i�, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER - O! �ao',� 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. 3206 R Residential X Non-Residential
Fee $ 10.00 Septic x Cesspool
PERMIT ISSUED TO:
Name : ROY RODRIGUEZ
Address 1: 420 E 54TH STREET, APT 14C
City St Zip NEW YORK NY 10022
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 #R10-03-0056
Name Of Owner RODRIGUEZ, ROY
Mailing Address 1 420 E 54TH STREET, APT 14C
City St Zip NEW YORK NY 10022
Property Address 1 975 HILLCREST DRIVE NORTH
City St Zip ORIENT NY 11957
Tax Map No. section 13.00 block 2 lot 8.021
Cross Street BROWNS HILL ROAD
Building Permit Number Cross Reference:
Issue Date: 9/02/04 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
�Og�FfO(,rc
co ;
ELIZABETH A.NEVILLE xt y��� Town Hall, 53095 Main Road
TOWN CLERK ; P.O. Box 1179
v. Southold, New York 11971
REGISTRAR OF VITAL STATISTICS � � � �
RECORDS MANAGEMENT OFFICER RIAGE OFFICER `�y�Q( .�ali�,, Tel phoFax ne (631)31) 5-6145
765-1800
FREEDOM OF INFORMATION OFFICER
southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
RECEIVED
.Jif.. 14 3IO
TO: Southold Town Building Department AUG 2 6 2004
FROM: Linda J. Cooper, Southold Town Clerk's Office
Southold Town Clerk
DATED: July 14, 2004
Transmitted herewith is a copy of application No. 3347 for a Cesspool/Septic Tank Construction
Permit submitted by:
Roy Rodriguez
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:
C - -"
,04,0,42,ags/
Signature 7
Dated
OFFfcE OF TEE TOWN CLERIC �'.. /'/'•UL/r6•
TOWN OF SOUTHOLD ,��•'€'..S.
o��F� a Application No. ��
BLIZABETHA.NEVILE,TOWN CLERK ,� Q y�Z. Construction
P.O.BOX 1179 • !.
SOUTHOLD,NEW YORK 11971 % v • T Z
Alteration
Telephonetoe
-.0,f tic ',, $10.00 - Residential �—
(631) 765-1800 --��1 �,��,� $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE 7// 4
APPLICANT NAME: ' ,rt 3U e,i;- (& (Arn9 Mit r;A) - A-16131")
APPLICANT ADDRESS: COS ti.l(Ctre_f LY. lY
Or-i.e.-int—, Al . V 1/ q-)
SEPTIC ✓ CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
N e.w Sal I c ,p,,',..Lt re-5-c aP .e_t_..,
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: RD1 Rea ri ve.Z.
OWNER MAILING ADDRESS: �2-o Cl'� Sfi• fpf 14- e-
sGwyor(c. J9 f00'22 ^ $1S1
OWNER PROPERTY ADDRESS: RIs- 14-ai cre„,,t- Dr. 14*.
Q rt t..„-t- r(Li
TELEPHONE NUMBER OF CONTACT PERSON: a-rni I'Y)Prie.7-ix) 4-'17_gTsa
TAX MAP NO. : Section 73 Block .:71t Lot t 22.x!
CROSS STREET: /� a
BUILDING PERMIT NUMBER CROSS REFERENCE:
0. , ?)1,Aldt.,) . .
dature of Applicant
RECEIVED BY: C/(
o n Clerk's Office
DATE: 7// V /d
I SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
' GRAM[1...87A 4
PERMIT FOR APPROVAL OF CONSTRUCTION FOR A
NI JJ I I------ - ; SINGLE FASLYRRESIDENCE ONLY
NV.lL.B59 �� nTCM Ip'/rt.� i DATE G__(-7.63 ..i*., t R to-O3 5
INV.CL.B43O
NV.lL.Bam INV.lL.MS?
43.-CP ' scare A? ID BCDre ArPROVW APPROVED /1 /1� s •
• `
10,C00 GAL. aowN, rRCCABT Ba'
p
— BCTCTANK LLACMINGROIL FyoOIA iO 0 „:JIl l' •
`J EXPIRESLTHREE YEARS FROM DATE OF APPROVAL
'I GROUND WATCR
PROPOSED SEPTIC SYSTEM DETAIL HiV. TEST ROLE CLL Cd ' 6 .30•-04
DATA
(BDT.L.a1CBTMWI!') 0'
CL.45,or
BROWN SILTY SAND SM
LO BROWN CLAYEY SAND SC
S,,0O44NE NG 1SLANu SOV BROWN CLAY CH
Z� _
o• • .I` 46, N� 58.41' 17.70
91\ TIE LINE ALONG APPROX. �. S85°50'39"E N83°54'25'T --- 34'
N N0.\ HIGH WATER MARK ^- PALE BROWN SILTY SAND SM
! 'Z 0 -48'
w.# •
PALE BROWN FINE SAND SP
\ �° 54'
9.41 B \ ....... BLUF ____-9.43����8� r
LOT 18 ------------- \ 20 10 -~""�`"-_
SUBDIVISION- --\___--_______ \ `�
_ a�
"HILL CREST ESTATES,5ECTIQN I" '---------------\-ao C ,.
(VACANT) --\\\--------------- � '
\4Q 4i LI--' -z1".-:
if
--\---------------- _ ` 50 w $A C 0 0
10 a
_ __ .70 Q+.� „
..)1,--.....--94.46 —` —, -----__ BO 144 , c:.
BASED ON SURVEY FOR /�- ' �,---/?OPO a!.. ______ .....,..,50
\ j 4 .�,q
ROY RODRIGUEZ 92 9;, ,,kms .. " .... '
LOT 19, "HILL CREST ESTATES,SECTION I"1�--- ` _ \ _�� =-- -92 '"
AT ORIENT,TOWN OF SOUTHOLD ` �49• _ _ ii
SUFFOLK COUNTY, NEW YORK \ +Cos �` ) 91--48 92 /
COUTY TAX MAP \ 92. 5ARo rroN \ \-/159'SN/9/F. ,,:
DISTRICT 1000
SECTION 13 / --._T - _-A- E` p" JANE:5ELUAR,,
BLOCK 02 \ // / E-e7.89 \ , ,, (VACANT] ,
LOT 8.21 \ /// LOT 19 // \\87.94 'rs
PREPARED JAN. 20, 2004 / / + \ x
SURVEYED BY W91.84 189.73 �, '
HOWARD W.YOUNG _ \
LAND SURVEYOR. \ `
' \\/ 90.76 90.+0\'``
AREA= 1.5655 ACRES + ___-
fffaaa / ��-.92 ..
MONUMENT FOUND
\�� \/ // 014\ ....L.94
-96 ,�/
\ 1‘.` 1` ; / %• �'\ :
A STAKE FOUND 1 \� / �__ \ ..
// O. \_,01_01.1. 14 1, ///V.\
SITE PLAN \ + 6 GPS 100. 9
SCALE: I"=4d \•\ \\- -;.---- ' / (549 —/ \ / \\ \
/ / Q�/ OQ / TEST\ CY
'P�, R. 'OLE \
Q 93+7� QXNi 994.62 100
k'.74.AJ.''''''
94.65 J\•;�f; SnILLROAb 583°35'30W �� CONC.CURB 150.00'
f'�..0r10 793_17.TO BROJJN � .�;
a t
CABLE BOX ;
TELEPHONE BOX
HILL GREST DRIVE NORTH 4_• ,.
RODRIGUEZ ,
05/21/04 LOT 20
FAI RWEATI-1 ER-BLOT21 ROWNSUBDIVISION- - -'
DESIGN A550CIATES,INC. (VACANT) ' "HILL CREST•ESTATES,SECTION I"
205 BAY AVENUE (VACANT) LOT
GREENPORT, N.Y. 11944 • (VACANT)
631-477-9752 (Fax) 631-477-0973