HomeMy WebLinkAboutRusso, Peter ,,i/iii,_
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ELIZABETH A.NEVILLE � d; Town Hall, 53095 Main Road
TOWN CLERK . o - P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS % i Southold,New York 11971
MARRIAGE OFFICER ` �. ���,, Fax(631) 765-6145
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RECORDS MANAGEMENT OFFICER ;-�Q! .j 'ii• Fax
(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. 3222 R Residential x Non-Residential
Fee $ 10.00 Septic x Cesspool
PERMIT ISSUED TO:
Name : PETER S RUSSO
Address 1: PO BOX 2046
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 #R10-04-0041
Name Of Owner RUSSO, PETER S
Mailing Address 1 PO BOX 2046
City St Zip GREENPORT NY 11944
Property Address 1 1400 SOUND DRIVE
City St Zip GREENPORT NY 11944
Tax Map No. section 33.00 block 3 lot 19.003
Cross Street
Building Permit Number Cross Reference:
Issue Date: 9/02/04 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE y� Town Hall, 53095 Main Road
TOWN CLERK va = P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS ��� Southold, New York 11971
MARRIAGE OFFICER y o 40' Telephone Fax 163) 76576545
RECORDS MANAGEMENT OFFICER I * ,�
FREEDOM OF INFORMATION OFFICER .0*°° southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
AUG I I 2004 TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: August 11, 2004
Transmitted herewith is a copy of application No. 3363 for a Cesspool/Septic Tank Construction
Permit submitted by:
Peter S. Russo
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:
PR
AP VE O
DISAPPROVE
Comments: alis,.
/Key At
Signature
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Dated
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ELIZABETH A.NEVILLE ��h� O4 :; Town Hall, 53095 Main Road
TOWN CLERK ; q P.O. Box 1179
REGISTRAR OF VITAL STATISTICS (1,
Southold, New York 11971
MARRIAGE OFFICER . G 4 11 Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER `� I a6.0'oe Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER = '' * "0 southoldtown.northfork.net
OFFICE OF THE TOWN CLERK a
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10 /or Non-Residential @ $25 Application No. '133
Permit No.
Applicant Name 7-- - 7- lZ S• ,i64.5—,..1--0
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Applicant Mailing Address /� 0 • C )( ,2O � ,-
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Septic Tank or Cesspool
Brief Description of Proposed Construction or Alteration ;'
Location of Proposed Construction/Alteration:
Owner of Property: 7'�=ii i2 ,c. ,,e,..,5--,5-0
Owner Mailing Address: /-Z p . ,1 ' , &te'C
Owner Property Address: V. -- ��,_ , /._.:�!/ V2
Name and phone number of contact person G"3/ _ 7»ltera3.
Map No: Section Block - `S Lot /2, ,.�
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
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Signature of Applicant ate
Received by:
SURVEY OF LOT 3
FINAL PLAT ROGKGOVE ESTATES N . .
FILED JUNE 11, 2001 FILE No. 10637
T : PORT \ e'=
SITUS C�l�l .fid' \ W � � E
TOWN: SOUTHOLD OJ I
SUFFOLK COUNTY, NY 0) \/' S
SURVEYED 04-28-03 /l /
AMENDED 05-13-03 / //
PROPOSED ACTIONS 01-21-04 /' / ,
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SUFFOLK COUNTY TAX # a` /'
1000-33-3—Iq.3 ' ' '
CERTIFIED TO: \\
DOROTHY R.RUSSO
P`o e 'b ,' /' i i i
PETER S.RUSSO t`9 \2-t cc\ / ', t 'i. ,
FIRST AMERICAN TTILE .- a. // / (�j,' ,/ - , ,,
INSURANCE COMPANY OF NEW YORK �`i'�c> \0 ,';',�,`,;-t' ;/ , '„
TITLE 0 LI-30035104—NYSX , .Q� ''`// / '/ " ,.• / , /,',/
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GEHL ANNOTATED FROM NYS DEC COASTAL '` i4.5 w.� ' CEH/ ` .
EROSION HAZARD AREA MAP TOWN OF ,'r*
50UTHOLD, SUFFOLK COUNTY, N.Y. vi athon of elle anon a addlio to a survey
mop eetl-Iny o oeasee o.,d s„-.eyors deal s o
? ,� F I. � violation or section izoa sub-division z,or the
r s flew ror1,store ea,cat on taw.'
PHOTO No. 51-606-83 SHEET 14 OF 4q r t 1 o y caplee from!ro o gba of i,wrvey
S mar'ketl wilh an origNnl of tro land wrveyo-s
PARCEL LIES ENTIRELY IN FLOOD ZONE X ' ,t { ,,, s`ompedseal5hailbecarod°re'aae a'Id`re
' y )44,, ape,
AS DETERMINED FROM FIRM MAP ti ,' ..4`=,',7,;r:".=
Gerttf calla,;hdcared Mr aansignifytt�ot Mb
L 4 1 rvey was preporetl H accordmce with tro ex
No. 36103G015"1 G DATED MAY 4, I qq8 '` �v.. .., -zs ,js r lethg deo t;��; s adopted
` "'rt a '- 9. Land r sors. Sold certifications shall run only
TEST HOLE SHOWN ON FILED MAP u £_ �d� "itis,
the panda,far when he rvey 1e preps ed
ey 7�' jj k�6 and on his beroif to the title cowpony,govern.
'$.e .LA {si
Gni agency and lending Institution listed hereon,and
9� • to the assignees of the lending InstlwtIon. Gertifice-
ELEVATIONS REFERENCE NGVDt2q b.ore not lranefe arable o addita al Institutions
AINI)00 -19AAns JOHN C. EHLERS LAND SURVEYOR
AREA = 46571 SF OR 1.01 ACRES ?� 3..130:18
6 EAST MAIN STREET N.Y.S.LIC.NO.50202
GRAPHIC SCALE I"= 40' RIVERHEAD,N.Y. 11901
369-8288 Fax 369-8287 REF.\\Hp server\d\PROS\03-165.pro
. 2.110130041.26.1141,1mte W W V5fG0-165Gf0 ,