HomeMy WebLinkAboutSalvitti, Don 4
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ELIZABETH A.NEVILLE �I Town Hall, 53095 Main Road
TOWN CLERK y • P.O. Box 1179
REGISTRAR,OF VITAL STATISTICS i Southold,New York 11971
MARRIAGE OFFICER ' Fax Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER � �Ql �a0lil'� 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. 3224 R Residential x Non-Residential
Fee $ 10.00 Septic x Cesspool
PERMIT ISSUED TO:
Name : GOLD CREEK BUILDING CO
Address 1: 1070 DEPOT LANE
City St zip CUTCHOGUE NY 11935
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 #R10-99-0185
Name of Owner SALVITTI, DON & VIN
mailing Address 1 1070 DEPOT LANE
City St Zip CUTCHOGUE NY 11935
Property Address 1 2055 GRANDVIEW DRIVE
City St Zip ORIENT NY 11957
Tax Map No. section 14.00 block 2 lot 3.002
Cross Street OLD MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 9/02/04 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
. -, 1
OG'
ELIZABETH A. NEVILLE 1 isi�O y1; Town Hall, 53095 Main Road
TOWN CLERK % va Z $ P.O. Box 1179
REGISTRAR OF VITAL STATISTICS O 41$ Southold, New York 11971
MARRIAGE OFFICER : y �. Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER 01 � ia�,i�� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER , ,•1" southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
AUG 1 8 2Vut4 RECE!\'ED
TO: Southold Town Building Department
AUG 2 6 2004
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: August 18, 2004 Southold Town Clerk
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 3366 for a Cesspool/Septic Tank Construction
Permit submitted by:
Gold Creek Building Company
Please review the application and location map and advise if this office may issue the permit.
Please complete the form below and return it to me. Thank you.
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: vi►/ /t..... .. .
244....<7. ,. . 411.1. ,,.
Signature
Dated
!. 1
ELIZABETH A. NEVILLE /0 t\ Town Hall, 53095 Main Road
TOWN CLERK ? c r4 % P.O. Box 1179
t V, Z , Southold, New York 11971
REGISTRAR,OF VITAL STATISTICS v.
MARRIAGE OFFICER
O .F �� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER \‘9# Odle Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER =O'� ,,*,a' 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 or Non-Residential @ $25 Application No. 3 3 '
Permit No.
Applicant Name O /I CYv k 0 e&
Applicant Mailing Address 1 0 r1 0 Qep o4 1-6, Cv+c1l1,1 N Y 1/F3 -S-
Septic
Septic Tank or Cesspool.
Brief Description of Proposed Construction or Alteration Ale rn/ / Fa ki.A4 Pe(
11
Location of Proposed Construction/Alteraion: 67 ren n d U!e vy 012, 0)-141 �/
Owner of Property: 6,014 Cre,a 13113 C.4 % Doh '- v1!'1 co,I v ili 14i1
Owner Mailing Address: J/9e
Owner Property Address:_ E,-.--- =_ I 0 vc 9 - .411i .
Name and phone number of contact person 1) ort �.?'/ 631/2 V hi' c L/ ,95d
Tax Map No: /O°13 Section 1e00 I 'I Block G Z Lot 3 120
•
Cross Street u main 1 d
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH E TH DEPARTMENT APPROVAL
r ' 0-AAJ '
Signature of Applicant Date
Received by: t/C6499
�o�a tie
Geo Calee>C COwS�cn 1WQ LNyr
c. n
. (1I '
om familiar with the STANDARDS FOR APPROVAL ,— __ i
SURVEY OF PROPERTY
AND CONSTRUCTION OF SUBSURFACE SEWAGE ..vi.._ T, 'i
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES SUFFOLK COUNT`
and by the conditions setforth therein and t ORT �*T
on the permit to construct. "f14 JUN 25 till S: 44 A 1 ly 1
The locotion of wells and cesspools shown hereon are �' TO WN OF SO U T uO.]� ]�
rl
from field observations and or data obtained from otherb.� l V l l L i/IJ
4 �° " SUFFOLK c O UNT Y, NEW YORK
Elevations are referenced to an assn ed datum
we,;,��) 1000- 14-02-3.20
,ot\k Q ld a k + •
\a�'� Xy, h� (C• ,5 SCALE: . 1 —50
�' ri Aug. 31. 1999.
�� - -fir June 14, 2004 (additions) .
el
�� o to
3I?FFOLIC COUNTY DEPARTMENT OF HEALTH SERVICESy
\ _ �j03 .p• PERMIT FOR APPROVAL OF CONSTRUCTION FOR A
0.u'. SINGLE FAMILY RESIDENCE ONLY
�.Zp. Nw/\ i e717 °t,l DATE 6 -Q 1 H F. • •, l0, ""-01.9"5"
N B APPROVED —
li
- e ti3+ \ FOR MAXIMUM OF BE: , s>•
\ \ "V.s.
ctv 0) . k
• `'� EXPIRES TErYEARS FROM DATE OF APPROVAL
1.
e2 A
,� A. '�� 3 \ EXC AVT S/1NiT UN SYSTEM REQUIRED
a � \ e1
-ZS /so I _— % w- 8 tati v -J r• t°0 4 \ 8Y HEALTH DEP
ti '�. 18 �+� 9 LEASEf�OE
• ZA`� t Mil imurr distance. between well
l
*. A. 4, ss. 1 and cesspool is to be 150 feet.
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s .AO
4 S 66.1P ,� '0R 3 .42
APm 15
o n O, 5 t.. ;
14 \ 0 . NI -"-- -
S. cp°"'1
1.
5 NYbETr p "'
CERTIFIED TO: v AV
.0,‘", { �` -K
Fidelity National Title Insurance Company of New York, �y T4
99-23018 r4, C� :t *
i M Y S. LIC. NO. 49618
ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION PE js•�+. Vie`'' P.C.
OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. (516 ' •, -•.,
EXCEPT AS PER SECTION 7209—SUBDIVISION 2. ALL CERTIFICATIONS
Lot numbers refer to "Map of Grand View Estates" HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF P. 0. B•
Filed in the Suffolk County Clerk's Office on June SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STREET
AREA = 47,757 sq. ft. 8. 1982 osFAlSOUTHOLD, N. Y. 11971 99-292e No. 7083. WHOSE- SIGNATURE APPEARS HEREON.
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