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Home My WebLink AboutBernhart, Sanford � �OS�fFO�,�c . � �G ELIZABETH A. NEVILLE �� yj Town Hall, 53095 Main Road TOWN CLERK v�a Z P.O. Box 1179 REGISTRAR OF VITAL STATISTICS O � Southold, New York 11971 MARRIAGE OFFICER 'y • 0�� Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER ��l � �►a Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEW1aTER I�I5POSAL PERMIT CONSTRUCTION OR A�.TE�tA�ION PERMIT SEPTIC TANK or CESSPOOL P�rmit �vo. 3253 R ��s�idential x Non-Residential ;=ee $ 100.00 sep��c x Cess�ool PERMIT ISSUED T0: Name : SPaRyT BU2LDING CORP �4ddres5 1: 230 UNION AVE City St Zip HOLBROOK NY 00000 �esc�ripton of Proposed Const�uction or Alteratian ^!EW R�SIDE'VTIAL DWELLING 4iIi�AL A�P1tOVAL REQUIRED FROM THE SUFFO�K C(}U'�TY HEALTH DEPARTMENT �dame Of Owner BERNHART, SANFORD & SARAH ------------------------------ Mailing Address 1 355 SOUTH END AVE APT 5M ------------------------------- ------------------------------ �'ity 5t Z1p NEW YORK NY 10001 -------------------- -- ---------- �roperty ,4cidress 1 OLE 7ULE LANE ------------------------------ ------------------------------ City St zip MA7TTIUCK �Y 11952 -------------------- -- ---------- Tax Map No. section 122.00 block 4 lot 80 ___--- --- ------ �'ross Street OLE 311LE LANE ------------------------------ �s�ilding Permit Number Cross �eference: � v/ ---------------------------------- ��ssu� :�ate: 1/26/05 Elizabeth A. ►�eville -------- Southold Town Clerk (TOWN SEAL) � � � osuFFot,� �2�3 �O�' �'pG ELIZABETH A. NEVILLE � y� Town Hall, 53095 Main Road TOWN CLERK t�/s Z P.O. Box 1179 REGISTRAR OF VITAL STATISTICS O � Southold, New York 11971 MARRIAGE OFFICER 1' • �� F� (631) 765-6145 RECORDS MANAGEMENT OFFICER ��l � �►a Telephone (631) 765-1800 FREEDOM OF INFOR.MATION OFFICER southoldtown.northfork.net _ $ 2�� OFFICE OF THE TOWN CLERK . TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: November 5, 2004 Transmitted herewith is a copy of application No. 3395 for a Cesspool/Septic Tank Construction Permit submitted by: Spirit Building Corp for Sanford & Sarah Bernhart 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: Signature � d"� � Dated � � . 4 �S�FFO�,�c ' ELIZABETH A.NEVILLE h`1`� �� Town Hall,b309b Main Road TpWN CLEgg � , P.O. Box 1179 REGISTRAR OF VITAL STATISTICS�� Southold, New York 11971 MAR,RIAGE OFFICER � '� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER �� Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER �'� � �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. ��J�- Permit No. Applicant Name 1`� ' � L � Applicant Mailing Address ��O !,�N/o kJ �CJ/� � �7y� - /7��-- , Septic Tank C or Cesspool Bri f Descri tion of Proposed Construction or Alteration�� ,�.� _ � . Location of roposed Construction/Alteration: Owner of Property:y�i�,t,D .�S��a�,B�.vNa.�7-- Owner Mailing Address:,��5'S� �. �,u��apT �t'wJ '/U.�cr� Y�: N,�!_ /dn 6 / Owner Property Address:�r�s�f��,�j��c/L Name and phone number of contact person �.(�Yl1a,�,� �r(T—�zz s��-� Tax Map No: Section /�,Z. Block O �/ Lot z�Fs� Cross Street D�d_Tu�_ .<�,✓� NOTE: LOCATION MAP MUST BE SUBMTTTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES 5URVEY TH DEPARTMENT APPROVAL 0 0 S�gnature of Applicant ate Received by: � i � - � � . � � SURVEY OF PROPERTY , � � k�" '�`�� AT MATTITUCK �' �NGP�Er �� US � \�� E�-, w � OF S D UTHOLD II � .� TOi�N \ ��'��' � ' � S UFFOLK CD UNT Y, NE W . YORK ,, ri= " 1000-122-04-30 �G �� bx SCALE: 1"=40' I� ; ��, P� E� ,� AUG. 13, 2002 �� ' �, ' l� 6� W DEC. 6, 2002 (prop. h�e. J � �� 1,�1N.'3 2003 (rewslon J `?U0 '�� c � 29 r.>3(r ..�i? ' ,� � AREA S 18,083 to tie �6ines 5 � ��' '��`r . �. �`��,' . p�� n� Dac. lO, 2003 (Bul/erJ ', ,�� '� - � G- ,a. , _. + � ... � , �. t��P 6 -, ; d � ayZL � �' . .�" 0 ;- °'s J� 1'L � �-: �- �, ? P . C 2 � ,.� I N T � v •, t ��r--. �' � . p O COtJNTYDEPAR 7fI VI o F e. g6 w a, SUFt^OLK TMEN1'OFI�AL SER CBS I SUBSURFACE SEWAGE DlSPOSAL �- =� � � F SYS �c TEM 0 S/GN E � �, J., ; %L-. d� P'ERlYII1'FOR APPROV.U�OFCONST�3UCfiON FOR A BY+ JOSEPH FISCNETTI, P.E. C '' ��* �p!� `, '�:, F Y \ TJ; /� 3QTGLE AMII. RESI�ENCE O1VLY H `� OBAr7T ROAD / , \ ) ,� ,� , `.-,,P �'L 9 , SOUTNOLD, ,V.Y. 1197/ Z E �r'ns , � \,t,,� �'py DA18 -�, HS RBF.NO. -02-0 �'1 (63lJ T6� - 2954 f.N� 4\ �F`,,,��, `n'; �'., � . � �b��d � �y�3 APPKOVED . tn I "v;� (",� ` `� 'L� L� Z i'f',�v a'� . ` POR NSA7CA�ltJNl OF T MS � � 'L��e° N `� -- ,�r� ^ � w `n� SXPIRES 7HRBE YEARS FROM DATS OF APPROVAL � � ,+a�sE � � '�` �-�� '� p � m .. . v.F. e;.n 7► - �� : � �� Z o �`.: %" ( �° � C . . PROPOS£D .�R J� �� >S � � o � � . '� � :- ' , ' 2 a ; 9- -- _ _-- p � . � 5 �- Jy�,y; c I'I I �oved e —- - ._ -t� ilf, _ / �� c� �.,.. Z r � o� rE,4D �20G CAL. - .. 4 ` 3. I !,\ I� ��5� SEP'!G A' � � � �/ . , N \ TEST HOLE app'o�ed ��SSPOO � ra.�r �� E+ r� E" st� W�! e;G . i __ �_ _g5,1 � Ccim• o� ��r.iF�tln Sand' �,'0.9 9�� R �,, MIXED SAND AND LOAM \ � CENILR :P oF g••a`�' �.L : N p�Es'; "'-"'m\ as� rrvoPosea sew�cE a,sPos�c srsrE�u s Paocs Po� c-usrER h, ,-�,=exo��f�.f _ 9 �'�. ;-2-,;'' Z NVTH CL£AN SAND J COLLAR tY00 GAL.PREGST - � . . / PnLE BROVN FINE TO MEDIUM SAND �/ �. . � i � CONCl�tTE SEPTK TAAK BOTTQM QR'LEAChMK> � � �� , • . � ' PoOLS TO BE 2' N' - a�o ,e rov. �v+ v�'��,8h 2q � ' CROSS SECTIQN-SEPTIC SYSTEM '`�� ' P� a� � � � / �y� 5.1' A ,,5 O`�• / 1�8 R � �p l� �,P' / � .,.� �� '� S�' .E''qo' /� � t�'r(�� 4�r� �CC ` VATER IN PALE HROVN F DIUM SAND� I�I�TES, �� `� �� a '� ��y92 �9e�� Of MfW II�,I aM far�lUar with the STANDARDS FOR APPR❑VAL �. . ,,� : �'''�M , y ��saP��s b� 2°�4'A��a e�'t��•�► r�'�,f. . P � � +o Q �i e c '`�b i. c �s� �° Qr AND �❑NSTRUCTION pF SUBSURFACE SEWAGE �y Y •, s ,'. r c � �o� �a`1 9 f� + r+�' , DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES /ti S{��. �, w�^; e * j and will abfde by the conditions set forth therein and �_�.,,,n <<N�:> it:�+�' f�k-�"� / ��ds o�°�'m^C y * � on the perMit to construct, 3�ie3 cc•�Y,'? �,� S/g/yY� �a�'"�� ;f'�Wa , 13- r' w� ,� n '��o-r s�� 1r�' � �' ;h �� N� • ' The tocation of wells and cesspools shown hereon are L� �!'�'r'' ' � �'"` ' "' �o+e i/� • N,Y.S, frnM field observations and or data obtained froM others, ° ANY ALT'ERATIQN OR ADDITION TO rHIS SURVEY IS A VIDLA'fI�N CONIC S VEY�RS, P.C. Elevations are referenced to N.G.V.D, OF SECrION 7209 OF THE NEW YORK STATE EDUCA710N LAW. C631) 765 - 5020 FAX�C631) 765-1797 I EXCEPT AS PER SECTIpN 7209-SUBDIVISION 2. ALL CERTIFICATIONS P, O. BOX 909 I •=PIPE HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF �NLY IF 1230 TRAVELER STREE7 Q �/ SAID MAP OR C�PIES BEAR 7HE IMPRESSED SEAL OF THE SUI7VEYOR SOUTHOLD, N,Y. 11971 O�—,i[ �'/ WHOSf SIGNATURE APP�ARS HEREON.