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HomeMy WebLinkAboutPike, Beth ,,,i/iii, ..° ° 4•0 ` ELIZABETH A. NEVILLE �� � ` Town Hall, 53095 Main Road TOWN CLERK vis ; P.O. Box 1179 �� Southold, New York 11971 REGISTRAR OF VITAL STATISTICSVass MARRIAGE OFFICER Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER _'y�/l * `0„.. 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. 3259 R Residential X Non-Residential Fee $ 100.00 Septic x Cesspool PERMIT ISSUED TO: Name : PIKE, BETH A. Address 1: P 0 BOX 907 City St Zip MATTITUCK NY 11952 Descripton of Proposed Construction or Alteration -'WO STORY SINGLE RESIDENCE FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT Name Of Owner PIKE, BETH A. Mailing Address 1 P 0 BOX 907 City St Zip MATTITUCK NY 11952 Property Address 1 1125 STERLING ROAD City St Zip CUTHCOGUE NY 11935 -ax Map No. section 104.00 block 1 lot 26 Cross Street SKUNK LANE Building Permit Number Cross Reference: �,v4 4 Issue Date: 1/27/05 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) ,/•• \ss• 11EFO(,��0 , y. G ELIZABETH A.NEVILLE ,' � Town Hall, 53095 Main Road TOWN CLERK t y Z ; P.O. Box 1179 REGISTRAR OF VITAL STATISTICS ‘`%‘ 1 $ Southold, New York 11971 MARRIAGE OFFICER Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER '�°1 4 4. 0. Telephone (631) 765-1800 pi FREEDOM OF INFORMATION OFFICER ,,,•�1 southoldtown.northfork.net 7 2004 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: November 17, 2004 Transmitted herewith is a copy of application No. 3402 for a Cesspool/Septic Tank Construction Permit submitted by: Beth A Pike 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 lo ation map of the project cited above and make the following recommendations: APPROVE DISAPPROVE Comments: /1t , Signature /// 8 °f� Dated ,/�,o�„BUFFO /'c ELIZABETH A. NEVILLE Ile OG# Town Hall, 53095 Main Road TOWN CLERK ' O P.O. Box 1179 y = ; Southold, New York 11971 RI GISTRAR OF VITAL STATISTICS W MARRIAGE OFFICER �=y '� 1� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER 0 O. Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER "O4 n!* ',;00 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 v or Non-Residential @ $25 Application No3YO 2-- Permit No. Applicant Name _Mil 1 I(e) Applicant Mailing Address Q 907 ..., U Septic Tank or Cesspool Brief Description of Proposed Construction or Alteration 4 s iL y 3/ le as,4,26,, Location of Proposed Construction/Alteration: st Owner of Property: €th 6. PI VIL Owner Mailing Address: P© 6:))( 967 .&+h OC k_ \ VI LL1062- Owner Property Address: 1(1 a-7 C)l jP t i t it* oto: VI ( ( 93 ,) Name and phone number of contact person Tax Map No: Lf//Section (Q Block I Lot 6 Cross Street S/(O i')ic /a • NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVE WITH HE TH DEPARTMENTAPPROVAL 0 y' 0 d . Si i ature of Applicant D e .4 -;‘) Received by: P SURVEY OF PART OF PLOT 125 & PART OF LOT 114 MAP OF NASSAU FARMS SITUATE AT PECONIC 01; TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C.T.M. DIST. 1000 SEC. 104 BLK. 01 LOT 26 III DIST. 1000 SEC. 138 BLK. 02 LOT 25 —779 II'�I'i i 8 0 15 30 45 60 75 90 105 120 135 SCALE: 1 =30' DATE: OCTOBER 26, 2004 Y 0 F L M E FOR S.1r NIt !ETES&BOUNDS HERE ON FOR PARCELS AREAS SETFORTH IN ' VJ S WPB UBS\G � DNO EBG' Bye IBER 7188 PAGE 14 CPN PRI- GED GH SERB\ j ERTIFIED TO:BETH PIKE RO\lEO et.1g 6\ COMMNWEALTH LAND TITLE INSURANCE CO. \MP E app Op ' A O I N 69O4$`5p \ N t O_O ,\y'A9 nyON ' �� 0 ��/ mom GE�,g1 P0.; Q1p o 2 )B N0. 2004-487 ° AP N0. 1179 \ x ...S.,..‘ LED:MARCH 28, 1935 `f co EVIS/ONS: - 4f NEpy y x PARCEL 1 v 77 G IJ 41 fkb • •y/„�„L:,• $��'o ohm' _, ' \`'�, TEST HOLE EL. = 18.8' ,, y f i �1 (--- o�` rnr o O f - : .- 1 g�c�y�m N'\o ORGANIC MATTER $ 0.5' Q LAN ���` �,A 1,33 SANDY LOAM `m O \ \� © 3.5' LICENSE NOos . 050363 mZ w' 2g 3 14 • • -1)CI $' �P� rz \ PALE BROWN FINE TC HANDS ON SURVEYING �\g MEDIUM SAND&GRAS 46 NORTH ROAD " ,-44t\- sic:- a HAMPTON BAYS, NEW YORK �� �o A O . Dir 13S. , 11946 ,47-3 ���. �- PROP 1'-G \\ \ TEL:(631)-723-1954-FAX(631)-723-1329 �cn)�m� m 4p`-8,,-b.\N 15' EL. =3.8' \ �� \ WATER/N PALE BR( MARTIN D. HAND L.S -{5`. 1<< 0 • • o^ O oa FINE TO MEDIUM SA �` a \ �'m i AND GRAVEL )T AREA: - '$ ci 0 Nox- \ 19' PARCEL 1: 18,163 SQ.FT. =0.417ACRE �t�E,� I I. $ � � p 186 HANDS ON SURVEYING 10/25 PARCEL 2: UPLAND AREA:36 SQ.FT. 0.114 ..EVATIONS HEREON REFER TO APPROX MSL DATUM AND L �p�vim'` oS1 a+z�%E SURFACE WATER EVIDENT W/THINRE THE RESULT OF ACTUAL FIELD E300u0F PARCEL 1 _REMENTS - •` , ,\A �V p �Y e 0 PLEASE NOTE �Eo�EL , ,, �p 0' "'� jam„ CD P'� S pg°A$5p 00,6s g i 14 is 4ha avtn4innert r SMI Sitar t® /i L.)...e.t 128, 1935 ..-- ,‘_--- ----------* 00 • ,O,N, ,,,,, , PARCEL 1 )1/4-'‘ \ . L. al. onk 0 \, ....„ v (-) ,..... 0,..z. o -z. 1 .752'1,t , ,\Te•Po 'Z. To'ctiic'c ' -'''''‘ r'-s-/ ,' ,0 TEST HOLE EL = 18.8' i y / V;4...,. 111 a -73-sg1.-8.'40,.. \ '. ,a-- .1;.‘ °I Ar • (2i"r3z-P`lea ''r:\-' g•ul,u--)a- Li ORGANIC MATTER S, 0.5' ,--\ 0, LAND s\„ c>,.,„ , 1,p lq T.'3 va37...,‘ SANDY LOAM c3> , LICENSE NO. 050363 -*- -tA,4. .t.0C,., \1-,•-,',• , -.:.0o- •... 35' • • 0 0 0• rz \ HANDS ON SURVEYING - . 0. ..... *,-.3:t , ,,, _\ PALE BROWN FINE TO MEDIUM SAND&GRAVEL 46 NORTH ROAD . ' %i) .c :8° HAMPTON BAYS, NEW YORK . i vwg. 8) 0 11946 ,1 1r-I c:CIG")3 \'''. (R0 t-61 13,,. \ TEL:(631)-723-1954-FAX:(631)-723-1329 , TAN 94-A cIN‘11, .T3 PC;&,,B.*toG 15' EL =a 8' 40 ,ttle. • MARTIN D. HAND L.S • 1..._V:z... Ov WATER IN PALE BROWN ocrfrz 0 ..... FINE TO MEDIUM SAND .0 0 -fesT ) 19'AND GRAVEL 1: 18,163 SQ.FT. =0.417 ACRE "i et tiot- Jo- vc?. ri '-i.' VdrdA 6 0 HANDS ON SURVEYING 10/25/2004 2: UPLAND AREA:36 SQ.FT. ,fieo- \ ,.. 4. el-l'3' '1,1. iNt"' 09'14 re HEREON REFER TO APPROX MSL DATUM AND ‘j jdecesci,t•-ot. - ULT OF ACTUAL FIELD MEASUREMENTS 6-ct v2s1%.•9 WATER EVIDENT WITHIN 300'OF PARCEL 1 % PLEASE NOTE . A,A,'-'d'\I. oo.0°1 10- .14 1 oroN%Ile CA > •?.°P— .48'5° 1 001.6s )..,,,vrzitilh. It is th® applicant's res,..,,kii4siOivb41 to - so .........., r- _ill -‹ PARCEL 2 maintain adequate sar:1-ary dist6 ance . .. CD -\ , I , Et-.1B ' G \ < between all water supply am sewage PAVEMetsIT disposal facilities. fi"-EDGe°F g ' Z. 0 ..,\ 1 Z. 0 Cl) .045-43' ,o/k1 PS) Mi 0 N78°3651" E 2- u::, -\ cn) M sG RO rn ..x) 14.00. _ ..--1 . ni •--'•(3, - S 69°413'5° IMPROVED WELL IN FRONT YARD ois50"W 1. .koco -< 01(411, t _-_---- SANITARY REAR YARD - rri 11.96' 1.-- - _ ril- __---- Se gil EXACT LOC. UNKNOWN ............ 1 1 1 .36151"W "8). ----- '- - - . ,\NEI).-q• AckD -\ ItAPR°41\egtist ReulkiiIci4 01414 • sp011r.11,0C- Eft"' rt tieLL _ -_-- ---i SUFTYII:4 f-'):,7cry'217-7,PAP,7:M7\17:.11F17ALTH SERVICES RED RUN SURVEY DE SW.I LE 1 a _ :-. ,1.. _ FOM / , L,—i,%.10. P, cgirrva.... EXPIRES THREE VEARSFtid )ATE OF APPROVALy„ 7/ .. 7 .,,, .Rrm-IR FIVIDC)R.qPMFAITR ' .?, 1