HomeMy WebLinkAboutPeterson, James Ogle 00 f c
ELIZABETH A. NEVILLE 1 y�` Town Hall, 53095 Main Road
TOWN CLERK y Z ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �Oy� „_‘..471 Fax(631) 765-6145
, Southold, New York 11971
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER ': -4 � �a��� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER .0's° 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. 3290 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : CANO, HUGO A.
Address 1: 20 HIGHLAND PLACE
City St Zip FARMINGVILLE NY 11738
Descripton of Proposed Construction or Alteration
NEW CONSTRUCTION
FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT
Name Of Owner PETERSON, JAMES & DEBORAH
Mailing Address 1 11 PARK CIRCLE
City St Zip SHIRLY NY 11967
Property Address 1 1105 NORTH GREENWAY
City St Zip ORIENT NY 11957
Tax Map No. section 150.00 block 1 lot 26.000
Cross Street NORTH SEA DRIVE
Building Permit Number Cross Reference:
Issue Date: 2/10/05 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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AD •• \,oC0._
ELIZABETH A. NEVILLE �� a• Town Hall, 53095 Main Road
TOWN CLERK % y P.O.Z Box 1179
REGISTRAR OF VITAL STATISTICS O v i, Southold, New York 11971
MARRIAGE OFFICER Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER `%MI * �'�p,0'`�' Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER sols" southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: February 9, 2005
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 3434 for a Cesspool/Septic Tank Construction
Permit submitted by:
Hugo A. Cano for James & Deborah Pederson
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"/�
. .. 2
Signature
'2 0 7/95--
Dated
• ELIZABETH A.NEVILLE ��h`�� `% Town Hall,53095 Main Road
TOWN CLERK 3 P.O. Box 1179
Southold, New York 11971
REGISTRAR,OF VITAL STATISTICS y. ?77
MARRIAGE OFFICER : O '1` 1 Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER = 40*of Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER O'� 41g41 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.xlY3 Y
Permit No.
Applicant Name I1O A (J\L)O
Applicant Mailing Address a0 \-1;r�\t A Pl. . OkQ k lv\\\*
Septic Tankor Cesspool
Brief Description of Proposed Construction or Alteration f f QvJ OnuS\rl1CA tC
Location of Proposed Construction/Alteration:
Owner of Property:TO,M\eS a-)2,\0b\rO..\,- -obisot.
Owner Mailing Address: 11. 11;04-V\ CA Y'CLQ „ SLi rLy t 1 Ct NY
Owner Property Address: I l OS &(•eevJ
mA7/Ev 7 �1
Name and phone number of contact person d 393 4,c)
Tax Map No: Section CAS.00 Block 01,40 Lot O`ao 00
Cross Street NO r"\\\ S \1't'11 9--
NOTE: LOCATION MAP MUST BE SUB D WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVE Ajj, ALTH DEPAR I NT APPROVAL
4 .14
ArAgy
4. Apr
e of Applicant Date
Received by: oY
I
SURVEY OF LOT 15
TEST HOLE RIVE MAP OF GREEN ACRES AT ORIENT
BY BVCE ,� EA D SITUATED AT
(EL ) H :S U
OL DARK BROWN NQRT TOWN OF SO THOLD
tAOM o SUFFOLK COUNTY, NEW YORK
— BROWN F:4/13/1962 MAP NO. 3540
sc CLAYEYS.C.T.M. NO. 1000-15-1-26w2 % v
GRAVEL al AREA = 23,191 SQ. FT.
—12.0' w ELEVATIONS ASSUMED DATUM
PALE BROWN `
SW FINE TO soti
COARSE SAND
—18.0' VACAJT
WE ° ( SU-27'1A'COU; TY DF5ARTIYIENT OF HEALTH SERVICES
100 ^�a F "1"-.
p &f x a - 4 P 5 4. -"�
rE 1 ski �:or4 F0 A
N 8036'00"E 1 6'
X11 I1 DATE / 03 _
---i�" e O II DWELLING - WELL AAT I
O o ; �a �'�a ,v?•D c, __. r:_____-----
PROP.
SEPTIC 1 CO L.J.//!
SYSTEM kF
04.
O
O
F....N°1 I 1. 10Z ) 103.2)
/ N o PROP.DWYcA
O
O GUARANTEES OR CERTIFICATIONS ARE NOT TRANSFERABLE. UNDERGROUND trams
I
\,\I;
EASEMENTS NOT SHOWN AND UTILITY POLE LOGO/ONS ARE NOT GUARANTEED.
VACANT ' e� THE OFFSET DIMENSION SHOWN HEREON FROM THE STRUCTURES TO THE PROPERTY LINES
• ARE FOR SPECETC PURPOSE AND USE; THEREFORE ARE NOT MENDED TO GUIDE THE
Q //------
V
, O A ERECTION OF FENCES. RETAINING WALLS. POOLS.PATIOS, PLANTING AREAS.
Q • ADDITION TO BUILDINGS AND OTHER CONSTRUCTION. THE EXISTENCE OF RIGHT
r / PROP. DAG. OF WAYS, WETLANDS AND/OR EASEMENTS OF RECORD.F MTV. NOT SHOWN
A FF. EL. 104.8 CARE NOT GUARANTEED ' 4 (.r1GF. FL. 103+ W b UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF
Sr • SECTION 7209 OF TIE NEW YORK STATE EDUCATION LAW. COPIES OF THS SURVEY MAP 42 b o abNOT BEARING RHE LAND SURVEYORS SIGNATURE AND RED INC OR EMBOSSED SELL SFALL;� `T1
O4. O - Wb NOT BE CONSIDERED A TRUE VALID COPY. rn ---n• n DWELLING - WELL WATER �') ,
O8' 33.
s r`Ao. W w . ,r�Y'�
(101.8) (1 = ) .0' I
VACANT — WOODED o PAT T. SECCAFI C0 a
/ , PROFESSIONAL LAND SURVEYOR, P.C:�'
2i — SUCCESSOR TO —
�' DONALD TASE, L.S.
1...
F) PI i RICHARD WILHELM AND ASSOCIATES
goo S 80• ,'90"AT 160.94' lit
o I NORTHSTAR SURVEYING, P.C.
to w •. I PAUL T. CANALIZO, L.S., ROBERT A. KART, L.S.
TIMBER WALL ,A `—— — —— ' GOOD GROUND SURVEYORS, P.C.
� o
y,�P,� 328A Main Street 107-5 W. Montauk Highway
DWELLING - HELL WATER * QP . Center Moriches, NY 11934 Hampton Bays, NY 11946
WELL o I� . Phone: (631) 878-0120 Phone: (631) 728-5330
61.-
r 1 Fax: (631) 878-7190 Fax: (631) 728-6707
.2-it Y N.Y.S. LIC. NO. 049287
FILE NO. T50407 SCALE:1" = 30' DATE: 11/30/2004
'j' COPYRIGHT — 2004 PAT T. SECCAFICO P.L.S., P.C.
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