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Home My WebLink AboutRosenberg, Wendy Y -- pF SO(/j�®l ELIZABETH A.NEVILLE,RMC,CMC h O Town Hall, 53095 Main Road TOWN CLERK l�[ P.O.Box 1179 REGISTRAR OF VITAL STATISTICS Southold,New York 11971 MARRIAGE OFFICER • aOQ Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER ��'i Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER Comm 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. 3893 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : WENDY ROSENBERG Address 1: 22035 SOUNDVIEW AVE City St Zip SOUTHOLD NY 11971 Descripton of Proposed Construction or Alteration ADDITION TO EXISTING SYSTEM. APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION REQUIRED. TRUSTEES PERMIT REQUIRED WAS ISSUED Name Of Owner WENDY ROSENBERG ------------------------------ Mailing Address 1 170 W 78TH STREET ------------------------------ ------------------------------ City St Zip NEW YORK NY 11971 -------------------- -- ---------- Property Address 1 22035 SOUNDVIEW AVENUE ------------------------------ ------------------------------ City St Zip SOUTHOLD NY 11971 -------------------- -- ---------- Tax Map No. section 135.00 block 1 lot 12.000 ------ --- ------ Cross Street GOLDEN LANE ------------------------------ Building Permit Number Cross Reference: ---------------------------------- Issue Date: 8/24/09 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) SOUryo ELIZABETH A.NEVILLE,RMC,CMC �� l0 Town Hall, 53095 Main Road TOWN CLERK l P.O.Box 1179 REGISTRAR OF VITAL STATISTICS Southold,New York 11971 MARRIAGE OFFICER • COQ Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER Oly Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER COW N,� southoldtown.northfork.net OFFICE OF THE TOWN CLERKn,." TOWN OF SOUTHOLD Rr TO: Southold Town Building Department 8 2009 FROM: Carol Hydell, Southold Town Clerk's Office DEPT.OUTNOLD DATED: August 17, 2009 Transmitted herewith is a copy of application No. 389 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Wendy Rosenberg 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. Thank you Carol Hydell I have reviewed the application and location map of the project cited above and make the following recommendations: 01D Lu ^ APPROVE 1/ ,(fin by r 1`-s `► v � ��s fav 1 DISAPPROVE Comments: Maintain required setbacks from adjacent wells,buildings,property lines and water Bodies. EXCAVATION INSPECTION REQUIRED. Signature Dated N CD SURVEY OF PROPERTY AT SOUTHOLD TOWN OF SOUTHOM � ND Soo SUFFOLo�-O UNT2,. IV.Y. L4 G 6� S 11--20' E 5i SUMVM 25, 2OW 0. D o IEC"ifj1 J/ ry YLoaD Zarin f s � p � � �� Hms pyuoD 1��y�' /�_ to CS 11. YZ OOp T�pt' ��i t Of rJL oF NLE6gr FLOOD ZONES FROM FFM 500D y�A est SET? �F LD JWO-IC0155 G Afar 4, x998 - Lo ELENA 710,'JS REFfRfldCED TO N G.V. y, 9 8 MY ALIERA DAV OR ADD UM FO "8 SU93£Y IS A 110LADgi OF SECTION 7209OF THEfrPW YORY. STATE£A'1 MI £CA\'1C UR ON LAW Ec I MEPT AS PFR S£CTOK 720-9-SLOMWSVI 2.ALL QWWIGAnoNs' ( ) 65-502D AREA-4,465 80.Ff, ACW0M 617E VAM FAR Dfl'S ASAP MID,oac;--5 THEREOF W-V HF P.O BOX 909 LD TO�UNE SAM RIP O7 COMEF BEM RAT_-AUFW S�iD MU OF THE SURWMV 1230 717A1'ELER 5177 r� Lo Ie�ra sF 9GNA r APPFA 7S xFlaEow .= SOUTMHOLO, IV.Y. !1971 -225 rn CTI M CD N m m ®SQFF®��C ELIZABETH A.A.NEVILLE Town Hall, 53095 Main Road �`Z` y TOWN CLERK o P.O. Box 1179 COD 2 Southold, New York 11971 REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER ®y • �� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER_ ® Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER 0'` �a southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK i Residential'@) $10 or Non-Residential @ $25 Application No. AU/ _3 Permit No. Applicant NameLA Applicant Mailing Address Septic Tank or Cesspool Brief Descripti n f-Proposed Construction or Alteration @c t stn `r MOT -n (k tD 't C cM UC7 e,0 Location of Proposed Construction/Alteration: Owner of Property: `c�.�'ll Owner Mailing Address: Owner Property Address: Name and phone number of contact person � '� (� SQN►:tet 1 r Tax Map No: Section ��J Block ' 0 1 Lot Cross Street -_I P� yn / a_ine NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY,WITHH ARTMENT APPROVAL L� a f e of plicant Date ' Received by: C ' pF SO!/r�ol ELIZABETH A.NEVILLE,RMC, CMC O Town Hall, 53095 Main Road TOWN CLERK P.O.Box 1179 REGISTRAR OF VITAL STATISTICS y Southold,New York 11971 MARRIAGE OFFICER • �� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER COU southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 4398-R Residential X Non-Residential Fee $ 10.00 New X Existing Name Of Owner WENDY & PETER ROSENBERG ------------------------------ Mailing Address 1 170 WEST 78TH STREET #D-1 ------------------------------ Mailing Address 2 ------------------------------ City St Zip NEW YORK NY10024-0000 C13 -------------------- -- ---------- Property Address 1 22035 SOUNDVIEW AVE ------------------------------ Property Address 2 City St Zip SOUTHOLD NY 11971-0000 -------------------- -- ---------- Owner Telephone No. 917-854-5900 ------------ Tax Map No. section 135.00 block 1 lot 12.000 Cross Street GOLDIN LANE ------------------------------ ---------------------------------- Issue Date: 9/22/09 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) � G ELIZABETH A.NEVILLE yl Town Hall, 53095 Main Road TOWN CLERK eC'is P.O. Box 1179 REGISTRAR,OF VITAL STATISTICS O � Southold, New York 11971 RECORMARRIAGE S MANAGEMENT OFFICER y�o� �a�� Telephone 63 6576541800 �3 P � FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION OPERATION PERMIT CESSPOOL or SEPTIC JANK Residential @$10 V or Non-Residential @$25 Application No.�-3 ?8 Permit No. 5Eff�2,>� Owner Name Owner Mailing Adden's' `tv- - B Owner Property Address Cl I Owner Telephone No. Tax Map No: Section 1 �J J O d Block Lot 12 - 006 Cross Street Please check each that applies: New Construction Alteration to Existing System Residential. ,-' —Non-Residential NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. (Locate building and system; give north arrow and approximate distance in feet from system to building and closest road. New construction may submit copy of survey with SCHD approval.) � � — 9 Iv d Signatuig of A,�p icant Date Received by: l