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HomeMy WebLinkAboutEsteves, Mannuel o, %pF SO(/r�,O ELIZABETH A.NEVILLE / 'lam 4 L Town Hall, 53095 Main Road TOWN CLERK * P.O. Box 1179 REGISTRAR.OF VITAL STATISTICS cn Southold, New York 11971 MARRIAGE OFFICER ,�� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER �l�`, mm, 'e� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER 0Un �, ��� 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. 3371 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : ROBERTS CUSTOMS HOMES Address 1: 50 DIANA COURT City St Zip WADING RIVER NY 11792 Descripton of Proposed Construction or Alteration -NEW CONSTRUCTION, SINGLE FAMILY DWELLING -FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT Name Of Owner MA NUEL ESTEVES Mailing Address 1 P.O. BOX 372 City St Zip WADING RIVER NY 11792 Property Address 1 61155 C.R. 48 City St Zip GREENPORT NY 11944 Tax Map No. section 45.00 block 1 lot 5.000 Cross Street N/A Building Permit Number Cross Reference: Issue Date: 10/04/05 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) • �'� F SOFT • A% 'yol ELIZABETH A. NEVILLE • '`pO : Town Hall, 53095 Main Road \ TOWN CLERK ; 4g 4g P.O. Box 1179 co, Southold, New York 11971 REGISTRAR OF VITAL STATISTICS h G Q MARRIAGE OFFICER . Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER 'rN Telephone (631) 765-1800 lyCOU , ��� FREEDOM OF INFORMATION OFFICER VUNTY+ southoldtown.northfork.net 011°16 ; OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: Transmitted herewith is a copy of application No. 3508 for a Cesspool/Septic Tank Construction Permit submitted by: Roberts Custom Homes 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: / 4r j Signature . /710'e• o2cPoS-- Dated . i° "k,` ELIZABETH A.NEVILLE 011 0 G `� Town Hall, 53095 Main Road TOWN CLERK 1 P.O.Box 1179 REGISTRAR OF VITAL STATISTICS ! ry, Southold, New York 11971 MARRIAGE OFFICER : O ,I� Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER V** � i� Telephone (631)765-1800 FREEDOM OF INFORMATION OFFICER O * ',. " 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. -,12,5 C)S Permit No.1 Applicant Name ' V.k Y'�� A. � h^ y'►1 Applicant Mailing Address# c© 7 t Wad( L( ( ( 7 �-- Septic Tank or Cesspool Brief Description of Proposed Construction or Alteration IkJ CO r')s+YL c_17.09( Le +a �1,—( d t.0 21 Location of Proposed Construction/Alteration: Owner of Property: v\ bulk txiA £c 4-€v es Owner Mailing Address: P0 P0 X 39 1)3ad l Ri\ k)Y i(7/ ',— Owner Proper y l r' s. e Qz.en p)-4- icQy r Name and phone number of contact person j/(C i To-n4 ( 3 &3I -/q Tax Map No: Section J5 Block 0/ Lot D 1- Cross Street NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL \r( R--Fi4 9 //510,r- Signature of Applicant Date Received by: 'iit p � 1 I am familiar with the STANDARDS FOR APPROVAL ' AND CONSTRUCTION OF SUBSURFACE SEWAGE SURT ' OF PROPERTY DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES � _ #ti ,3 and will abide by the conditions set forth theoein a Je{t+1_,% t.,0 i'a ` r NEAR GREENPOR T and on the permit to construct. AUG403 UU28 Pil 3_ 27 TOWN OF SO UTHOLD The location of wells and cesspools shown hereon are from field observations and or data obtained from others. 33 v� � ares . „_ .:.ILS FOLK COUNTY, NEW YORK Kites Elevations referenced to an assumed datum. \\\ Ctiffside ',OA �• ��� 1000-45-01-05 N/°fi 100. SCALE: 1'=30' �•• E SEPT. 2, 1999 / N �3•�•2 o o icc�.t'4�o hJ, 0 Sept.P ' (P P .se) 1X 1 ` , a0 tat. I 4 i. It S. 1 N� r-1 Z VA// IS Ct P (at C. / a� • A o_ - 3a nse el -1.5 �. N < , ` kv_ P t ��G. n , . \ / i "\\ 'srk/:' ri--- /.1" \ f , 4. p , o Pr"° ., /7 1 ye . +�� /�,�/ Q ii N /40 o EXCAVATION INSPECTION REQUIRED �'%nom' , /' rod' t1 FOR SANITARY SYST A c, 'i i'e HEALTH ISP {{ ��/ �/ Q� ' S 1 9�G SUFFOLK COUNTY DEPART OF HEALTH SERVICES ro / ;F,�' ��, t, f b1 gangSe v / ` , �P` �� ,� _ flu�e i o ff/ NMI'FOR APPROVAL OF CONSTRUCTION FOR A N �G �. SINGLE FAMILY I E DENCE ONLY 35` ` A-�,;, 1 'V DATE '�' , v 3 HS NO. .I` �gm � d� 5• i , e.P. \�F, APPROVED _ % �� 63'2 `ray �?''� At� FOR MAXIMUM Ofr , ,, IDR •MS G V N X3.0 1 1 9-y �QP� c • EXPIRES THREE YEARS FROM DATE OF APPROVAL mor` i 9� O'-- _— 35 .ee` • ...i. 4140 / o\.e� \� CERTIFIED TO, , 3". ROSE V. MCCANN(A X• 41111111116111111°.---. •G i E OF % woiei met0e( PJ /63 C6",1 L " S,C�µ 1. 410).°C01- W. * .-C1) ... IOW* wt�j atom cQNTQUNt[�V 'S.Alm l TO V 4 111111111..— Y FIVE EASTERN TO$P45 TOPOGRAPHIC MAP / ,� V'AvAio .. '}•,( * ' } 1 :L �jj N. `. . IC. NO. 49618 — • ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION '. '.4'1"3".- , OF^SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW ��FiON7F I,•j4'VT.C. 1