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HomeMy WebLinkAboutSalous, J • / • o&N% SO0rgo. ELIZABETH A. NEVILLE '` O Town Hall,53095 Main Road TOWN CLERK I sig l , P.O. Box 1179 vy a e Southold, New York 11971 REGISTRAR OF VITAL STATISTICS G MARRIAGE OFFICER COQ�I Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER \�l�'`, i 0' Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER ,,a" 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. 3373 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : CHRIS RIVERA Address 1: 250 SOUND BEACH DRIVE City St Zip MATTITUCK NY 11952 Descripton of Proposed Construction or Alteration -SECOND STORY ADDITION -FINAL APPROVAL REQUIRED FROM TUE SUFFOLK COUNTY HEALTH DEPARTMENT Name Of Owner J. SALOUS Mailing Address 1 305 CAPTAIN KIDD ROAD City St Zip MATTITUCK NY 11952 Property Address 1 SAME AS ABOVE City St Zip 0000 Tax Map No. section 106.00 block 5 lot 4.000 Cross Street BEACHWATER DRIVE Building Permit Number Cross Reference: Issue Date: 10/04/05 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) • °''�pf SOi, do ELIZABETH A. NEVILLE e iO l0 : Town Hall, 53095 Main Road TOWN CLERK i 4 ilig Z P.O. Box 1179 REGISTRAR OF VITAL STATISTICS % G Q ,� Southold, New York 11971 MARRIAGE OFFICER '� . , Fax (631) 765-6145 • RECORDS MANAGEMENT OFFICER `:��eec �,I Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER . 0�NTi' 0', 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: September 28, 2005 Transmitted herewith is a copy of application No. 3520 for a Cesspool/Septic Tank Construction Permit submitted by: Chris Rivera for T. Salous 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 ocation map of the project cited above and make the following recommendations: APPROVE DISAPPROVE Comments: , ...4.4....:\ s 214....,/..e.\ _4(‘Z Signature 2 9 2005 .2-9 Abe s--' e' i 1 Dated 1 1 a „,,,, I."1 gOFFOLt-co ELIZABETH A.NEVILLE 41.0. 4\ Town Hall, 53095 Main Road TOWN CLERK i 1 : ;at P.O.Box 1179 REGISTRAR OF VITAL STATISTICS ! �y, Southold, New York 11971 MARRIAGE OFFICER . O �� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER =y P��.0, Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER RI 4, -0/ 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 @$25 Application No. WA-0 Permit No.c PQ3 Applicant Name&_.s: e, .� � G�� . � Applicant Mailing Address .,-0 �d"" 2/ .4- ar- Ale2ei,& , Septic Tank or Cesspool Brief Description of Proposed Construction or Alteration �n -1s - y Location of Proposed Construction/Alteration: Owner of Property: - - - f fjx,ri'"'' j , Owner Mailing Address) L?9 - �J (I, 42 T r7 7v(.1- / //1ffL_ Owner Property Address: -5'Z4' — _ Name and phone number of contact person �Iy, 'S Tax Map No1.01' Section /O6 Block b S' Lot 6r Cross Street /6,---40.0--42.) /9? NOTE: LOCATION MAP MUST BE SUBM�.: ED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY Tii' EDEPARTMENT AP ROVAL Signature o Applicant Date Received b ed . 1 • I I • 11 t_ f . . cApTAIN KIDD DSI (Z:GONG. CURB •• - ' N 1500 SAL. EDGE OF PAVEME FrT41 5 &6'OO'300" E I SEPTIC TANK ^ O V- X . N N N (I) 8' DIA.xib' N gb•O0 " W 214.43' 6 < 2 XX DEEP L.P. M.T.S� WW / 2t0 t j((�� I W 10 MIN. iQ 8' 0 �` X Z u- 1 . a \ Is.a' • u l I� T-_ . �cs. (off PROPOSED 5 BEDROOM Tr)�$� E''I o ' d3 I O- �? SEPTIC SYSTEM: , '�'�'- I(-21 USE 1500 SAL. SEPTIC TANK N w 35.-0"FRONT YARD Q Q 9.4 35.8' -, 1 AND (I) 8' DIA.xIb' DEEP AGK \ _ t )-4/1..... ' EXISTING 2 STORY - . - - LEACHING RINGS t1; FRAME RESIDENCE �I• I tn; ._ m (5 BEDROOMS) Ni I u FUTURE 5O% c2nd. STORY IQ EXPANSION tiRp. HOU��E -!z p = OVERHANG 4' OUT I'� i Q - 26.1' lair- � �C 1/4) 9.6' = 24.3' -cp • �I I VACANT �C1/� EXISTING RESIDENCE PUBLIC WATER (DEG 0 • I / �C/ 'DECK) • 0 I STORY ENGLoSEp I Q �/ IL I DECK ovER GONG. >..., 1th IL XISTING - "'- �\ ( :`---___- � I O METAL SHED 35'O" RE�4i2 YARD SETBACK -- ,t 0 S'U��tiT 7777, , - (mak ww47---, 0 tt, /7)--i- -F/ATA 1)A/0e-724 �' F NE�,y► PO _p �0 r I EXISTING SANITARY j� I.Ln w �. Y _B, f4. Q °n CO . 1 [X }- I 0 SYSTEM TO BE m REMOVED PER I°� * ,., ;:!V * (� Z 0 • m , tJ SCDHS STANDARDS a 0 O 1 r' if',t' �tipi ��' L �L - _ CHAIN LINK FENCE - r 3 oA Ati W 1L F � �F N �•� " 1'4 WIRE --- - t L , '"i A t f ; 'H Vt 'dal SS1 ? - FENCE 100.00 YA>E.tIEj4ILON t/1 # EXISTING RESIDENCE Ip l i d' D_ .s -1 PUBLIC WATER I . �'Y 1tII�SI�R�Ne$ONLY EXISTING RESIDENCE ?) b.. F- 0 I PUBLIC WATER Mtn / /- ©S I-F''F .�O -^ ( .ITE PLAN BASED ON 0 Z — • ,.-ISINAL SURVEY BY: m SITE LA\ I �A i CD X �3 ? um' � ' per $ '�� • -H A. INGEGNO O31 Ii- '"' 1`. ri �/ RHEAD, NY 11101 ' — TEL: (631) 721-2010 Z 20 10 0 20 40 60 80 100 FAX: (631) 721-1121 GRAPHIC SCALE I" = 20'-0" DATED: OCTOBER 27, 2004 0