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Home My WebLink AboutHorton, Debra (3) .1e%OF SO04 5, o ELIZABETH A.NEVILLE '` 0 : Town Hall, 53095 Main Road TOWN CLERK fig 4g P.O. Box 1179 REGISTRAR OF VITAL STATISTICS G Q ,�` Southold, New York 11971 MARRIAGE OFFICER . ' Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER l o, Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER :.. uU ,�II,� 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. 3381 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : DEBRA HORTON Address 1: C/O CRAMER CONSULTING GROUP City St Zip MILLER PLACE NY 11764 Descripton of Proposed Construction or Alteration -SINGLE FAMILY DWELLING 36' X 44' -FINAL APPROVAL REQUIRED FROM THE SUFFLOK COUNTY HEALTH DEPARTMENT. Name Of Owner DEBRA HORTON Mailing Address 1 1465 PINE TREE ROAD City St Zip CUTCHOGUE NY 11935 Property Address 1 3555 DUCK POND ROAD City St Zip CUTCHOGUE NY 11935 Tax Map No. section 83.00 block 1 lot 13.000 Cross Street VISTA PLACE Building Permit Number Cross Reference: Issue Date: 10/27/05 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) • 0'*pG SO!/j •�' y> 4,0 - ELIZABETH A.NEVILLE 1� '` 0 Town Hall, 53095 Main Road TOWN CLERK 4 4 P.O. Box 1179 REGISTRAR OF VITAL STATISTICS co Southold, New York 11971 MARRIAGE OFFICER . - . � Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER l�`, '�rtrtVV �A�� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER OUn l i� `';� southoldtown.northfork.net eases •'S OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: October 21, 2005 Transmitted herewith is a copy of application No. 3530 for a Cesspool/Septic Tank Construction Permit submitted by: Debra Horton 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 DISAPPROVE1:12.r.-.11",a.0...---47 .....--e4—...,44#e€ Comments: f4Signature Dated OFFICE OF THE TOWN CLERK 01 TOWN OF SOUTHOLD �J�� S:-.. Application No.�'��l ELIZABETH A.NEVE(LP,TOWN CLERK %`.. 4�T P.O.BOX 1179 Construction SOUTHOLD,NEW YORK 11971 I g T / � $ Alteration 1// Telephone O �0��,' . $10.00 -Residential (63t) 765-1800 .Yl. ilig� e''' $25.00 -Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No� A Fee $ DATE /O.' -6-D5 APPLICANT NAME: IA)e tor('bflL) !f lK -(/ • APPLICANT ADDRESS: D ---B 5-3-3S' 14�.kr (aCe (•(76 Lf SEPTIC CESSPOOL / ESCRIPT ON PROPOEq, CONSTRUCT ION OR ALTERATION I 6J'lei�' lel.) t t l l F(0 )( f . LOCATION MAP: Must be attached hereto before permit may be issue . LOCATION OF PROPOSEDNSTRUCTION OR ALTERATION:�e41 ..Cry OWNER OF PROPERTYCl h 11u OWNER MAILING ADDRESS: 4(p, p,,,_ \ r Nsd..., 04/ 1.1 . 11 3s OWNER PROPERTY ADDRESS: ou J10ut. TELEPHONE NUMBER OF CONTACT PERS :1 . ef' TAX MAP NO. : Section ,3 Block ( Lot j 3 CROSS STREET: V (, C R et cr . BUILDING PERMIT NUMBER CROSS REFERENCE: 10' i _ , .. ..,' - ' . V ► Signat of Apyficant lcIA4i RECEIVED BY: Town Clerk's Office DEIRDRED.FEDUN �� "" i ' DATE• Notary Public.Slate of New York AIA. No.4994281 / -2-i 'Cssi n reMarch 30 , Commission Expires �►'' � LOT NUMBERS REFER TO "MAP OF VISTA BLUFF" FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE ON MARCH N 15, 1968 AS FILE NO. 5060. ELEVATIONS REFERENCED TO N.G. V.D. SURVEY OF PROPERTY AT CUTCHOG UE EXCAVATION INSPECTION REQUIRED TOWN OF SOUTHOLD FOR SANITARY SYSTEM BY HEALTH Ti i DEPA TMENT SUFFOLK COUNTY N. Y ..c::* 1000-83-01-13 SCALE: 1'=30' JANUARY 13, 2004 M<..ty // -+ /13' F. I.1 r SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Nov. 22, 2004 fre vis/onsl PER'►" t' "OF \PPW°'• ' i.OF CONSTRUCTION FOR A 4INC .:FAN:_.< RESIDENCE ONLY DAT!, I1-1.1-12.1 o'{ _ HS REF.NO/ I 0-O I-005q APPI1/4.411'ED_-..�.. ../IA. A./ AA/ItaI OR MA 5t.it\,:i _ OF DROOMS EXPIRES THREE YEARS FROM DATE OF APPROVAL 1 �Ot 5 1 YY, .. r 7�42 \ t N � \ 1 \ \ \ , • i ')W,414 4;:444 ' ' 1 t , 1 1 t 1 1 i 1 1 t \ \ \ \ 1 I �/� ! \ t 1 t ( \ 1 t t \ \ \ 1t 5�Y\\ .1 r ) / / j�, )/ / /! ,)/) ) ) 1) ) , j 1, \\► t\ \\\ V \\ \\ \ \\ \\ ,/ , I� 1 1 / / / I / ! / 1 / 1 1 I I I 1 ! I / 1 ‘ ID \ 1 t -• / 1 "7 1 I l it / / / / / l / / ! /1 l ! I II II / --, \\ .--�, 1 t \ 3i r/ , 1 ! I , i r 1 / //I / / 1 1 / / 1 / I / i 1 \ j C1Cp 1 \ v �' I , / /11 r I 1 / / / / / / / / 1 / ( I I 1 ‘5114 o s \\ 1 1 r" ,t\ r, // / /// r / / � I /� l 1 11 1! 1 I I 1r J i !� \ 1 • \ ` I r—...__ ._.j//r,�//r/////r // l/J/ 1 / I 1 / / 1 1 f) 1pik 1 1 i / / / // / / ///// II /1 / ! /1 r /I , i •? // �¢ 1 t 4 is t© l ////rte /// / / , l / / / / / l / 1 / � .. s � S --$` 1 1 t / / / / / / // / / f ! / l / I I ! l / l t �S - - el ! ) 1 vii < �\ \\\\ 11 I i 1 1 1 1I 1 1 ! { 1y t1 1 L T I _ ! ) / 1 1. 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I I ! i 1 I , 1 1 r ! r \) , I I I I i I l I l , r i 1 1 I `__ t ' ' ' 1 I I I I ! ! 1 / / I 1 1 t é ' ` 1 j 1 I I 1 i l / / / / j • M11 .1 / 1r / 11i 1 <\\ FlFIN FLR. 4 t k 4 i \ MO isof ESSIO,yg4 '� < '`f r ♦moi 0 /4.2 ",,' /s-aR AP) 4( I. 6NrFy� LOT / pia le ?7;---'-- ..� --4,21:._ c! �\! fa,"-( i �+ y . is� ? r ,ps ,z1E 13 WOO 047E-7 D 1 I 3 fir, Sapp* L.P. ROAD i d �, • 401::7,-,„t_' 90 j, / F 'ENNAC --- _ E R CI D NA 7Vt AL."-hi DISPOSAL :_ z — - L � M ERS P.4 �..cs OF NEI,1, CROSS SECTION SEPTIC SYSTEM 0.. /�R> A=20,789 SQ. f 7: c° OWRICA, vi rave AND `' o0 •METSc•`�, /li2i = prdF> I r v u`+ r r�,1 (3151 364-9890 * •1 �� li ' ♦:' ,,,„,..s Y� �•-0. , ANY ALTERATION OR ADMTIQM1/ TO THIS SURVEY IS A VIOLATION t t 1R 14 _, OF SECT,JN 72090F THE NEW YORK STATE EDUCATION LAW. ECO�tC 0 ! ' ,. • EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS (631) 765-5020 FA :.3 p : H010 ARE' VALID FOR NsAMP AND COPIES THEREOF" ONLY IF P.O. 8()X 909 SAID MAP OR COPIES BAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STREET I ..,. ....