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HomeMy WebLinkAboutHorton, Debra (4) ,•%pF SOiii ELIZABETH A.NEVILLE '`� Kol0 : Town Hall, 53095 Main Road TOWN CLERK ANI , P.O. Box 1179 va Southold, New York 11971 REGISTRAR OF VITAL STATISTICS ; G Q ,� MARRIAGE OFFICER �t Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER l�'C �/4\���� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER OUI�1,+ ,.�' southoldtown.northfork.net os OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 3382 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 Alterarion -SINGLE FAMILY DWELLING 36' X 44', IRREGULAR -FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT Name Of Owner DEBRA HORTON Mailing Address 1 1465 PINE TREE ROAD City St Zip CUTCHOGUE NY 11935 Property Address 1 3205 DUCK POND ROAD City St Zip CUTCHOGUE NY 11935 Tax Map No. section 83.00 block 1 lot 15.000 Cross Street VISTA PLACE Building Permit Number Cross Reference: Issue Date: 10/27/05 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) • • le• o SO�j ELIZABETH A. NEVILLE �' � yOIO Town Hall, 53095 Main Road TOWN CLERK l * , P.O. Box 1179 va �r Southold, New York 11971 REGISTRAR OF VITAL STATISTICS ; G Q ,� MARRIAGE OFFICER Az. r Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER �,� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER `= CU(J %� , ,0 , southoldtown.northfork.net v��.. •• OFFICE OF THE TOWN CLERK ju OCT 2 4 2005 J TOWN OF SOUTHOLD i L TQ2:_� o tlroi T ucvniBuilding Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: October 21, 2005 Transmitted herewith is a copy of application No. 3531 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 DISAPPROVE Comments: -' �/ 400"- Signature g-4?V"-L- 'EX'S— Dated OFFICE OF THE TOWN CLERK ,'e'col oureOG. TOWN OF SOUTHOLD iQ Application No. 11(3k FT T7ABETH A.NEWT IF,TOWN CLERK V 4C-1 P.O.BOX 1179 y� Construction SOUTHOLD,NEW YORK 11971 tiTS 1Alteration Telephone `004, ���6', . $10.00 -Residential (631) 765-1800 _"1. �,�" $25.00 -Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 33ga Fee .$ DATE /O - OS APPLICANT NAME: ))5(O G Afortelf APPLICANT ADDRESS: lb erOr In I ' 4 fro .P0 _r. - SEPTIC y CESSPOOL ESCRIPTIO OF PROPOSED CONSTRUCTION O ALTERA ION 3 J/vN- - 31{ x tr-e U�4 . LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED C STRUCTIOI OR ALTERATION: UC PUVd / U\4?&/ OWNER OF PROPERTY: ra . ICS OWNER MAILING ADDRESS: (sl1 &e.1t Ow 'o1 �c ( rOs PO ;� 2 M r er -�1 Ke (06 OWNER PROPERTY ADDRESS• 0 I Ia./ ft- • TELEPHONE NUMBER OF CONTACT PE ON:7k0 ( l (-�(�i(�v `f76-6 TAX MAP NO. : Section _ CEJ Block I Lot / S CROSS STREET: Pt( (°c BUILDING PERMIT NUMBER CROSS REFERENCE: Signature o' Applicant RECEIVED BY: A1 W--' Town C rk's Office Notary ,SateofNewYork DATE: LUkaO , No.4994281 Qualified in Suffolk County Commission Ex;-;723"' ' 4' EXCEPT AS PER SECTION 7209-SUBDIWSION 2. ALL CERTIFICATIONS SURVEY OF FROP'ERT Y HEREON ARE VALID FAR THIS MAP AND COPIES ?HEREOF ONLY F SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR AT CUTCHOG UE WHOSE STOW TORE APPEARS HEREON. TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000-83-01-15 SCALE: 1-X' JANUARY 14 2004 N Nov. 19, 2004 tod ►lions) I well 0 1 _ r 1E FFOLK COUNTY DEPARTMENT OF HEALTH SERVICES %%RMIT FOR.APPRO' '_d OF CONSTRUCTION FOR A 6INGLE FAMILY RESIDENCE ONLY 1 I t It TE 12" ZS 0 S REF.NO..- l to 0 L{ -°0S.6 / t 1 1 f Ala/Lk \ `T? Off. PROVED r FO• MAXIMUM OF ''{ BEDRv OMS a/ 12 \`�� \\' \\ \ . i ; f R. P ` + i EXPIRES THREE YEARS FROM DATE OF APPROVAL / • I 1 • 'Z1... / / / I f/ I i +1 I 4 / a C j 1 11 , /' / /, '. / / / / ) 1 I 1 1 h 1 i ��' /// // // // / /1 / / /I , j I i I 9' ,ice —,,/ /�/�/ // // 1 / % 1/ // /I 1 I i __- , . / o. •Jit' vt' 1 ,/ �/ / // / / f/ / / / ff / / 1 / 1 t / / / / / CAVATION INSPECTION RffQUIR^-��v ' ,•-• 4-- i 1 1 ! / // / / / /<' , / /� t 1/ , ; FOR SANITARY SYSTEM t q'<', " , //,1 // 1 t //, / I / ?`$ ,,/ / // , ,1 i t, BY HEALTH DEPARTMENT / \. ¶ / / / /1 /1 1 r' / / / / / /1 , /1 / / 1 I `*" 6 ` `_ / / / / / I I / / / / / / / / ; , ?-'�._,1 1,/ i / I I I / ; / , i i1 / I�// I f / / 1` "+ ' / / \`"- t '/ 1 ' ,-/ �__,/ ,, ;// ' % / / / 1 //!"f\ / -. ,j / / ---,,� _,l / /1 / r . --- ;/ / / 1 ,` / / - %,, / `�`• / / 1/ . _.-..._ f,' / / r—' / ,' / / , / I , A',// / +. / / / 1 1 1 1/'// // ,/ / �//�/�/ // /r ---- / �� /+:: // 1 // / / ,.1t ,,"":„:><- .. , ' / //// / // /,// // // / (/1 'f• if // A;,) li / „Ab, _,..,.-..- / f k V / / r f ! '// I ) Ariii 'ai Apr H: / / I �OZ, 1 11 errs / , 1 1 / / • c. 1 �� I I ,r . . 1 1 / , ( �, �/ // /,/ /i :-/1 / � �1,5 I I / // i , �/ ,' / Vis /'/ � // �f/ fi� i I r �� ) / i/ j / / i ! �� -rte i �.- f I '/ ' / / - // / / ///, ' ,� // fI / \ / / �l' / / / - / ' A Abri: / \ / / 0 / / / / / '" "' S� C. 1fr v / / / / / / ` _ / A DISPOSAL SYSTEM i /' -f�N //// ,///�/ ,/14S6 / '4) \, '7A�) DESIGN BY P.E.I r. / ,7L /` ; / f / / f r / 7 BAER, G l r / �/ / / / r' / i C/O (VCA AND `r / `; ///// // / ,Nn, / ! j BARTLL.UCO '! ' i r`� // `/ti. ,'/ S /<;</`// / y0�`X.,r/ _ ` ' CONSUL TING �S t 1 1 ,p / , \ ( \ . T.` (5/6) 364-9890 r ! �/ // / / 9r i' / _ (!.:9_,,1 ! , '_�', ' // !? / // / � � / 1 ►4I 1 ' // // / s� / i. , /51 I 4�►� 1 1 // / / ` t t _ �- a 43 tin ro. .e N 44 / 6,, / / / \k / r E 4-;"------ fi-- Mai* =7— ) \ �� Wice OT ' 1i ! I 1 v 1 .y9 fE i[. JP- Si ! I 0 / l• ! TAMC �g"5 �a LEA011,6 ' k, POOL° I 1el 2; B'I 1 1 I 2o't Ayrabooa widen YPICAL FULL CRIB # CROSS SECTION SEPTIC SYSTEM •I E TAS WALL .. 1tt_ L O T NUMBERS REFER TO "MAP OF VIS TA BLUFF" FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE s - • 7 \..:0,I, 15, 1968 AS FILE NO. 5060. PIE OF NE&"� co ANT.METS O4) 1 Ott Es g., ELE VA TIONS REFERENCED TO N.G. V.D. '9 ' c� * { r , ,•„i ' i j 4b.496$, '< '' i�,CONIC YORS, P.C. AREA=22,498 So? FT (631) 765-5020 FAX (637) 765-1797 , P.O. BOX 909 1 1230 TRAVELER STREET SOUTHOLD, N. Y. 11971 03-306 , ! i