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HomeMy WebLinkAboutBerwald, David e,„ ��',•#`*pF SOUr'foe ELIZABETH A.NEVILLE is '` O Town Hall, 53095 Main Road TOWN CLERK IF , P.O. Box 1179 N �r Southold, New York 11971 REGISTRAR OF VITAL STATISTICS G Q MARRIAGE OFFICER �� j. Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER �,_�l�C ���� Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER "UNTY, ���� 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. 3401 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : DAVID BERWALD Address 1: 1525 AQUAVIEW AVE City St Zip EAST MARION NY 11939 Descripton of Proposed Construction or Alteration -REPLACING EXISTING SYSTEM IN ACCORDANCE WITH SUFFOLK BOARD OF HEALTH PERMIT -FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT Name Of Owner DAVID BERWALD Mailing Address 1 1525 AQUAVIEW AVE City St Zip EAST MARION NY 11939 Property Address 1 SAME AS ABOVE City St Zip 0000 Tax Map No. section 22.00 block 2 lot 3.000 Cross Street STARS ROAD Building Permit Number Cross Reference: Issue Date: 1/05/06 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) ,00,%,%,.. Y3 �� * DEC 7 20(�Town So11r�e - ELIZABETH A.NEVILLE P '`� � Hall,53095 Main Road TOWN CLERK AlitP.O. Box 1179 REGISTRAR OF VITAL STATISTICSG ,i �uthg1d, New York 11971 MARRIAGE OFFICER .'Rc. 0 jtTC,m.,. ., Fac(631) 765-6145 RECORDS MANAGEMENT OFFICER li�' I� Telephone (631) 765-1800 C+ FREEDOM OF INFORMATION OFFICER OUN1O11.1° southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Michelle L. Martocchia, Southold Town Clerk's Office DATED: December 23, 2005 RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 3553 for a Cesspool/Septic Tank Construction/Alteration Permit submitted by: David Berwald Please review the application and location map and advise if this office may issue the permit. Please complete the form below and return it to me. Thank you. * * * * * * * * * * * * I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE DISAPPROVE 1 Comments: Signature fol-71 7/1.5" Dated / � %gOFFO(,� �,w CO, ELIZABETH A. NEVILLE Town Hall, 53095 Main Row TOWN CLERK • ; P.O. Box 1179 Z ` Southold, New York 11971 REGISTRAR.OF VITAL STATISTICS . MARRIAGE OFFICER 1 Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER =y'f 01 Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER - o'' * 1,,." 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. 5 3 Permit No. Applicant Name `i . t�2r� "J(c, Applicant Maiting Address 1 S PT"- Septic . wSeptic Tank jor Cesspool Brief Description of Proposed Construction rorrAlteration ' - f -'- �' 4 (1‘-1 �--- 0.. cc eY���.L �� • L. Sw l T� 'K1�•.-r t^�t.1. 1)-264-1"-4- Location live Location of Proposed Construction/Alteration: Owner of Property: Owner Mailing Address: Owner Property Address: "°\"`' Name and phone number of contact person '31 Y ' 2514- air Y43 ' Tax Map No:413$$1Section Block c 6 �-- Lot o 0 3 Ce.l.l, Cross Street ''�S NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES S Y WITH H : ' • 'TMENT APPROVAL (7.4 ' / /o '," Si: ?a of Applicant Date 'C i�x Received by:�n(,e �. � I cert©f ��issrrtgt nnsaeftittare)quycAdb destetzest be i Srrc SYSTEM pirroe�mfent Submit FINNEDAAP' mfD��mce With icRS s a AaeCompleed form — -er- CONC COM?as • SHALLOW DOW mV Pp{ I %y \ ,A4•DAA. iF te► - rmoo oo RALQN/ � 300 - AIV S IDE,_,- PrAAcKWALL J'MrI SEPARA PROM r---/-". 1, v " IMPERVIOUS sac a SEASONAL SID WATER AU�AD . 1FtlAL•B+VE��'LY 4,,-.'"7"000",,,.. scAsceAL /ei SWUM UARr SO7°o ANp /-"-- I Iph 9 aSL ,—'-- I;ne O 22' e• SURVEY OF ,----- N. 82 2%. __ PROPER T Y 5°'°S , - '�, AT EAST MARION _ , o TOWN OF SOUTHOLD SUFFOLK COUNTY, N Y. 7- �' o ,, 1000 - 22 - 2 - 30 i -- om Scale: 1"= 30' Aug. 22, 1997 O btu{f O — July 2, 2004_loddilionsl of i �' z JAM'10, 2005 l(evls/ons) �o t. f Ma 3� 2a5 (rev/sio7s> a , �' i c ��� - 25. M Y , 2005(ra✓inion /' /-' + i� SUFFCOUNTY DEPARTMENT Gr" a rm HEALTH szriVIC�:.a 15 . �z PERMIT FOR APPROVAL OF CONSTRUCTION FOR A u � ? �o bluff Z SINGLE FAMILY RESIDENCE p— i �o..-. 104 o f • ' \ ,� . 1i • w¢Il ,g• /U—/1'� /�D Z : Z °P 15 C3 O DATE H.J. REF. P>0' G�:D'^(��—.�li CSS til p ;.A APPROV D ../...-- ,, moi ,� � j N ' s Z (� Fon MA f•UM Or f BED 1:3 rr y ,,, Q,,g� EXPIRES THREE YEARS FROM DATE • APPROVAL _1 ft00A in -,'� ;a- w' f i "w felt 1°dyer Oa • tail 2 '.Vb 414 ifLAY R1 0 1 .i.ory ' / i �N_ fir. �� �� EXCAVATION N 1�!•PE "isQN REQUIRED • �.e SAWN -RY SYSTEM . R1 BY HEALTH ►e PARTMENT O�We�t'nND"i* s,, - 110 s K 1 73 ' �, 11 ' TIO TpN S • I► tJ� �� /oc , .VE ole� �� f. ��m /00 j` R Os '� m .73 i cel,------Z \ '.r. H 4 REµ0VE owgtl NT% kAl � N 4 N COL/R LINES ARE ' CO REFERENCED TO THE FIVE �1 N r 5a 9' EASPS RN TOWNS TOPOGRAPHIC C 7Dik ....A 00,./.0 \ 9�r N U1 srj0j0 u o00 TEST HOLE fit► \\._ \` q' 1 4/27/04 • , — 6' a- \o et 3 • 0 } ��omon.?Sid. 100.00' vor - --- r DANK BROWN LOAM AL o E/3I PREPARED FOR ++ `l• PATTY BERWALDe0 AVENUE w 0 :: .esti e i \ mon. '( r 1 kra. 6 BROWN AND PALE RON7•I. .TY SAID 511/ \ S. `� 3 C 30 `Y - ` ' • - - PD PALe ROMIV FOIE TO MEDIUM SAND Sp i e� 14°°4' \ C,p loo f k' o� AREAOlt ,01° ,1 • . ifb0c 5* 'O r2Q'Qf. 14,633sgft. ( totie line ) 61 cP' ANY AL TERA TION OR ADDITION TO THIS SURVEY IS A VIOLATION --.......',.j;--- OF � SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW EXCEPT AS PER SECT/ON 7209-SUBDIVISION 2. ALL CERTIFICATIONS �j�y) ��p� HEREON ARE VALID FOR THIS MAP AND COPES THEREOF ONLY/F /'i/Q�.1 a SAID MAP OR COPES BEAR THE IMPRESSED SEAL OF'THE SURVEYOR ( �� 04i6 : SIO WHOSESIGNATURE APPEARS REo P CONIC SURVEYORS, �lw ADDITIONALLY TO COMPLY WITH SAIDD LAW THE TERM 'ALTERED BY' 15161 765 - 5020 CJI� MUST BE USED BY ANY AND ALL SURVEYORS UTILIZWG A COPY P. 0. BOX 909 OF ANOTHER SURVEYOR'S 4P TERMS SUCH AS "INSPECTED'AND 1230 TRAVELER STREET A WROUGHT-TO-DATE'ARE NOT IN COMPLIANCE WITH THE LAW. SOUTHOLD, N.Y. 11971 . 47 — 047