Loading...
HomeMy WebLinkAboutCollins, Kathleen , � �oF So�r 3 y�� �.. � yo � ELIZABETH A. NEVILLE '`� l0 Town Hall, 53095 Main Road TOWN CLERK � � P.O. Box 1179 REGISTRAR OF VITAL STATISTICS �' � Southold, New York 11971 MARRIAGE OFFICER �'�c` � �� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER �IiYCOU�'�� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER 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 X Cesspool PERMIT ISSUED TO: Name : DONALD FIELER Address l: P O BOX 1692 City St Zip MATITTUCK NY 11952 Descripton of Proposed Construction or Alteration -NEW DWELLING Name Of Owner KATHLEEN COLLINS ------------------------------ Mailing Address 1 540 E. 20TH STREET - MG ------------------------------ ------------------------------ City St Zip NEW YORK NY 10009 -------------------- -- ---------- Property Address 1 PECONIC BAY BLVD ------------------------------ ------------------------------ City St Zip LAUREL NY 11948 -------------------- -- ---------- Tax Map No. section 126.00 block 10 lot 21.000 ------ --- ------ Cross Street BRAY AVE ------------------------------ Building Permit Number Cross Reference: ---------------------------------- Issue Date: 2/Ol/06 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) �o��pF SOUT�,oI ELIZABETH A. NEVILLE 4 Town Hall, 53095 Main Road TOWN CLERK � � P.O. Box 1179 REGISTRAR OF VITAL STATISTICS U' � Southold, New York 11971 MARRIAGE OFFICER � � �� F�(631) 765-6145 RECOR.DS MANAGEMENT OFFICER �IyCOU'M'�� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER ir i� southoldtown.northfork.net _ `.. � �' � �t OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD �AN - 4 a°� 1 � F M' �� TO� �- �� S���a�o�d�Y'��iilding Department ����s� FRO : Linda J. Cooper, Southold Town Clerk's Office DATED: Transmitted herewith is a copy of application No. 3554 far a Cesspool/Septic Tank Construction or Alteration Permit submitted by: ' Donald Feiler 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: ' � �o,�..+t�.�� ignature Da ed , : � O�g11fF0�,�c . O ELIZEIBETH A.NEVII,LE �` �`Z` � Town Hall, 53095 Main Road . TOWN CLER,K � � - '. P.O. Box 1179 _ REGISTRAR OF VITAL STATISTICS x Southold, New York 11971 MARRIA4E OFFICER Oy � ��` Fax (631) 765-6146 RECORDS MANAGEMENT OFFICER O Tele hone (631) 765-1800 FftEEDOM OF INFORMATION OFFICER ��'� � �� 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. � Permit No. O� Applicant Name �bNO`� �,� Applicant Mailing Address �'�� l,(��1 '!i ► �/��,�i�i Septic Tank � or Cesspool N� Brief Description of Proposed Construction or Alteration DV�►I�Cs Location of Proposed Construction/Alteration: Owner of Property: �F`��N �I�l� t (`1 cJ Owner Mailing Address: ��� � � � �� �1M1�. N� N " � a�o 9 Owner Property Address: �FCoI� �C �.�'a'r ��� L�v �-EL� Name and phone number of contact person ���D �—1 t.t1'l_ �-�8'�'�'S� Tax Map No: Section f�r Block �' Lot �oDcti – t Z G to Zt Cross Street �,R a T����,. NOTE: LOCATION MAP MUST BE SUBNIITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES S Y WITH AEALTH EPARTME APPROVAL � � � � 45 gnature o lic t Date Received by: r \'. .:_.."' '_ ' SUiZ�Y� -'?�����`�'��'�i�TY ' _ 51TU�T�; L�t�� N TOINN: �O�TH62LD SU��OL���G�l�ITY, NY ,� � `: W ___ , E SURVEYED 09-�-�1005 AMENDED II-OQ- 005 SUFFOLK GOUNTY TAX # � °�� � -.. 1000-126-10-21 �- S�1"rC��,�`:d?��I+i1""Y I3��R�'c.'��vl�I�I'�`�>'�'•:�:I'.;�.�'�2t��;F<5?'tf:.';>:; � � gs+S�t:vYSY �� .�SK'��1'{Y�i'�.:'SBG�Ia.�l�a:.3�.�s�`k..T'�A 1lG.YlG s�fT.'1�S t � �a��: ������^�.����t� �:W:����r��.� , R�� DA'TE / /9 �' ����.�f�. ►��'4�.�� I sria�mp�on N�s� � F'ide it�y Na�a115de Insoranoe APPRO�� - Co�peny o�Naw Ya9c � F�'+�i�v."s�C�T���i3�:,�F�3EDRC}DIyfS Oti� �`�' f �t�� DO SJQ'IRES THRE�'i��,I'���.dl I1�'�`E a�APPROVAL ot�� _ O�' �� �� � qn/ Q ��\���` �� Lo��q, � � ��J�� J0�' 0.' �'Y O/�� 0'���'� ,� ry o. �f p Se�j�^ � � � 'l�' F, �--� � d �'' '� I �a .' \y� ` �' `�"e G�'' � ,,�i � r, � .<�l oQ�ya`'�' �` �b�' ��'' '�9 9�^i � � � ,`�� ��� �. �` ��r- �y �,� ryj , • . � o ,. I o� � 'q, �� ,�� i � �� . , �f ti e� ,� � ' � � , �q., ,� � � �. `� c �4 . � . �, � �\ �'�� '��� � . � � �qq, � \� ,� �.^� r.�Y. . s . \ `� / \r,♦`\��t `L ' % tT' Q � �h �'/ c��� Q, �c�" ' !� �r - 0�' . p�`' ♦ s. vi O ;� � � � � �� � T��'> . (��' � . . . � • 0 �,"�• � O , •�;.�(�'�' �`� ) ��O ' Gl� '. ;' ''Z��« �� , '�p, *� �p� ��.`�. 5'r .h. �,j �\ , (y� �! � �� � � � `C�O�" � � `� 'rX" \� \ \� � n �(� \ ��9'y,\ �rn c ;� r� � E � ; \:J �� "�� � �y � \� � x� Y \ �� \ i \ \ h � � � `\\ �` G4� \��RS��\ � � \ ` \ / �Io� , . �,•�`a�� • • �"g . � , �-}�� �c �` � � • • ` �•�° /C� �� . � V yQj ���J ���. �� `�\ �� '�/ k CJ� � � 'n J � � � � � �o b�� \� �C�"4�' `, �: �,�� i� , `\� ;O. ♦ � �f � � /` i'' � � �/ ` O �/ �,�: g�� ' �' �.\ OOD�� /j _ . / ' G � �\ � ���i � A e�`V 6��,ei, y� � \`� i v �` O �j,''7 ���p � �o ���`� . �:, ,1 '`' q�,9 r�'L �� �i Q�� CG � Lo� p��' '�' v' o ,� � �� 0 � � cchG��^ . ��O �� ,��� � io y .p ���/,,` / E,� G; � ��' p, �n� f Q° / ;, . �`�/° �'� G� � �/ 7 ��'e+ /e,�j /• i` TEST HOLE � ` � �� McDONP.LD %' �' ��� ����,c,�� GEOSGIENGE ��ti° o,p� �j� � �,�� J� ' �-/ J`�� �,�� �. � Q � BROWN Sf�NDY / o �{ �� LOAM OL �.�" � 1' PALE BROWi�I 3, SANDY SILT ML PALE BROWN FINE SAND 5P 17' NO WATER ENGOUNTERED � pF NE� ; �'t C. E C�,� �p`�,,,� °"� "'�+��► ,�,,,,,.,.,_��,,,,,c,<.�.,,w.titi,��,,,o�„��, ,,�,� inW l. �'v)�i I4 '.1 4v41 wv�•yaxr�yeal. ��{'r„ �....� � m tw��m i w�i .�.+w>-ar�,a oi m� � K Y 1� Aala EM.ntk��L•ar.' ��5: * �: � i �. .. I+. ,`ir .* cH�ha����� 1 xi9+K�1 nl IFM r..ry ■ MONUMENT �OUND r� ��A � r ���•.�,����„~ :N y. ' I.4 1 4 s.1 la.Ix+vnl4f t.w � aV4!i . A ��\ ^ ' 'Ik tkw Y ' t. .zae�ak�n�ly tluit�1�1:. �� -� b ' x��kvt.i ndt�rylvs n.- i 1�� . IN�NF tk 1 1 id'urv.�yn S,�IeA ELE�/f�TIONS RE�ERENGE SUFPOLK GOUNTY TOPO MAPS SF'p� SV�` ��' � A M p �t4„„'q��4�µ,I L 1 'y �1 -Id iNiw.,..lrill�w�[n��� !��flu,.� xx�law�J�n Itx..wrv<�'e.FrCyav'cv.Y, rKt on lun 1»Ir�ll tn 11.�lif4>4avryxy�y ynve�rm�a�- ' lulr��iv.yarr]I..n�1Y]'vralifWkr�lkilr�llr!�eav�.,rul � ��tIM r.rr.4]�^..-,aA 1�..Lv.4���Y�ifNiwv �ti•r�tOrati- AREA = 50 p00 S.F. or 1.14�f A�cres ,:....,�,.>�'�...5,.n,...,�..�,....,��...,,.;.,,���:... TIE DISTf�NGE FROM SU��OLK GOUNTY TP�X MAP JOHN C. EHLERS LAND SURVEYOR 6 BAST MAIN STREET N.Y.S.LIC.NO.50202 GR�PHIG SGALE I"= 40' RIVERHEAD,N.Y. 114a1 369-8288 Fax 369-8287 REF.\�,Server\c�pms�05�05-311.pro � .;