HomeMy WebLinkAboutBennett, Debra ���
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ELIZABETH A.NEVILLE ' �� l0 : Town Hall, 53095 Main Road
TOWN CLERK tl 41 ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ; G ,�` Southold, New York 11971
MARRIAGE OFFICER 4 . ,1 Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER lTelephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER `=T OW,\‘' •619�' 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. 3418 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : SCOTT EDGETT
Address 1: 330 E. LEGION AVE
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
-NEW HOME
FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT
Name Of Owner DEBRA BENNETT
Mailing Address 1 20 LION HEAD ROCK ROAD
City St Zip EAST HAMPTON NY 11952
Property Address 1 570 MAPLE LANE
City St Zip MATTITUCK NY 11952
Tax Map No. section 107.00 block 3 lot 3.100
Cross Street GRAND AVE
Building Permit Number Cross Reference:
Issue Date: 4/05/06 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
�'� OF SOUr• y-
ELIZABETH A.NEVILLE / '`� l4 Town Hall, 53095 Main Road
TOWN CLERK 1 * Ali' t P.O. Box 1179
4, N % Southold,New York 11971
REGISTRAR,OF VITAL STATISTICS ; G
MARRIAGE OFFICER i�c► �O �1 Fax(631) 765-6145
RECORDS MANAGEMENT'OFFICER `._�l�C ,,,,t�VV � ,�', Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER V(J I I �►�� southoldtown.northfork.net
'''
kArR 7 OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: March 15, 2006
Transmitted herewith is a copy of application No. 3573 for a Cesspool/Septic Tank Construction
Permit submitted by:
Scott Edgett
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: �.....P J =am►r�� t �-�L
7.),.. ...„:„",.
Signature f"
6
Dated
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��� $ufFO,(,�c;
ELIZABETH A.NEVILLE „I oO ` Town
Hall,53095 Main Road
TOWN CLERK P.O. Box 1179
•
REGISTRAR OF VITAL STATISTICS Southold,New York 11971
MARRIAGE OFFICER1 Fax(831) 765-6145
-„=
RECORDS MANAGEMENT OFFICER y�� A� o.° Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER 1 * �' ,.I 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 Nc 3
Permit No. _ C /?
Applicant Name C0+
\
Applicant Mailing Address 3 3C) C� r��j i rJ 1'C a V� L
Septic Tank p or Cesspool ,_
Brief Description of Proposed Construction or Alteration N E+h' 1 v-k
Location of Proposed Construction/Alteration: M eco tv\� �
Owner of Property: ebrA 3c1, CA+.
Owner Mailing Address: 10 L,t1v N 1'leovi Zo c 1L A4 h ni
tiY 1137
Owner Property Address: 5-..7D "A() E La, GkA ik }i,4-L.L 1L,. t'-U _ k(5 5 2--
Name and phone number of contact person Sc aat" E ci (a 3( 2--ssS Ltc 2.8
10� 03
Tax Map No: Section 11,'&49. Block 1-t'1 Lot ' - 7.
Cross Street C1((A Pi d- Or%)
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEYA, EALTH DEPARTMENT APPROVAL
dWIt-' H 3/1 cL4
Signature of Applicant Date
Received by: it- .
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v
DefoeriOVA Foy'tww• 1
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SURVEY OF PROPERTY `
SITUATED AT — 7,:es.s.:,
MATTITUCK , . '.TOWN OF SOUTHOLD ,- .SUFFOLK COUNTY, NEW YORK �,'
S.C. TAX No. 1000-107-03-3.1 tel
SCALE 1"m50'
/14.t:'§1
/ �
3p000T0OBER 15,15p119p9�8ry %.•
MALI ZIS Tt ':« ADDED PIAT PIA �!" `v�4 4. 1.
FEBRUARY14,2005 A PV0.I;FeRDIED PC PROPOSED MUSE Cju. t // • *
JUNE 1,JANUARY 26, 2006 REVISED PROPOSED HOUSE .�+ p G // 4�� 1'
AREA . 60,796.63 q.f1. \1i�z 1h1�
(10 TE UNE)1.65 0..
C' ' ;
A ELEVATIONS ARE REFERENCED TO N.0.V.D. 1929 DATUM 1. 22��$$++ A ;
EX6T1N4 BEVATIONS ARE SHOWN THUS: 76 r;
EXISTING CONTOUR LINES ARE SHOWN THUS: rN op?
2. FLOOD ZONE DIiORMAT10N TAKEN FROM: it*
FLOOD RISURANCE RATE MAP No. 36103C0143 0 �' "p'4A
ZONE AE: SASE FLOOD ELEVATIONS DETERMINED to
ZONE X': AREAS OF 500-YEAR FLOOD;AREAS OF 100-YEAR FLOOD WITH AVERAGE
DEPTH OF LESS THAN 1 FOOT OR WTH DRAINAGE AREAS LESS THAN 1 SQUARE /
3
MILE;AND AREAS PROTECTED BY LEVEES FROM 100-YEAR FLOOD. *I
ZONE 0: AREAS DETERMINED TO BE OUTSIDE 600-YEAR FLOODPLAIN. / A 1:_:
3. MDRMUM SEPTIC TANK CAPACITIES FOR A 1 TO 4 BEDROOM HOUSE IS 1.000 GALLONS. i
I TANK; 6' LONG. 4'-3" WIDE, 5'-7" DEEP _.
4. MINNIUM LEACHIND SYSTEM FOR A 1 TO 4 BEDROOM HOUSE IS 300 ea ft SIDEWALL AREA. \�� '
I POOL,; 12' DEEP, 6' dlo. pyT�qy 1y�.1m p�yw 7 y�yr pp ggyw ;
PROPOSED EXPANSION POOL ` EXCAVATION 1'Aed! �u ` �' '" 6::e C: N`e®
j PROPOSED LEACHeNo 1'001 FOR
ta,74 y6 a�yx K6"9c--�I t[ �VKa �.:
EM PROPOSED SEPTIC TANK 9 o 1 e AyN l Y AP6' S 8 E M
5. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD - i^"ti -
OBS[RVATIOWS AND/OR DATA OBTAINED FROM OTHERS. M 6 y
6. S.C.D.H.S. REFERENCE No. R10-99-0021 Y ii ;fes a m � ��� r� � �O
TEST HOLE DATA - LP
(TEST HOLE DUG BY McDONALD GEOSCIENCE ON DECEMBER 12, 199: N
03.
EL 323: SUFFOLK COUNTY DEPARTMENT OF HEAL ' RVICES
s'./ /-:.. RK DABROWN SANDY LOAM OL .4
.//1 BROWN LOAMY SAND SM PERMIT Fifa: 1'twOVAL OF CONSTRUCTI i N FOR A /
,,,,.,.4,A'..4', 2.5
SING
FAMILY RESIDENCE ONLY
64',..,'...R DATE �+• _.__ •
wrb
�' APPROVED
T,r ":`'1 FOR vIAXINIUM OF 41 BEDROOMS
...0,.t,;.;.:::,,...,;ttfPALE BROWN FINE TO MEDIUM SAND SP:. '
' ,ti•,r G' EXPIRES THREE YE/RS FROM DATE OF APPROV 1 ��+
+ , on;: c,,,ti w r• •
Lir'i tl 19
LY'`biN �,�Ie,� ry eS G 6
17' CERTIFIED TO:
SCOTT EDGETT
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"T1 u 111.1 IRWJTH0RI D ALTERATION OR ADDITION PREPARED IN •. - /HEMINIMUM
rri TO THIS SURVEY IS A VIOLATOR OF STA163AA03 7fiLF ae.4t;• TABLISHED
CO SECTIONT>EDFTHE NEW YORK STATE
EDUCATION
AND Joseph A. Ingegno
TRLE t
DOPES OF THIS SURVEY MAP NOT BEARING ♦ �,.« 1Y! <. 'Land
----I, THE LANG AUD T DR'S INKED 9E'AL DR ��{ 1�.---'4,' _ i..ii n d S t.l l"1/e y o r i
TO Rose TR COQ BE CONSIDERED
N 1 #"$ � "I •.„. 1.
Q i� ONLY SHALL RUN
P WHOMCERTIFICATIONS INDICATED N Y .4 �.
IS PREPARE*. AND ON HIS BEHALF TO THECD" Fuii
ntLE COMPANY. AGENCY AND 'vii'
Title Surveys - Subdivisions - Site Plans - Construction Layout 11
LENDING NISTRIJTIONO�NOMA.AND 1
i�
TO
ON. TIOASSIGNEES NS{ARE LENDINGF THE TRANSFERABLE. ,, ``I''`- 1
PHONE (631)727-2090 Fox {839)727-1727 _
THE EXISTENCE OF RIGHT OF WAYS �� q• OFFICES LOCATED AT AWNS ADDRESS
AND/OR EASEMENTS OF RECORD, K
ANY. NOT MOW ARE NOT GUARANTEED. -WS`CO . Lic. No, 49848 322 R0AN0KE AVENUE P.O. 8MK 1931
' E $ !MENNEN), Now York 11901 Riverhead, Neu York 11901-0985
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