HomeMy WebLinkAboutZeuits, Michael O''0OF S011r'
ELIZABETH A. NEVILLE '` l0 : Town Hall, 53095 Main Road
TOWN CLERK ; '1' J , P.O. Box 1179
ua Southold, New York 11971
REGISTRAR OF VITAL STATISTICS G
MARRIAGE OFFICER ,0 ,t Fax (631) 765-6145
l
RECORDS MANAGEMENT OFFICER . Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ -.. OU111 i, ,1 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. 3423 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : COURTNEY GALLAGHER
Address 1: P 0 BOX 2047
City St Zip GREENPORT NY 11944
Descripton of Proposed Construction or Alteration
-AS PER SURVEY
-FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT
Name Of Owner MICHAEL ZEUITS
Mailing Address 1 33 BEAR MTN. ROAD
City St Zip RINGWOOD NY 7456
Property Address 1 WEST LANE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 88.00 block 6 lot 18.500
Cross Street LITTLE PECONIC BAY ROAD
Building Permit Number Cross Reference:
Issue Date: 4/05/06 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE '` O Town Hall, 53095 Main Road
TOWN CLERK i irig * t P.O. Box 1179
REGISTRAR OF VITAL STATISTICS
ac I Southold, New York 11971
MARRIAGE OFFICER : :� . It Fax Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER `. 4 'rtV •I' Telephone(631) 765-1800
FREEDOM OF INFO IQ _0OFFICER _0 oUryt'� ..� southoldtown.northfork.net
1OFFICE OF THE TOWN CLERK
O.. t TOWN OF SOUTHOLD
'TO: Southold Town Building Department
FROM: Michelle L. Martocchia, Southold Town Clerk's Office
DATED: March 31, 2006
RE: Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 3578 for a Cesspool/Septic Tank
Construction/Alteration Permit submitted by:
Courtney Gallagher .
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
:00.. ..,arni._..."4
Comments:
// i 4/
Signature -' .444-r-')..
006
Date 1.
,,,,/iii,,,_
ELIZABETH A.NEVILLE 4' 4 Town Hall, 53095 Main Road
TOWN CLERK d1 P.O. Box 1179
REGISTRAR,OF VITAL STATISTICS
Southold, New York 11971
MARRIAGE OFFICER *
�I� Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER ``..### ill
Telephone (631) 765-1800
FREEDOM 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 x or Non-Residential @$25 Applicatio • ti7
Permit No ,/'
Applicant Name CovrMe C--1ct1 La.c
Applicant Mailing Address ?I!)l o- i GI ree h por`4 N ' ictAl9
Septic Tank ac or Cesspool
Brief Description of Proposed Construction or Alteration
pcs per s+.i.rvai,
Location of Proposed Construction/Alteration:
Owner of Property: M,eha`1 ?...co s
Owner Mailing Address:
3 3 Qeca_r Nl+-In. R,cl n cJ,w oo cl )i y 0 i 4S4
Owner Property Address: Wes r- Lwvx..`..
l7�wi-11�1c� JY 11971
Name and phone number of contact person Cour`}-n e y Gicti Ice ?€e<5.-y9 o O
Tax Map No: tonc., Section C)$a Block-b (o Lot Olg..5
Cross Street ROW eiPec..c„nic. 6(A7 12.r.1
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
`�� D3 f3)lulq
ignature of • i licant Date
Received by: (,C.M2K J
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si7;h:wii,, :;f _ ,,,t,,; 11,..,c; ,,f ,d‘rporvoc.s,tion:
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etozptt.
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ANY ALTERATION 0 R ADDITION TO MS SURVEY I S A VIOLATION le - ,
OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. '411-4V and or r,jiit i '•1:44Nii. ed from others.
EXCEPT AS PER SECTION 7209 - SUBDIVISION 2. ALL CattIFICATIONS
,Cap"
' ARE VALID FOR THIS MAP AND COPES THEYEOF ONLY F ,
SAD MAP OR COPES BEAR THE*PRESSED SEAL OF THE StRVEYOR
WHOSE .4 TIRE APPEARS HETEON. 11 ' -
ADDITIONALLY TO COMPLY WITH SND LAW TERM 'ALTERED BY ' , SUFFOLK COUNTY DEPARTMENTO:c1,4EAT:jcTTFII0SENRFVIOC:SA
PERMIT FOR APPROVAL OFcoTQ
.., -_
AL/ST BE USED BY ANY AND ALL SURVEYORS UTIUMG A COPY 42. 9.49 z. - .
, '
-
OF ANOTHER StRVEYOR'S MAP. TERMS suas •PISPECTED 'AND 4?0' ,„.
...
'BROUGHT - TO - DATE 'ARE NOT I N COMPLIANCE WITH THE LAW. _:.
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El), , ..t g om‘
1 , . ., DATE Ap REF N
3 241N0G_LE FAMILY RESIDENCI:..ONtr
----
ititic / 11/4'4-w'7.1* QP 11 ' d4.‹ ) _./fiebv/.1-') '1..
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1 am_familiar-4M the STANDARDS FOR APPROVAL • .:44)P 14' 'tato li,d '', ' APPROVED
AND CONSTRUCTION OF SUBSURFACE SEWAGE .
- ,
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES 4.4 ".. 6*p...311, 4'4'1: i -14k. ' • FIR MAXIMUM OF BEDROOMS
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and wN abide by the conditions set forth therein and on the • _ $:00. I
permit to construct. - r° - - 4,- ,
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44" EXPIRES THREE YEARS FROM DATE OF APPROVAL
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c)4 4u_, s ._ wo „,,, x .... _ ,.. ,,,. . FINISIED
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9.2 1000 6.4L. 4*opprow4 11.--1 I.46.1.
, LE SEPTIC TAW --r.-4
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NOTE' $ c--- ,-- _ •
corer of eloan soNIFT mit
IS , i
PIKPOSED SEWAGE DISPOSAL-SYSTEW 5 POOLS--
SUBSURFACE StWAGE DISPOSAL zof, ...1-• 1? \•-•4
SYSTEM DESIGN e Z.4,2,. ..- ..1-
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` -..s 3'DEEP WITH CLEAN SAND 3'COLLAR-109OfoL pooLCENTERat&-fiERM°L OF 3
RECAST SEPTIC TAW-BOTTOM or izaaira
.Poots TO B E 7 ABOVE GITOUND WATER
-;-\ - •
BY, JOSEPH FISCHETTI, P.E. i ,
- - ----___ e:-) \ '2. 41045.- A ' Ix ,A* -••, •-•.- /4C-- '
HOBART ROAD • SURVEY OF PROPERTY
SOUTHOLD
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(631) 765 ! 2954 .1. 7 • ,
/4N 1 ' 1 1'4 AT BAY VIEW
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TOWN OF SOUTHOLD
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TEST HOLE SUFFOLK COUNTY,_ N Y.
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SCALE 1" = 30'
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_ Feb 3, 2 oo5 ( fe-le-o)
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to coarse 14°,/ 24,200S(revlAivi s)
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sand -Sept. 8, 2005
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FLOOD ZONES FROM FIRM MAP -- ' C0169 G MAY 4, 1998 402. • .
ECONIC SURVE P
ELEVATIONS ARE REFERENCED . • .a (631) 765 - 5020 ,--'4'.°(my '•7 /797
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st
, , - . O. BOX 90z 1[
AREA = 18,097 sq. ft to tie lines •
''4- 1230 TRAVELER STREET
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SOUTHOLD, N.Y. 11971
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