HomeMy WebLinkAboutHaase, Robert (2) .0,'%*pf S004,
ELIZABETH A. NEVILLE e �� 49
l4 Town Hall, 53095 Main Road
TOWN CLERK 41P.O. Box 1179
REGISTRAR,OF VITAL STATISTICS
ce, Southold, New York 11971
MARRIAGE OFFICER e ��, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER :l ii" Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER 'yCOUN 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. 3447 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : ROBERT HAASE
Address 1: P.O. BOX 303
City St Zip ORIENT NY 11939
Descripton of Proposed Construction or Alteration
-NEW HOME
-FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT
Name Of Owner ROBERT HAASE
Mailing Address 1 P.O. BOX 303
City St Zip ORIENT NY 11939
Property Address 1 1695 GREENWAY EAST
City St Zip ORIENT NY 11939
Tax Map No. section 15.00 block 1 lot 11.000
Cross Street
Building Permit Number Cross Reference:
Issue Date: 6/08/06 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
��• soot
ELIZABETH A.NEVILLE • l0 Town Hall, 53095 Main Road
TOWN CLERK 4 4 P.O. Box 1179
N , Southold, New York 11971
REGISTRAR OF VITAL STATISTICS G Q c
MARRIAGE OFFICER 4 �O �1 Fax(631) 765 6145
RECORDS MANAGEMENT OFFICER .Oli,'C�UN� ���� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER + 0 southoldtown.northfork.net
OFFICE OF THE TOWN CLERK 41114
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 6, 2006
Transmitted herewith is a copy of application No. 3604 for a Cesspool/Septic Tank Construction
Permit submitted by:
Robert Haase
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: V"' j � C
_#.24e,i.,,e.r...i...._)
Signature
40V0 ‘7s .
Dated
'� OSOFFO�,�co
ELIZABETH A.NEVILLE ,,�4# , ; .. - NTown Hall,53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS rbe � Southold, New York 11971
MARRIAGE OFFICER �?, �1� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER =### �� i� Telephone(631) 765-1800
'1 4 �.
FREEDOM OF INFORMATION OFFICER = ,isoutholdtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD / �
SOUTHOLD WASTEWATER DISTRICT -3-11-7
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$10 or Non-Residential @$25 Application No. 3(O
Permit No.
Applicant Name Oa `f /(oiS €_
Applicant Mailing Address .0 . PJ()? 303
p 2�` �- ✓U��-/ (leis`)
Septic Tank a -or Cesspool
Brief Description of Proposed Construction or Alteration 1- ' -e
Location of Proposed Construction/Alteration:
Owner of Property: (a ber4 c- -
Owner Mailing Address: o.8D- �o 5
(Z` `, � yti. 11Q s "7
Owner Property Address: (6 1 G„�`,�J ,4� E4 5 0
Name and phone number of contact person Pobe--r+ tkq Cc- G 3 132 3 Y ) '
Tax Map No: q73$F7Section p/S Block oo / _ Lot 6 / /
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
a%6SI
Signature of Applicant Date
Received by: l/� L
. 3),-; - ),1/41, _. .
LOT NUMBERS REFER TO " MAP OF GREEN ACRES AT
ORIENT" FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE SUR TVEY OF PROPERTY
ON APRIL 13, 1962 AS FILE NO. 3540.
AT ORIENT
TOWN OF SOUTHOLD
N SUFFOLK COUNTY, N. Y.
1000-15-01-11 -
' SCALE: 1'=30' t
....34„
OyE JUNE 16, 2005
01 Dec. 21, 2005 (lol coverage)
SUFFOLK COUNTY DEPARTMENT OF 114401.°-.:
I
SERVICES
i
PERM T FOR APPROVAL OF CO STRt��' ON FORA
6111IGLE FAMILY RESIDENCE OWLX
DATE I 0 1 sl t 1 Hilia.NO. - iL {
APPROVED w Flan Approved 1'14 g ' ��
FOR HIAXIMUM OF...4_BEDROOMS �s I T 5 2007
C. . EXPIRES THREE YEARS FROM DATE OF APPROVAL
well /5d
cxwe/lln , j!:
Ya.CQ� r` CPS /5o,4 •
LOT 44 well in {ren
Al( , 3
(Inn-r Y
l',-ast my
81I"
ff�O.vt 0 D ezar+ftyocs z-4 • j',
8�3''900, /✓,arm,
N89'32'110"E ' 132.00' e//4.0
----- • t e11•¢•S
O prop
N` O
,SOc'' 13 d w e/lens
N /,, r-op c�r1vEwa`y n'1 CO we11 t.
a cit , ,,,
si____
420.
„ ,i,
40
l
LOT 45 N a
LOT 36 o y
1 zo' F „ - , p
R
V � b I 10 ,, Q .
N
,11 o w � � � �
.i ,ti) t ti I 4w R b ..� � � Baca-cd'
1 .
co irl \---L
2c 6\ �'
Ul
w +, y
¢9' o
0
w i I. es/W.2
tLII.z '
/18
. 134.00'
dell . al 12•>
------- 58371'50"W
\\ va.ca-
LOT --
�
CERTIFIED TO:
HOUSE 8 GARAGE = 3073sq.11. ROBERT HAASE
DECK 7/5 salt DONNA HAASE lie hi a`
=
POOL800 salt NORTH FORK BANK
4588 sq.11. FIDELITY NATIONAL TITLE INSURANCE CO, " - ea.�
4588/21111 = 21. 7% L 0 T CO VERA GE OF NEW YORK ��P�E ` NF Y
\AT'MEI'?
• =PIPE �0 1 c "r
AREA=21,111 ' SQ. FT. I i'I ---N. .* LIC,` f \"4 1; ,F
ANY ALTERATION OR ADDITION TO THIS SURVEY IS A Vl0 ' ---------- / i ;•.al
,� PECONIC URVEYORS, P.
OF SECTION 72090F THE NEW.YORK STA7E EDUCATION L W f r " (' r -+�,�-1.�.
EXCEPT AS PER SEC770N 7209-SUBDIVISION 2. ALL CER FICA. TIONS ' '-• `' ' (631) 765-5020 FAX �. - 7
I
HEREON ARE VALID FOR THIS MAP AND COPIES THEREO ;:ONLY IF .; P.O. BOX 909 S, 49C1�
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE'SURVEYQ 5 ,;,).3y j 1 1230 TRAVELER STREET '4' ... ,,, .
WHOSE SIGNATURE APPEARS HEREON. IVV�M (41 ..r.,1 1 SOUTHOl�7, N. Y. 11971 -
c ., • • T H
P. l_ OLD