HomeMy WebLinkAboutSullivan, Bob SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3471 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MARK J. SHWARTZ - ARCHITECT
Address 1: P.O. BOX 933
City St Zip CUTCHOGUE NY 11935
Descripton of Proposed Construction or Alteration
-FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT
-MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINDS, PROPERTY
LINES, AND WATER BODIES*EXCAVATION INSPECTION REQUIRED*
Name Of Owner BOB AND JACKIE SULLIVAN
Mailing Address 1 118 HAMPTON ROAD
City St Zip GARDEN CITY NY 11530
Property Address 1 2175 NASSUA POINT ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 104.00 block 13 lot 8.000
Cross Street
Building Permit Number Cross Reference:
Issue Date: 9/18/06 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
oi
ELIZABETH A.NEVILLE ,�0 '` Town Hall, 53095 Main Road
TOWN CLERK ` 41 411 ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ; G ,, Southold, New York 11971
MARRIAGE OFFICER 4 �O r Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER `��1�'C ``^�,'l�� Telephone (631) 765-1800
FREEDOM OF INFORMATION-OFFICER �U , eo southoldtown.northfork.net
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1 OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
ell`-T$— Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: September 8, 2006
Transmitted herewith is a copy of application No. 3626 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Mark Schwartz for Sullivan
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: Maintain required setbacks from adjacent wells, buildings, property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED. ��.:4
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riice44 ,-Airee;.,,Ar .di r„
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Signature
0 ,/,/
Dated
Town Hall, 53095 Main Road
. ,
ELIZABETH A.NEVILLE - /� �: - -'
TOWN CLERK 4 • P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold,New York 11971
MARRIAGE OFFICERtOy�f� p�`
1� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER �� �� Telephone(631)765-1800
FREEDOM OF INFORMATION OFFICER '� t �`,.�' southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL of SEPTT KK
Residential @$10 or Non-Residential @$25_ Applicatio t •. to
Permit Ns
Applicant Name M. . \ 1c. t c\n.\-e c.\-.1
Applicant Mailing Address ?•O. CSatic 9 3 31�...6Nov. I N 111 3S
Septic Tank 1C or Cesspool
Brief Description of Proposed Construction or Alteration 1$o $4., S e ep+c w. ;-�•
(1) S ,Q- x lo' Aeea tpr‘, ?DAs Fe Q,6.s4..i� 1►,16u1e �t-V% a4e1,4.4151‘
Location of Proposed Construction/Alteration:
Owner of Property: $o\5 t Q
Owner Mailing Address: W8 W►aMQ ton C oo.d
Go.cckec C..�..j N`/ 1t53O
Owner Property Address: 2 v75 Ne,.sso.v ?ttnnt'., rd•
ue N si
Name and phone number of contact person 7 3 —41 SS--
Tax
STax Map No: toot) Section t p A- Block t 3 Lot S
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVE Hj 1 ; ►EPARTMENT • 'PROVAL
as/o6
Signature of Applicant Da
Received by: `� '�
REVISIONS:
\e, . 02. 0' DARN BROWN SANDY LOAM 01.
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....**** *** S'--.V BROWN SILTY SAND NI 2 V\ e/
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Ni ‘..1 PLAE BROWN FDC TO COARSE SRC SW
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\ IT PALINE BROWN PDC TO MEDIUM SAND SP
WATER PALE BROWN FDIE TO MEDIUM SAND SP ,...Ca
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COMMENTS:
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/.. \ . WATER ENCOUNTERED ILO'BELOW SWAIM
TEST HOLE DATA .q.,
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DATA SUPPLIED BY:McDONALD GEOSCIENCE LO • (41 "
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BOX 1000,SOUTHOLD,NY 1171 (631)T65-3677 44 ' 'I
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.6, I 11 SCTM#1000-104-13-8 z
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WOOD W LOT COVERAGE:14.8%
,RY oax 17.4
WOOD WITH \I
4E BULK- PROPERTY:30824 SQ.FT.
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( C 1 UNSelt I I- EXISTING HOUSE:2847 SQ.FT. .I 0
0n1 =in HOUSE DECK&COVERED PORCH PORCH:506 SQ.FT. <
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HOUSE&GARAGE:1032 SQ.FT. 173 .0
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I SHEDS:176 SQ.FT. LLJ
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TIMER WALL
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SUFFOLK COUNTY DEPARTMENT OF HL111 SERVICES CD 1
PERMIT FOR APPROVAL OF CONSTROCTION FOR (I)A = g
SINGLE FAMI RESIDEr AND 0 ce
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DATES'—i1-e+GH.S.REF. . 0.
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TOTAL MAXIMU :EDROOMS Se- lk II. • . ;k- p ; ,
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EXPIRES THREfe'lEARS FROM DAT t 9F:?CkPPROVAL 1 it t i. 1 k * 0 t
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.. PIT .127 4.,ft- 44.1 Kr.'02,2006
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