HomeMy WebLinkAboutFox, Robert (2) SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3475 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : ROBERT E. FOX
Address 1: 5 WIGWAM PATH
City St Zip BABYLON NY 11702
Descripton of Proposed Construction or Alteration
-NEW CONSTRUCTION, SINGLE FAMILY DWELLING
-FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT
Name Of Owner ROBERT E. FOX
Mailing Address 1 5 WIGWAM PATH
City St Zip BABYLON NY 11702
Property Address 1 980 EVERGREEN DRIVE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 102.00 block 1 lot 413
Cross Street DEPOT LANE
Building Permit Number Cross Reference:
Issue Date: 10/25/06 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
„ ,o�oF so�ryol \
ELIZABETH A.NEVILLE o° 4 ”`O Town Hall, 53095 Main Road
TOWN CLERK 4[ lg • P.O. Box 1179
REGISTRAR OF VITAL STATISTICS � G Q 1� Southold, New York 11971
MARRIAGE OFFICER Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER l�, •0 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
01°I
OFFICE OF THE TOWN CLERK
SrP 2 1 TOWN OF SOUTHOLD
oTd o Building Department
artment
FROM: Lynda M Bohn, Southold Town Clerk's Office
DATED: September 28, 2006
Transmitted herewith is a copy of application No. 3630 for a Cesspool/Septic Tank Construction
Permit submitted by:
Robert E Fox
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.
Lynda M Bohn
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE _
-
ec
Comments: �- �
Signature
/00A4
Dated
41/0 0
,�� ,°��gOFFO fr'; `
ELIZABETH A.NEVILLE "4� c'G Town Hall, 53095 Main Road
TOWN CLERK C 1 * f P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ` 4 � Southold, New York 11971
MARRIAGE OFFICER :10 ' 1� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER 4#0* 0. 01 Telephone (631)765-1800
FREEDOM OF INFORMATION OFFICER =_RI * 1'/i southoldtown.northfork.net
OFFICE OF THE TOWN CLERK M
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$10" or Non-Residential @$25 Application ,o. _=�'
Permit No. `_��
r
Applicant Name -C. E FOX
Applicant Mailing Address B N( A M_P
'mayIaN1 ty 1 [7c2.
Septic Tank ✓ or Cesspool
Brief Description of oposed Construction or Alteration Nev.) L_ U
SiN &le (y• `- ) e_1(_c N
cy
Location of Proposed Co i truction/Alteration:
Owner of Property: , a' ° ta,_
Owner Mailing Address: ' ULit(akf,A-N\ 'P AT (.4
l' Ailit.i N
Owner Property Address: 980 ofee Cet. IF-_,
*,
Name and phone number of contact person c..eC ('31_374-- (90
Tax Ma No: [(C)0 Section" "(C) Block 0 ( Lot 4. [3
Cross Street i- L-A---N -
NOTE:
A---N
NOTE: LOCATION MAP MUST B ' : :MITTED WITH APPLI P• I . NEW
CONSTRUCTION REQUIRES SUR ' ' H HEALTH DEPART i" :i'PR VAL
_ 9 a St.
Signature of Applicant Date
Received by:
1.
.6� 'II
‹� SURVEY OF
��O�' LOT 13
SUBDIVISION MAP OF
4. THE WOODS AT CUTCHOGUE ,
FILE No. 8717 FILED MARCH 23, 1989
SITUATED AT
4c" CUTCHOGUE
:, TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-102-01 -4.13
SCALE 1"=50'
/V
JULY 10, 2006
C3 1
_
AREA = 48,542.91 sq. ft.
1.114 ac. y I
tt, .
3 rn X J -7"---
'
e'e, O NOTES: cs—n
ti0 1. ELEVATIONS ARE REFERENCED TO AN ASSUMED DATUM
EXISTING ELEVATIONS ARE SHOWN THUS: 50.0
2. REFER TO FILED MAP FOR TEST HOLE DATA.
3. MINIMUM SEPTIC TANK CAPACITIES FOR A 1 TO 4 BEDROOM HOUSE tS 1,000 GALLONS.
4 1 TANK; 8' LONG, 4'-3' WIDE. 6'-7- DEEP
4. MINIMUM LEACHING SYSTEM FOR A 1 TO 4 BEDROOM HOUSE IS 300 sq ft SIDEWALL AREA.
1 POOL; 12' DEEP, 8' dia.
>, PROPOSED EXPANSION POOL
PROPOSED LEACHING POOL
.' ® PROPOSED SEPTIC TANK
S. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD
1tOBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS.
CP.
O00e
;
."4 'n M ACCORDANCE WTIH THE MINIMUMsr '• -•. FOR 1TRE SURVEYS AS ESTMIUS1ED
HY LIALS.AND APPROVED AND ADOPTED ''.
SUCH USE BY THE NEW YORK STATE LAID
(-' i°
a . 1
:n, '.,,
*
€ r�
e �'
N.Y.S. Lic. No. 49668
UNUITHORZED ALTERATION OR ADOn1ON \ 4N .,mac
TO THIS SURVEY S A VIOLATION OF \
SECTION 7205 OF THE NEW YORK STATE 1 - C
EDUCATION LNR.
1 ri A. Ingegno
COPES OF TIS SURVEY MNP NOT BEARING
THE BE A V LAND COPY. SEALINKED OR ,Land Surveyor
EMBOSSED SEAL SHALL NOT BE CONSIDERED
CER1WFEATIONS INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED,MD ON HIS BEHALF TO THE
TITLE COMPANY,OONEANMENTM.AGENCY AND Trtle Surveys - Subdivisions - Site Plans - Construction Layout
WONTO THE G minunoN ASSIGNEES ll�LENDING�-
nmoN. cE TIFTCATDNs ARE NOT TRANSFERABLE. PHONE (631)727-2090 Fax (6.31)727-1727
THE EXISTENCE OF RIGHT OF WAYS OFFICES LOCATED AT MAILING ADDRESS
AND/OR EASEMENTS OF RECORD, IF
ANT, NOT SHOWN ARE NOT GUARANTEED. 322 ROANOKE AVENUE P.O. Box 1931
RNERHEAD, New York 11901 Riverhead, New York 11901-0985
28-22'2:1 II