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Home My WebLink AboutBMA (2) SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 3476 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : THEODORE PETIKAS Address 1: 225 STEWART LANE City St Zip BETHPAGE NY 11714 Descripton of Proposed Construction or Alteration -NEW CONSTRUCTION -FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT Name Of Owner B.M.A. Mailing Address 1 1565 NORTH SEA DRIVE City St Zip ORIENT NY 11957 Property Address 1 SAME AS ABOVE City St Zip 0000 Tax Map No. section 15.00 block 5 lot 2.600 Cross Street RYDER FARM LANE Building Permit Number Cross Reference: Issue Date: 10/25/06 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) • 01 sour*- ELIZABETH A. NEVILLE • ,O l0 .\ Town Hall, 53095 Main Road TOWN CLERK 4 4; P.O. Box 1179 REGISTRAR OF VITAL STATISTICS va Southold, New York 11971 MARRIAGE OFFICER G @ $$ Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER ��Olp � , Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER courI,�� is' southoldtown.northfork.net OFFICE OF THE TOWN CLERK SF? 2 I TOWN OF SOUTHOLD _ 3' o TO: Southold Town Building Department FROM: Michelle L. Martocchia, Southold Town Clerk's Office DATED: September 19, 2006 RE: Cesspool Construction/Alteration Application Transmitted herewith is a copy of application No. 3631 for a Cesspool/Septic Tank Construction/Alteration Permit submitted by: Theodore Petikas 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 Comments: ./ ' � ,/ � "‘•c4-4-73- G�r Signature /6/9/t Dated ,%gOFFOZ4. c 049 ELIZABETH A.NEVILLE •` 4 * Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR,OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER ` t 1� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER �lj�l �a�"�,ii� Telephone (631)765-1800 FREEDOM OF INFORMATION OFFICER 4. ,,tsoutholdtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @$10 ior Non-Residential @$25 Application N• -- Permit No.44+--? Applicant Name =�;'kko .e ,LE P T\ \(M C '?-j . A Applicant Mailing AddressQ r r �j4)l1��Mr4 L r�7` JI lQ Septic Tank or Cesspool Brief Description of Proposed Construction or Alteration Location of Proposed Construction/Alteratio 15 65 Owner of Property: 1)--), 61n , _ 10 1 Owner Mailing Address: Q Q I Oo A- Owner Property Address: I B(05 . QDRk 3ea, D( 1 Cori en-i- q 5 9 Name and phone number of contact person -OFF o p ET 1 jc PSC 1/6-17 5/-2)-51 Tax Map No: Section / c Block c Lot £ Cross Street '2 ()tit. c-1-\ L NW C. NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL 411.1111._ ignature of Applicant Date 4 Receive. • \ '1' Ct i SURVEY OF LOT 81 MAP OF ORIENT BY THE SEA, SECTION TWO FILED OCTOBER 26, I161 FILE No. 3444 L.ot SITUATE: ORIENT 55 TOWN: SOUTHOLD dwe11inP 150 tic over SUFFOLK COUNTY, NY we r 5e-- 4-4 j SURVEYED O1-11-02 HEALTH DEPT. UPDATE 8-22-2006 SUFFOLK COUNTY TAX # el_ 28 1000-15-5-26 North Sea Drive CERTIFIED TO BMA CONSTRUCTION - ------ NSS 9 el Zt, 6 z 0 I NOTES W 56 • MONUMENT FOUND O o PIPE FOUND n Lot I i 54 k b, • 35' AREA = 1,710 5F OR 0.45 ACRES dwelling PARCEL RESIDES IN ZONE DISTRICT R-40 -,(4--AIL u<, per ;owner -T. - ELEVATIONS REFERENCE SUFFOLK COUNTY r a 00 P TOO MAPS 0 PROPERTY ZONE R 40 SETBACKS BASED ON NONCONFORMING LOTS OF LESS THAN 20,000 SF SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES 5.58° PERMIT FOR APPROVAL CF CONSTRUCTION FOR A PLEASE NQIE SINGLE FAMILY RESIDENCE NM Minimum distance bniwe n `: Pec-►n 4 Rewle R-i -o& and cesspool is to be 150 << Ei. Il DATE 1--0 --0 2 H.S. REF. No. ( t d-o -o ac i il APPROVED c/1iiii,„'".-."'j I TOTAL .MUM BEDROOMS I-01110 V IS Lot t -�� c.4 EXPIRES TYEARS FROM DATE OF APPROVAL rlwe,il,n,j EXCAVATION INSPECTION REQUIREp FOR SANITARY SYSTEM �I BY HEALTH DEPARTMENT I 1 GRAPHIC SCALE I"= O' I i 1 o t - I dw�1 l l„(.1 we N � 5epr�1 '.5L) � - E -- W ---7 S _____ -(0,. a�e _ e, 2e' _x'00"E SI 101 2e, ' awn OL 5"t`y LS I� � Loom 7 S l� - 13 Vo � ovrm ML �II (t�Q O B-o_ -1 $iI[u fico US p I v I f. SM Gro e Lot I Lnyei, , 22 , -]. Proposed \0' dwe"'ng t. House POIa 45' , ". I w \ swI Fine�� o 0 —O.; \ \ „orse CS 30[t�1e).2-4‘ S14. 0.22-1 \ '00'1 W 81.61' Lot 100 1 N Vrc — %bo,Narlced afNrotbn ar 0ddtSmto a survey - mop bes . g a Sunda IOM surveyor's...al b /” o Notation of section Tog,sub d.bbn 2York 5tote. .of Lfake • the / Orel"glee from the orltfwl of Nb survey marked dd.an orlUHol of 8lend d weld' \ VI, /. valid ` •y , - tNot Nb survey MOD in accordance Nth Nee- Istsg Code of Pr 2to Lod LoH. . adopt., by the led York State.Ire.octotlo5 of Prof*Worn! Lod.p..Surveyors. Sold te,U.. olo.y shop no Deets to bre person ito ream d..savvy b p-eep�al�re..d�. ,..- 105 on Ns behalf Lo We ttonally itle bn listed hereon,ago mWI .` elq'ee�.of the l.ndtg sbtbMon CearbfIca- ----- ___--- Woo or.net praOerabla to eddtkeot settvtto,e I, 15 JOHN C. EHLERS LAND SURVEYOR S11" �� 6 EAST MAIN STREET N.Y.S.LIC.NO. 50202 ��u RIVERHEAD,N.Y. 11901 369-8288 Fax 369-8287 REF.—\\Compagserver\pros\02\02-257.pro 1,,,2,0,,,1,,,2,0,,, 5.24,26.1 W..........,,,,,05.1.2 2"-r '