HomeMy WebLinkAboutSamaan, Selim (2) ti
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3488 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : FRED MILLER
Address 1: 985 WHITE EAGLE DRIVE
City St Zip LAUREL NY 11948
Descripton of Proposed Construction or Alteration
-NEW GARAGE WITH SINK AND TOILET
-FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT
Name Of Owner SELIM SAMAAN
Mailing Address 1 NOT AVAILABLE
City St Zip 0000
Property Address 1 NASSUA POINT ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 111.00 block 9 lot 1.000
Cross Street NOT AVAILABLE
Building Permit Number Cross Reference:
Issue Date: 12/08/06 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
•
••oig\oF SOiryo
ELIZABETH A. NEVILLE Town Hall,53095 Main Road
TOWN CLERK 4* P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Q i Southold, New York 11971
MARRIAGE OFFICER A` . , Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER l Telephone (631) 765-1800
1
FREEDOM OF INFORMATION OFFICER '�CouNr\v/
. southoldtown.northfork.net
',...
OFFICE OF THE TOWN CLERK
6 TOWN OF SOUTHOLD
TO; Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: November 3, 2006
Transmitted herewith is a copy of application No. 3644 for a Cesspool/Septic Tank Construction
Permit submitted by:
Fred Milner for Selim Samaan
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: � e-
1 / ,
Signature
///0
Dated
.
ELIZABETH A.NEVILLE ���/At �` Town Hall, 53095 Main Road
TOWN CLERK 2 , P.O. Box 1179
REGISTRAR OF VITAL STATISTICS % yy. Southold, New York 11971
MARRIAGE OFFICER '� 1� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER =y D�if� Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER �'� * */•`',60.
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 /or Non-Residential $25 A lication •@@ pp
_ Permit N A. _
Applicant Name N.
lL- /� pi !. _ i
Applicant Mailing Address 9 aS 'v'/ K 1 te- L.ct q t ‘--"D2_
k 00A,._.\ ru , ,_4 v \ffi-t ci
Septic Tank or Cesspool X
Briefe ription offPr osed Co stru tion r Alteration Y v edit/ I ' e_,\fl51 ' -\----A6 %
Location of Proposed Construction/Alteration:
Owner of Property: S C ' wi 5cW4
4
Owner Mailing Address: �Ir %ke". L11
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Owner Property Address: SS Cc.i) 70 i Ift-72 d
Gd'oje
al,
Name and phone number of contact person ED *N\t i Y1.e..1-
Tax Map No: t Section ( 11 Block 0 7 Lot JJ
Cross Street / 4
NOTE: LOCATION MAP/// MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WIT HEALTH EPARTMENT APPROVAL
N
I Signature of Applicant Date
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SURVEY OF
LOTS 30 & 31
AMENDED MAP A OF
NASSAU POINT
FILE No. 156 FILED AUGUST 16, 1922
SITUATED AT
I
NASSAU POINT
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000- 111 -09- 10 `''
SCALE 1 "=30'
' CD
JUNE 21 , 2006
346,09 �
�? OCTOBER 13, 2006 REVISED EXISTING CESSPOOL LOCATION
tri
gULKHFI�D AREA = 67,190.70 sq. ft.
1.45' (J) (TO TIE LINE) 1 .542 aC.
Q
3 I
FENCE o
2.1 S
y. rn
� LO t.---i
NOTES:
1. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUM
EXISTING ELEVATIONS ARE SHOWN THUS:_.0
F L - FIRST FLOOR
o L�.� GiL - GARAGE FLOOR
w� ` B - TOP OF BULKHEAD
o r R.B - BOTTOM OF BULKHEAD
z-
0 £ I'.
trAf g 2. PROPOSED SEPTIC SYSTEM STRUCTURES: F-n ;
,� ::: PROPOSED FUTURE 50% EXPANSION POOL
ICD m i 00.
i PROPOSED 8' DIAMETER X 12' DEEP LEACHING POOL �'
trA
'' V/1 PROPOSED 1,000 GALLON SEPTIC TANK
0
3. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD
r- 0 ' O OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS. I.
-
_ _ �
BULKHFAD) — — I`,
169.4' (TO _ — z
— (�° , M) - * �� TEST HOLE DATA
!.
tIZ (TEST HOLE DUG BY McDONALD GEOSCIENCE ON JULY 6, 2006)
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1.
Z I DARK BROWN LOAM OL
00 c \
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m
x o N BROWN CLAYEY SAND SC H.
® TO BULKHEAD) — — 3
LOT 132.2_(— — �i i.
143. �p HWM)— ' 1
_ e 4
4 4
a I
,14
PALE BROWN FINE TO MEDIUM SAND SP I
. ..4,
5 gULK0.9S
J 227 •AO'
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A
CONC WALL a
1Y
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
PERMIT FOR APPROVAL OF CONSTRUCTION FORA PREPARED IN ACCORDANCE WITH THE MINIMUM i
STANDARDS FOR TITLE SURVEYS AS ESTABLISHED
- •• ■ G - s i BY THE L.I.A.L._ . • .••ROVED AND ADOPTED
' ' FOR SUCH@1(�Tj ORK STATE LAND
TITLE A �I�011' OR
h.
�Q. N.IN%
DATE 0-24-0( H.S.REF.No.R10- C ' • co is, _,;,iei o
APPROVED C i 4a0libmr,_ 7 '`"; ' 111
TOTAL MAXIMUM BEDROOMS ;`� t,:e.7-+—"' ''''I. y
EXPIRES THREE YEARS FROM DATE OF APPROVAL `>o4966,
.._ LA14O N.Y.S. Lic. N(
UNAUTHORIZED ALTERATION OR ADDRION
TOTHIS SURVEY IS A VIOLATION OF
SECTION 7209Joseph A. Ingeg�
OF THE NEW YORK STATE
EDUCATION LAW.
COPIES OF THIS SURVEY MAP NOT BEARING Land Surveyor
THE LAND SURVEYOR'S INKED SEAL OR
EMBOSSED SEAL SHALL NOT BE CONSIDERED
TO BE A VAUD TRUE COPY.
CERTIFICATIONS INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED. AND ON HIS BEHALF TO THE Title Surveys — Subdivisions — Site Plans — Constructi
TITLE COMPANY, GOVERNMENTAL AGENCY AND
LENDING INSTITUTION LISTED HEREON. AND
in TIBC •eewjcry OW rue Jammu + mins'''. /c�.\�n� nnnw