HomeMy WebLinkAboutKonstantaras, Katy (2) V
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3491 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : PETER DERLICOLA
Address 1: 1695 CHABLIS PATH
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
-NEW CONSTRUCTION
-FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT
Name Of Owner KATY KONSTANTARAS
Mailing Address 1
City St Zip 0000
Property Address 1 115 CHARDONNAY DRIVE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 51.00 block 3 lot 350
Cross Street CHABLIS PATH
Building Permit Number Cross Reference:
Issue Date: 12/11/06 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
•, %pF SOuryo
ELIZABETH A. NEVILLE ' '�� 4 Town Hall, 53095 Main Road
TOWN CLERK 4i P.O. Box 1179
N `
REGISTRAR OF VITAL STATISTICS � G Q �
MARRIAGE OFFICER New York 11971
�� � SoutholdFax (631) 765-6145
RECORDS MANAGEMENT OFFICER �• �► � ` 1�, Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER �U + �� ,� southoldtown.northfork.net
0
OFFICE OF THE TOWN CLERK
l ^ 16 TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Michelle L. Martocchia, Southold Town Clerk's Office
DATED: November 16, 2006
RE: Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 3647 for a Cesspool/Septic Tank
Construction/Alteration Permit submitted by:
Peter DeNicola
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: $
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e
7 � .2,410
Dated
/',,,,iii,,,+-_
ELIZABETH A.NEVILLE o4 \ Town Hall, 53095 Main Road
TOWN CLERK CO P.O. Box 1179
H = ; Southold New York 11971
REGISTRAR,OF VITAL STATISTICS ; v. P,,i '
MARRIAGE OFFICER . O Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER = �v Telephone (631) 765-1800
f Tele
FREEDOM OF INFORMATION OFFICER �'�.' .,�,a" 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 Applicatio r 'o -y
Permit No.
Applicant Name ?e-ke,s- (0lk
Applicant Mailing Address '1\ C '31 t S 1 L
SOu4-1,a (41 119 --n
Septic Tank / or Cesspool t/
Brief Description of Proposed Construction or Alteration (\tea) CO w cstICA-64 4 0 y,
Location of Proposed Construction/Alteration:
Owner of Property: Vail PG h S 1- Lit 4 a a S
Owner Mailing Address: 16 9 I i_
StOu4-kOt tri I19�l
Owner Property Address: -7 /0 C.4,s L S C L i
&oL1o10 •r-l. 119 I
Name and phone number of contact person e/ii )'P4 cote. 761"3YK 2
Tax Map No: Section j I Block Lot 3
Cross Street4,04.1).0 e 4 pa_
NOTE: LOCATION MAP MIST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITIMEALTH DEPARTMENT APPROVAL
11— 149-0 6
Signature of Applicant Date
Received b & � l- i
S.C.T.M. NO. DISTRICT: 1000 SECTION: 51 BLOCK: 3 LOT(S):35 ®WELL
SUFFOLK COUNTY - .z.... . r,. :;u
-APPROVAL 1 -«:. siC T7 :dam.` ..•,
Datp OCT u S LUU f.--;6F. ° Fp- .5?
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NOTE: UNDERGROUND UTILITIES
FINAL SURVEY 08-29-06 THE WATER SUPPLY, WELLS AND CESSPOOL
LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS
FOUNDATION LOCATION 03-14-06 AND OR DATA OBTAINED FROM OTHERS.
AREA: 40,000 S.F. OR 0.92 ACRES
ELEVATION DATUM: _ASSUMED
` UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY
MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION
LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE.
THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS
AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY
SURVEY OF: LOT 5 CERTIFIED TO: PETE DENICOLA;
MAP OF: CHARDONNAY WOODS AT SOUTHOLD
FILED:
SITUATED AT: SOUTHOLD
TOWN OF: SOUTHOLD KENNETH M. WOYCHUK L.S.
SUFFOLK COUNTY, NEW YORK Land Surveying and Design
4r,,„,..1.41 At Plot& P.O. Box 3, Mattituck, New York, 11952
FILE #25-130 SCALE: 1 =40 DATE: OCT. 25, 2005 PHONE (631) 298-1588 FAX (631) 298-1588
{ I N. Y. S. UC N0. 50227 maintaining the records of Robert J. Hennessy
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