HomeMy WebLinkAboutReinertsen, John (2) . c
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3515 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JOHN REINERTSEN
Address 1: 1227 84TH STREET
City St Zip BROOKLYN NY 11228
Descripton of Proposed Construction or Alteration
BUILDING NEW HOUSE
FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT
Name Of Owner JOHN & ANGELA REINERTSEN
Mailing Address 1 1227 84TH STREET
City St Zip BROOKLYN NY 11228
Property Address 1 590 ARROWHEAD LANE
City St Zip PECONIC NY 11958
Tax Map No. section 98.00 block 2 lot 410
Cross Street INDIAN NECK ROAD
Building Permit Number Cross Reference:
Issue Date: 3/21/07 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
°I# SOU/
-
ELIZABETH A. NEVILLE '` 4 Town Hall, 53095 Main Road
TOWN CLERK 4 4 t P.O. Box 1179
th
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS G
MARRIAGE OFFICER . 1 Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER_ l 11 Telephone (631) 765-1800
1
FREEDOM OF INFORMATION OFFICER -
'yC�U' '���� , southoldtown.northfork.net
vIAR ( 6 _T OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Lynda M. Bohn, Southold Town Clerk's Office
DATED: March 15, 2007
Transmitted herewith is a copy of application No. 3672 for a Cesspool/Septic Tank Construction
Permit submitted by:
John Reinertsen
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
Comments: •:
V
/�.`4
Signature
03 / 07
Dated
'ofFoorc
ELIZABETH A.NEVILLE it •
� Town Hall,53096 Main Roar
TOWN CLERKd1 • P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �y, �� Southold, New York 11971
MARRIAGE OFFICER ► O 1� Fax (831) 765-6145
RECORDS MANAGEMENT OFFICER :y�f0 A*1011 Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER - '� * 4010 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 Application No. ✓
Permit No. 3,5/ 5
Applicant Name * --OV‘,V\ 10,2 n.e AS.&V1
Applicant Mailing Address \a.a:i Q luX31
e)rooK1tn Ail (1228
Septic Tank or Cesspool
Brief Description of Proposed Construction or Alteration filb 1(d i n t e uJ n (S
Location of Proposed Construction/Alteration: S' o i4rro heap( I-4 p
Pec.oniG
Owner of Property: b\ 4 Alge4. n,e0K-edv1
Owner Mailing Address: t 4-f+ .
r 5 iyVI /k.( `f ( ( Z/_ 8
Owner Property Address: 6-90 A rr (p1 hem )-c e. Peet,n 1 G
y //9(Ss
Name and phone number of contact person :t4 h iZ e(n A/ -a (7/6 Zig- '1767
Tax Map No: Section 98 Block bo\ Lot 2-/
.
Cross Street i444 Neck K o act
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HE TH DEPARTMENT APPROVAL
3//3/o
ignature of Applicant Date
Received by:
LOT NUMBERS REFER 'MAP OF ARROWHEAD COVE' SURVEY OF PROPERTY
FILED IN THE SUFFOLKK COUNTY CLERK'S OFFICE ON
U JUNE 20, 1963 AS MAP NO. 3810.
•
.°rn: A T PECONIC
, -------z, , TOWN OF S O UTHOLD
) I -"-
SUFFOLK COUNTY, NEW YORK
1000-98-02-03 & 04
SCALE: 1"=50'
MARCH 1. 2000
m� JUNE 28, 2006
Sept 26, toot(<o/u�raroi,e)
K ROA 6 Feb 22, 'Zoo7j, q#.r /, e)
��^
IND
o
W
coco
m
iiiV
VACANT ,-. r
I LOT 39
S./ Q -
124.14' <nap) - `*
fi
N GO 88'42'20' E 124.09' <actuat) a es., SUFFO t_ CU - _,
25,. .3 14'1 _
ci
�y L Teff (4 E""
g9 ERdd', r.7 ,. / _ .,..�\
z sccri I 0.3F LOT 38 60,'09 n
' DA'n'SP-67 r - ' - ' 7A 0 07 DO Z
CZ \1 r. ,. ., ,
n Q
z 4. i s
Z le ' E ;P' 1
o �
• r ;
- prop oo4 N N
d
bw t
•
ra p,76, 5794
s44.IS
...Iar Spid/iQ Q O
2 Dpro p
i
Z —— _Ziti — 3 '
^y dye grp Nla
t
7C w--_ c c 4 .A.P.4-# ;1 1 ,,,..--c;:#0S % -
I . t�
3% Q%n �a:o'r4".
� 4'6 v ; \ cz ( Cif- 7
fl y � c .
v c
o" ioP ci ,- vbil •
/S Z
_ P Poi + � * •
Pro
661 r11 ba
c�b Pn a" v o
0 R
N
C) ..3..
Q
nP
WO
' CERTIFIED TO'
P JOHN RE7NER TSEN
is 24.. " 1 el ANGELA RE/NER•TSEN
24.0
88.42'20' W 134.93' (actual) '
o s's itt 135.00' (nap)
• I LOT 36
(dwelling) Lo/ Coy era-,3e
ELEVATIONS ARE REFERENCED
WATER r hse 35O f
TO AN ASSUMED DATUM. P"�� $00 Sof'
Ccbc a. Soo b,f,
GL'Pwe. /3 eo s if,
S
/
AREA= 41,815 S.F. Dwell CC/6a s' ; / Sis.f. =/4'S %
C,P.s /5O'-14
TEST HOLE DATA
I am familiar with the STANDARDS FOR APPROVAL
AND CONSTRUCTION OF SUBSURFACE SEWAGE Dark brown silty loan ❑L
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES _____ 15•
and will abide by the conditions set forth therein and Brown loamy sand SM
on the permit to construct. L ,
43.5 I 3 4OF NE(ryr
The location of wells and cesspools shown hereon are 5���T �ET�O'
from field observations and or data obtained from others. O �`
Pale Brown fine to coarse sand S,/ "r,
•
• 1 / � N. S i r! 4''61 :
1. ,moi
ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION 'ECONIC SU'VE v-dk, -•
OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. (631) 765 - 5020 'sl '.
EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS .— I •• -1797
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF P. D. BOX 909 FQIA ,c3-
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STRE
WHOSE SIGNATURE APPEARS HEREON. 17• SOUTHOLD, N.Y. 11971 ;00 - 108•
•