HomeMy WebLinkAboutPisani, Edwin SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 4044 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MARK SCHWARTZ
Address 1: P 0 BOX 933
City St Zip CUTCHOGUE NY 11935
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-11, FINAL APPROVAL REQUIRED FROM THE
SUFFOLK COUNTY HEALTH DEPARTMENT.
Name Of Owner EDWIN & MARGY PISANI
Mailing Address 1 195 COLABAUGH POND ROAD
City St Zip CROTON ON HUDSON NY 10520
Property Address 1 7180 PECONIC BAY BLVD
City St Zip LAUREL NY 11948
Tax Map No. section 126.00 block 11 lot 9.001
Cross Street BRAY AVENUE
Building Permit Number Cross Reference:
Issue Date: 2/10/12 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
d� C4
ELIZABETH A.NEVILLE,MMC is�`Z ' Town Hall,53095 Main Road
TOWN CLERK p P.O. Box 1179
ti Z t Southold,New York 11971
REGISTRAR OF VITAL STATISTICS :Q ��� Fax(631)765-6145
MARRIAGE OFFICER ��
RECORDS OF MANAGEMENT OFFICER `_ ,( 111/ *-0 1'�� Telephone(631)765-1800
FREEDOM OF INFORMATION OFFICER -- �� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department SEP 2 ? 21 U
FROM: Carol Hydell, Southold Town Clerk's Office
BLOC, DEPT.
TOWN OF YOUTHOLD
DATED: September 23, 2011
Transmitted herewith is a copy of application No. 4044 for a Cesspool/Septic Tank Construction
Permit submitted by:
Mark Scwartz for Edwin & Margy Pisani
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.
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments:
Af.i ce/
Signature
Dated
-' ,�,ocOSUFFOLt
• ELIZABETH A.NEVILLE ���,``1� �Gy�; Town Hall, 53095 Main Road
TOWN CLERK % p • % P.O. Box 1179
y Z $ Southold,
New York 11971
REGISTRAR OF VITAL STATISTICS o. Aft
MARRIAGE OFFICER
O •F, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER �f0 aV-o� Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER : '� ,���' 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 V or Non-Residential @ $25 Application No. L40y
Permit No.
Applicant Name AIAle lLC/-1.✓ T Z---
Applicant Mailing Address f9 e a/ '-3.3
COZ-1-1-76 _ 0131
Septic Tank k/ or Cesspool ✓
Brief Description of Proposed Construction or Alteration
M g(A) SS'E to 77 c .S•7 ,-/--
Location of Proposed Construction/Alteration:
f�
Owner of Property: F----0 W/,/ t /"(/-fin C /-(,q1/
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Owner MailingA e R O fE c o/L l r
C z2)-7aL ✓d
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c47-ie- oc_ 1 ,Jv
Owner Property Address: i4 195 Cotc...boL.Lnhaylef Fcl
CrcAcnn 0 n Uud p i K(`I 10S-2c.)
Name and phone number of contact person ///4/2 f( J C/_v r Z 7J 4-,fid-1---
Tax
Tax Map No: Section / Z G Block /( Lot 2, 1
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WI H APPLICATION. NEW
CONSTRUCTION REQUIRES SURVE H i •/ a 'ARTMENT AP 'R VAL
, A,
•
k-It
Signature of Apphc. . Date
Received by:
lill)
19.4 c.-
lflt 4 as:. 20.4'
' EP /
EX.2 STY. / 20.0' �® O ..,
FRAMED HOUSE
/ \
EL Dom'
TEST HOLE
GREAT EL �''
19.6' C D 20.4' 7)i''. ,\
PECONIC STONE �
�"q„ DRIVEWAY EX.1 STY. - \
BAY GARAE -
1 B GARAGE A -../.
22.2' rode ./
�J --- -- s3 v
Fs
RIGHT OF WAY EL N RIGHT OF WAY
19.5' 1
AQ`
EL. EL. S 20° 44' 00" E 345.76'
6.0' EL. 17.2' y
10.o N /O/ F
SITE PLAN JOHN
O NH�NSCH
^ I 1 [PUBLIC WATER] v
SCALE■ 111 = J 0 -0 NO WELLS WITHIN 150' 1
OF SEPTIC SYSTEM
TEST
SCTM# 1000-121
E
EL. P
19.8' - -�
.29.9: ----
; tt di SEPTIC LOCATION TABLE SUFFOLK COUNTY DEPARTMENT OF
PERMIT FOR APPROVAL OF
Se
41.0' j ` /3I O' 4i, SYMBOL DESCRIPTION DISTANCE FROM DISTANCE FROM DISTANCE FROM DISTANCE FROM
LOCATION'A': IOCATION'B': `LOCATION'C': LOCATION'D': F CONSTRUCTION�`C
, EL. -' ST 1500841.SEPTIC TANK 44.4 54.7 31.1' 49.9' ii {,�,,`
20.0 0 LP 1 "dia.X 4eeaP LEACHING POOL 84.0' 92.3' 16.0' 26.4 SINGLE FAMILY;RESIDENCE AND
LP 2 4d1a.X 4 LEACHING POOL 77.5' 79.2'
15.9' 18.7
EL
20.1' EL. DATE `
19.6' 1111
D 20.4' ka � (...��
STONE APPR ED moi'
MEETS AND BOUNDS BY: NATHAN TAFT CORWIN
LICENSED LAND SURVEYOR �
LICENSE No.50467 TOT .�' ' tMUM BEDROOMSPARTIAL SITE P LAN EXPIRES THREE YEARS FRGS: DATE OF ;�R!
PROPERTY SURVEYED: MARCH 01..2011
SCALE: 1" = 20'-0'