HomeMy WebLinkAboutTurner, David SCUTHQ.D VASTEVIATER d SPC6AL PERM T
CCNSTRUCTI CN CR ALTERATI CN PERM T
SEPTI C TANK or CESSPCCL
Per m t No. 4177 R Fbsi dent i al X Pbn-Resi dent i al
Fee $ 10. 00 Septic X Cesspool
PERM T I SSIFD TO
Name : D4M D TIER
Address 1: 450 7TH AMENLE
CI t y St Z p NEINYCRK NY 10123
Descr i pt on of Proposed Const r uct i on or Al t er at i on
SAN TARP SYSTEM FCR SI NCLE FAM LY DI LLI NG
APPROvED AS SWM TTED AN) AS APPFOIED BY THE SU=FCLK CCWIY DEPARTMENT
CF HEALTH SERVI CES. Fl NAL APPF)/AL FEW RED FRAM THE SU=FCLK CCINTY
I-EALTH DEPARTMENT. REF #R10-13-0037
Narre a Owner D4VI D TIER
Mei I i ng Address 1 450 7TH AVEN E
SU TE 1907
CI t y St Zi p N_wYCRK NY 10123
Property Address 1 640 VEST SI-CFE ERI VE
CI t y St Zip SCUTHCLD NY 11971
Tax Map No. sect i on 80. 00 bI ock 1 I of 47. 001
Cross Street Q4K AVENUE
Bui I di ng Per m t Number Cr oss Ref er ence:
I ssue Dat e: 1/02/ 14 D i zabet h A Nevi I I e
Sout hold Town a er k
'0' FFO(j
CSG ; Town Hall, 53095 Main Road
ELIZABETH A.NEVILLE,MMC sol .Z► y
TOWN CLERK p P.O.Box 1179
H Z Southold,New York 11971
REGISTRAR OF VITAL STATISTICS ��
p Fax(631)765-6145
MARRIAGE OFFICER y� �► ��
RECORDS MANAGEMENT OFFICER 0,( * .���i�� Telephone 765-1800
FREEDOM OF INFORMATION OFFICER �� www.southoldtownny.gov
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
NOV 15 2013
TO: Southold Town Building Department {{
FROM: Carol Hydell, Southold Town Clerk's Office
DATED: November 15, 2013
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4177 for a Cesspool/Septic Tank Construction
Permit submitted by:
David Turner
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 to tion map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: Final approval required from the Suffolk County Health Department
Sig/nature-27r
ignature
Dated
ELIZABETH A.NEVILLE tits? �4� Town Hall, 53095 Main Road
TOWN CLERK y ` P.O. Box 1179
2 ; Southold New York 11971
REGISTRAR OF VITAL STATISTICS v. Al �� '
MARRIAGE OFFICER : O �� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ,`, � Telephone (631) 765-1800
�'
FREEDOM OF INFORMATION OFFICER 1 '
s 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. 9 17 7
Permit No.
Applicant Name �\ v 2 N V=`re.
Applicant Mailing Address 4 5 6- I- 19 v
Septic Tank or Cesspool
Brif Description of Proposed onstruction or Alteration L N1. a LGI '7'd
o� M0A- o 'gut Lb
Location of Proposed Construction/Alteration:
Owner of Property: �. .J/��� � v ?Z,4--I C— 12_
Owner Mailing Address: '1' D �—��/L Com" (1 . /cf
Owner Property Address: G 4 6 Iry L LI 1' '5 k 'Z
�7d v—fl-t o t�
Name and phone number of contact person VA- u H 6-I"1-.) s4+ -O 4-0
Tax Map No: 10 CO Section b 6 Block I Lot 4 7- 1
Cross Street D A- iks ) E
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WIT ...iac (TH DEPARTMENT PPROVAL
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Signature (•►'"Applicant ate
Received by:
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E. TRE!!) / g .- NEIGHBORING BUILDINGS HAVE PUBLIC HATER
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NEW ���`J� i F SUFFOLK COUNTY D
DRYWELL OPEN CELLAR 1 DEPARTMENT OF HEALTH SERV-:: t
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PERMIT FOR APPROVAL OF ,
NC..) �i J CONSTRUCTION FOR A 1
II SINGLE FAMILY RESIDENCE ONLY 1
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Ab AUG 0 5 2013
`� �uQnment of existing sari DATE /�_ _ H. . F. NO. l�/ -/,3 - a(1'
APPRO37EXI5TINI � (� ti- 60.15'
WATER METER ,l HOUSE aS Proof. FOR MAXIM • BEDROOMS
r 14, h / CONCRETE SLAB I TRAP ' - - - ----____-- EkPtRcS THREW
1! __ill cle/ ATA 11 �"� YEARS FROM DATE OF APPROVAL 1
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WATER LINE ,000000>000000�° -- C�-i/t ;de,- wt
, )000000 00ogogm0I r •� 450 SEVENTH AVENUE,SUITE 1907,NEW YORK,N.Y. 10123
_ 0 0 0 °O°04°) I 212 594-0840 FAX 212 594-1530
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I /nc 10'on,/, f NEW SEWAGE DISPOSAL SYSTEMS
1 19 .'o'c e SEE SHEET A-101.0 FOR DETAILS
0c0oopo��- e°3 1 SHEET
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re '/' i DRAWING BY:
GRAVEL ONI °000°0°+ 60.04' �s'f �' M.A.I.
DRIVEWAY 0°0°0°0' , POSSIBLE FUTURE SITE PLAN
EXPANSION IF REQUIRED WEST SHORE DRIVEI' ` J! >R CHK BY:
n °000• ,- NOT TO SGAL� f} '. j1t
LOT LINE ' +r .� DWG No:
TEST BORING y)k9Tk .gFjW"4 ' / A- 100 . 00
INSTALLATION PLAN TAX MAP 1000-050.00-OI.00-047.001 �Fh��
SCALE I/Ib" = I'-o" PLOTS 6,7 4 THE EASTERLY 10' OF PLOT 5 IN BLOCK 5,
CAD FILE No:
ENTITLED MAP OF REYDON SHORES, INC., BAYVIEW, L.I., N.Y., IN 1 OF 2
THE TOWN OF SOUTHOLD, SUFFOLK COUNTY, N.Y." AS MAP 6SI AIMOMMMIMOIMMMIMMIIMIMMIMNIMIMIIIIIIIIIINMIMMMIMII
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