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HomeMy WebLinkAboutLong Island One Real Estate , SCUTHCLD VIASTEVIATER CI SPCSAL PERM T CCTSTRUCTI CN CR ALTERATI CN PERM T SEPTI C TANC or CESSPCCL Per m t Nb. 4208 R Fesi dent i al X Nbn-Fesi dent i al Fee $ 10. 00 Septic X Cesspool PERM T I SSIED TO Name : LCNG I SLAND CNE FEAL ESTATE Address 1: P O BCD( 13 a t y St Zi p EAST MAR CN NY 11939 Cescr i pt on of Proposed Const r uct i on or Al t er at i on SAN TARP SYSTEM FCR SI NCE FAM LY [WLLI NG APPRO./ED AS SU3M TTED AND AS APPRO./ED BY THE SLFFCLK CCUVTY DEPARTMENT CF I•EALTH SERA CES. Fl Ng. APPRO✓AL FEW FED FROM THE SLFFCLK COUNTY I-EALTH DEPARTMENT. FEF #R10- 13-0013 Name Cf Owner LCNG I SLAND CTE FEAL ESTATE Mai I i ng Address 1 P 0 BO( 13 12910 Mal N ROAD O t y St Zi p EAST MRI CN NY 11939 Property Address 1 170 HOMESTEAD MY O t y St Zip C3ENPCRT NY 11944 Tax Map Nb. section 40. 00 bl ock 2 I of 17. 000 0 oss St r eet V'ESTV'XCD RD Bui I di ng Per m t Nunber Cr oss Ref er ence: I ssue Det e: 4/07/ 14 EI i zabet h A Nevi I I e Sout hold Town der k im . oil SUFFOLat :. ELIZABETH A.NEVILLE,MMC /4, 4 Town Hall, 53095 Main Road TOWN CLERK o= P.O. Box 1179 1 en 2 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS V O 47$ Fax(631)765-6145 MARRIAGE OFFICER N.y0��ii� Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER --7491 illi `t►a„ www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER -- ,�� ----,, OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department s` 'I-) r 1 1 'ice FROM: Carol Hydell, Southold Town Clerk's Office ( MAR 2 8 2013 -..�,� DATED: March 27, 2013 ;; r T nen RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4208 for a Cesspool/Septic Tank Construction Permit submitted by: Long Island One Real Estate Inc. . 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: Final approval required from the Suffolk County Health Department e241.4.44/1 Signature °V7/, 7i Dated /.�"F—. 4/0 4OELIZABETH A. NEVILLE 11,*. 4 .. Town Hall,63096 Main }Loa TOWN CLERKC d ;..,. P.O. Box 1179 ST p Southold, New York 11971 REGI RAR.OF VITAL STATISTICS . MARRIAGE OFFICER •.�G I Fax (631) 766-6146 RECORDS MANAGEMENT OFFICER �-yjffo 4O�I'II Telephone(631)765-1800 FREEDOM OF INFORMATION OFFICER = 'I 4, .„,• southoldtown.northfork.net OFFICE OF THE TOWN CLERK 1HOLD T TOWN OF SOUTHOLD ‘-.- 'EpARTMEN i3uiLkitip Box A179__, WASTEWATER DISTRICT - P•�• NY971•11 Southold, APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @$10 or Non-Residential ®$25 Application No. ` Permit No. Applicant Name Lot-j Ts/it,-f Oh c �-Cerl ti!-Y' Applicant Mailing Address l ' 6 ' l D /3 5 441. I' ©Gi A' (7 / / 7 7?5- Septic Tank �/or Cesspool - Brief Description of Proposed Construction or Alteration C d S 4 u L I / -I4--'-('/4 ,4_42--i `4 c'- G 1° -7 O ,h,Q41-4744° 14-1 Cke e��cyt�l� S�l� Location of Proposed Construction/Alteration: ff '' Owner of Property: LTA-) S 1/D�b 0 4-,..r E h1 )L Owner Mailing Address: O , /,O>e r3 on F Ail )4'1-Z / /9 ) Owner Property Address: 'Z 47! 0 l'I" °'. 92) f'-P-4 //9 5 Name and phone number of contact person 13 P--) 110--- v , I `--A° '''' 477 s"Li7 Tax Map No: / 0°O Section 01d • Block (9Z--i Lot 0 / 7 Cross Street t"' cf 4- LICOD NOTE: LOCATION MAP MUST BE S LO TTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURE40: HE• ' H DEPARTMENT I PROVAL- Signa'e . • pp ant ate Received by: el.......7- — — Survey for: • V SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Q. ,, PERMIT FOR APPROVAL OF CONSTRUCTION FORA �oZ �o�40'0 g1 wixe`' 6 BRYAN VILLANTI SINGLE FAMILY RESIDENCE ONLY 7 HA s)�e004 1� o. Lot 89, "Eastern Shores, Section 2" 4' •, A cP. At N DATES//c1/f H.S. REF. No. kit) ~-13 -0013 / - Greenport APPROVED �4..(..4..tit,t_0_-, /{ / , d Town of �,III#1,./ E,F, ('G0 , o,<e<� 0 0 ,,,z� fi o Southold FOR MAXIMUM OF / BELIROOMS\,O� Piey,c 4+ 15 c. �i Ill \ t. Suffolk County, New York s EXPIRES THREE YEARS FROM DATE OF AlpROVAL NO 0 cs, 9 0 S.C.T.M.: 1000-040.00-02.00-017.000 e LP CO^ 30 0 30 to IA0'' \\ Lot. .69 ,-'' SCALE:1"=30' I. •Q2 0 .1 10 L `' \\ E�'�o� PSO M _ �\ �- vo�onl N NOTES: S , . \ CS` \ ,-� ( � 1 / l��io 1. AREA = 20,250 S.F. 1- 1%3 ; c 1I--- -- `_�!/ a' s) ;a,-'10'33 n 2. • = MONUMENT FOUND, • = PIPE FOUND. \ N `� st 0 o` er • A= STAKE SET. yp \ 30�SFS��P��—\ ?�� GP` �` P v0`�GC \`� �oPosEO 0 7 3. SUBDIVISION MAP "EASTERN SHORES, SECTION 2" .� I cR r (goo \ 0 e \ P oc- SEs) FILED IN THE OFFICE OF THE CLERK OF SUFFOLK 2 `,-/ i rs\ .,�� PRo4��- �= COUNTY ON AUG. 10, 1965 AS FILE NO. 4426. 1..\\. y, Os 0_\,„,.1 \ 4. ELEVATIONS SHOWN HEREON ARE REFERENCED \ '� 'Y�.--' \ TO APPROXIMATE N.A.V. DATUM (1988). _ \ LA / \ \ \ _ \ O \ P�oPOSE� L's) �`��pv ,� `� \\ O R PRo?O5 s) \�\ \� DATE: JAN. 29, 2013 \i —�, i \ moo. O '/��-1,• \ `oo \\ a9 JOB NO:2013-041 \ \ \\ ? E.\--"ACERTIFIED TO: 0 , \ ��� \ �L��' �' \\ \ QQ� BRYAN VILLANTI 0 • \ \\ \15 \ g. • \ LA \ / i TEST HOLE DATA \ .O •1O"�N Ec.04" i / FROM FILED MAP f...\-��5 0 56gOZ �1 - rw 5 ,1 Q \\ TEST HOLE $2 0 \ /,1- / „0 PD \ -. EL=15.0 0.0 \ , / YIP' �S --i- TOP SOIL \ S �e009) APRs)) & LOAM \ , O� �s)\N REPR ('cP 1 DAVID H. FOX, L.S. P.C. N.Y.S.LS. #50234 C+,E\� \_,' FOX LAND SURVEYING 3.0 \ �\ 64 SUNSET AVENUE �So \ WESTHAMPTON BEACH, N.Y. 11978 SAND & E\-' doted (631) 288-0022 GRAVEL �P�b<,c 44 UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY e\\WA IS A VIOLATION OFSECTICN 7209 OF THE NEW YORK STATE LP * EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING \ THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALIC TRUE COPY. G.W. r EL=1.0 , i 114.0 \ \ CERTIFICATION INDICATED HEREON SHALL RUN ONLY TO THE RECEIVED RS ON FCR WHOM THE SURVEY G VREPARND AND CN HIS B LF TC THE TITI_E COMPANY, GOVERNMENTAL AGENCY Oyj AND LENDING INSTITUTION LISTED HEREON , AND TO THE onto \ ASSIGNEES OF THE LENDING INSTITUTION. CERTIFICATIONS <�� ARE-NOT TRANSFERABLE TO ADDI PCNAL INSPTU PONS �� OR lUBSEOUENT COMERS. _ ' DWG: 2013-041 , I)