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HomeMy WebLinkAboutGeiger, Kevin SCUTHCLD VIASTEWTER DI SPCSAL PERM T CCNSTRUCTI CN CR ALTERATI CN PERM T SEPTI C TANK or CESSPCCL Per m t Nb. 4207 R Resi dent i al X Non-Resi dent i al Fee $ 10. 00 Septic X Cesspool PERM T I SSIED TO Name : CHARLES THOVAS Address 1: P O BCIK 877 Q t y St Zi p JANESPCRT NY 11947 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 APPRD,ED AS SLEM TTED AND AS APPRC)JED BY THE SIFFCLK MINTY DEPARTMENT CF HEALTH SERA CES. Fl NAL APPROVAL FEW FED FROM TI-E SIFFCLK CCINTY HEALTH DEPARTMENT. REF #R10- 13-0007 Nine a Owner KEM N CE CER Mai I i ng Address 1 115 Il FF AVENLE Cl t y St Zi p PELHAM NY 10803 Property Address 1 2350 BEEBE CAVE City St Zip Cl1TCH03,E NY 11935 Tax Map Nb. section 103. 00 bl ock 3 I of 10. 000 Cross Street EMERY ROAD Bui I di ng Per nit Ninrber Cr oss Ref er ence: I ssue Dat e: 4/07/ 14 El i zabet h A Nevi I I e Sout hold Tow, Q er k 11111 . ,%c,UFFO�,-�; I• ELIZABETH A.NEVILLE,MMC i ,w o( ,\ Town Hall, 53095 Main Road ti TOWN CLERK C P.O.Box 1179 y Z i Southold,New York 11971 REGISTRAR OF VITAL STATISTICS �% p � � Fax(631)765-6145 MARRIAGE OFFICER y �. RECORDS MANAGEMENT OFFICER '_�Qi � -0„ 0 Telephone oldt nny.g00 FREEDOM OF INFORMATION OFFICER �,....,,i.'�� www.southoldtownny.gov OFFICE OF THE TOWN CLEW ��. ri n , � ' TOWN OF SOUTHOLDI D `- � j f 4 i TO: Southold Town Building Department i 2 , r FROM: Carol Hydell, Southold Town Clerk's Office �i ns �T: TCS ..is, 4n9 DATED: March 26, 2013 RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4207 for a Cesspool/Septic Tank Construction Permit submitted by: Charles Thomas for Kevin Geiger . 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: ir - APPROVE DISAPPROVE Comments: Final approval required from the Suffolk County Health Department ,,,,,,,,,,,,:4 Signature 2 372 Y /3 Dated „ ,iiiii ELIZABETH A.NEVILLE ,oof `�`� O4�; Town Hall, 53095 Main Road TOWN CLERK p P.O. Box 1179 REGISTRAR OF VITAL STATISTICS � yy, � G � Southold, New York 11971 MARRIAGE OFFICER : 1� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER =y�f� a,asit 0 Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER = I jig 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. gifi 4907 Permit No. Applicant Name GIikaiLL-- 14-1-0 04- Applicant Mailing Address V 0 X, 3 77 A► .-4 +L) 1 1,1-147 Septic Tank X, or Cesspool X, Brief Description of Proposed Construction or Alteration tQ A 4GA.c.L Location of Proposed Construction/Alteration: Owner of Property: 2Lie-V,,L`(2_ Owner Mailing Address: 115 C I;.cP AV e n u e_ Rc pt ry WI I 0 8O 3 Owner Property Address: 2 3 G-0 E•E 1 E Q'c -tv r Name and phone number of contact person G -k- 7-41)wAS ``7 Z-7---.7 9 C 3 Tax Map No: Section )C2 zj Block Lot IF 1© Cross Street ig a Ci'b I K10'Cl-” pC' WI L�Rs-f 4 (,ti -t- 5(QC: NOTE: LOCATION MAP MUST BE SUBED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY AL DEPARTMENT APPROVAL ,(,..(,,-„, Ignature of Applicant__________ ,„ Date Received by: s A " SURVEYOF _, .._.__.___._., ._.m,. . ,_r._.._..._......_.,_.,_ ,. ._mma..Ra.. .__ F (� SUFFOLK COUNTY E-PA.RT1',iENT C HEALT4'I SERVIWES LOT 5 6 PERMI FOR APPROVAL 0• CONSTRUCTION FOR A MAP OF r 4E„4L�. F .ii! rici..W.D =NC ONLY MOOSE COVE ,) E FEB222J11 Jo. 3230 FILED AUGUST 30, 1960' ;,.(, r _._ r,t✓; "it) _ i 3 , .. SITUATE 1 .t . R'CIVI AST CUTCHOGUE FOR M < < _ I. S : acv .c OWN OF SOUTHOLD e� lel E { R7 u E :A,I.,)FROM DATE OF L ' )LK COUNTY; NEW YORK w_. x . TAX No. 1000-103-03-10 SCALE 1 "=20' LOT 55 t rat JUNE 28, 2012 ' - --, N/0/F SMUSSEN Z 5, 2012 ADDED PROPOSED SEPTIC SYSTEM --- "'" ' st b i �. y\-c 11, 2013 REVISE PROPOSED SEPTIC SYSTEM ' stem�'�`�IS ' A �*gots 6N N Aiandonai�nt of existingsanitary ua emer�l Su ITAL LOT AREA = 33,547 sq. ft. 21 o � c.with departrnel�t req ..i‘ \ �` � (TO TIE LINE) 0.770 ac. ry m 001� ,IN Y �, as mod.s. \ \ CERTIFIED TO: / A,I' oompielet C3ri71 J \ \ \ N KEVIN GEIGER / %1�, \ �°�iaoN. \ \ \ DEBRA GEIGER 1 Ilii. \ y , 1 ALL Fuc `\ X I '�` 1 Water L e(s) MUST Be Inspected By The 1 \ Suffolk Count Dept. Of Health Services. x. �� ••,30° E \ y 1 I Ca'f52i700, 4 8 Hours InAdvance, I N uw\ To Sghedule inspe ;ton(s). 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