HomeMy WebLinkAboutBasani, Joseph o�oS�FFo��Co
JUDITH T.TERRY ���_ y<• Town Hall, 53095 Main Road
TOWN CLERK ; y Z P.O. Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER yifJ ' I. Fax (516)765-1823
RECORDS MANAGEMENT OFFICER Ol �a," Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ,•• �
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1415 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JOSEPH BASANI/VIRGINIA HINSCH
Address 1 : P. O. BOX 321
City St Zip EAST MARION NY 11939
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #R10-95-0131
Name Of Owner BASANI, JOSEPH/HINSCH, V.
Mailing Address 1 P. O. BOX 321
City St Zip EAST MARION NY 11939
Property Address 1 1673 ROW OFF ROCKY POINT ROAD
City St Zip EAST MARION NY 11939
Tax Map No. section 31 .00 block 2 lot 10.002
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 11/14/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY;; = < % Town Hall,53095 Main Road
TOWN CLERK i H = t P.O.Box 1179
REGISTRAR OF VITAL STATISTICS %%,.0 *.��, Southold,New York 11971
MARRIAGE OFFICER O�y� Q- 1 Fax(516)765-1823
RECORDS MANAGEMENT OFFICER �.( `�1. ►as,�� Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER - , iii•
OFFICE OF THE TOWN CLERK ----' -
,, I
TOWN OF SOUTHOLD '
TO: Southold Town Building Department ri, , 8 ,Y,.,
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: November 8, 1995
Transmitted herewith is a copy of application No. 1468 for a Cesspool/
Septic Tank Construction Permit submitted by:
Joseph Basani & Virginia R. Hinsch .
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.
Thank you.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments: yi:eitp• Qf -errs sC,ek 42,(, /e a 9, a/3/
Signature `' 9
9
Date
r
OFFICE OF THE TOWN CLERK „ ,," 'r
Town of Southold ��/''s \\MLi(
Judith T. Terry, Town Clerk �' % Ci
l/ Application No.
Town Hall, 53095 Main Road �� O '" Construction
P. 0. Box 1179 •
Southold, New York 11971 ; c=3
tr) ' Alteration
Telephone '4-'40 ��Q���'� $10.00 - Residential
(516) 7 65-1801 -_ 1
$25.00 - Non-Residential•
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE ///717S--
APPLICANT
/ 7 / 9S--APPLICANT NAME: JbSeA3- .BftsRidi f VI ho 3 .,fiNSC-h
APPLICANT ADDRESS: ftp 60Y 3DJ El rhagiON( ”
// `l3/
SEPTIC CESSPOOLX
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION ":()Sfdi0N
oc-
one 90 0 c afi-tokf . f 1k_ arik ave... M ' e55srotA also 4r)
ivi fa I( a \JEA.t) (neL
LOCATION MAP: • Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 'iOSF - B 5 1 J -44i/./S'Ci+
OWNER MAILING ADDRESS: PO 60X a:24 ±4 i'/Yla.2tdry )U(/
•
OWNER PROPERTY ADDRESS: /o73 Rpt RAH- e6
E 1sic hrl&21t - Focx0
TELEPHONE NUMBER OF CONTACT PERSON: -7 - 4(0E-1
TAX MAP NO. : Section /000--2) Block OgN. Lot JO.
CROSS STREET: �O i A1� goacQ
BUILDING PERMIT NUMB CROSS REFERENCE:
Signature of Applicant
RECEIVED BY: N. .
Town Clerk's Office
DATE: l7 r� �. •
5 , A
07
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2
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�lot _.o yravai •
wellCC
13T.00. I°,_" IC
125.00 fit B
gyp^ S. 85° 3300 W• 1,0.16
•
c 4o=jo2q RIGIIT OF WAY
- N 0/F G.S. HOWELL ESTATE
- (vacant')
LOT NUMBERS REFER TO MINOR
SUBDIVISION FOR KIMON 8
W00DENE RETZOS
eAlg‘t 141°
vp
AREA • 40, 158 SQ, Fr. No
101-t
SURVEY OF
ELEVATIONS ARE REFERENCED P PROPERTY
TO AN ASSUMED DATUM, P
The lacalions of wells and cesspools �C AT EAST MARION
and n are frombfield absolherlons TOWN OF SOUTHOLD
and or from data obtained from others.
I am familiar with the STANDARDS FOR APPROVAL SUFFOLK COUNTY •N Y
' AND CONSTRUCTION OF SUBSURFACE SEWAGE 1000-91- 02- 10.2
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES Scale r 1"= 50'
and will abide by the conditions set forth therein and on the
permit to construct. Oct. 24, 1995
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES SINGLE FAMILY DWELLNG ONLY
FOR APPROVAL OF CONSTRUCTION ONLY EXPIRES THREE YEARS FROM DATE OF APPROVAL
NOV 0 1 1995
DATE HS. REF. NO.42)--9C- 0 a/
eAgfe4/a4, olt•
• •
stiQf NOP),
APPROVED —� 5'<, \ta I'M"°rd. O-1
F4
ANY AL TERA TION OR ADDITION TO THIS SURVEY'RSA VIOLATION l' •. j 1
OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW,_ 1
EXCEPT AS PER SECTION_7209-SUBDIVISION 2. ALL CERTIFICAI�ONIS
HEREON ARE VALV FON HGS ACES THEREOF ONLY IF Alj t'r LIC. NO. 496/8
SAD MAP OR COPES BEAR THE AFRESSED SEAL OF THE SURVEYOR � �• v
WHOSE SIGNATURE APPEARS hEREOK • - ECO ° r._ vi)'--• , P.C.
ADDITIONALLY TO COMPLY WITH SAID LAW THE ALTERED BY' (5/6) 76 .
UST BE USED BY ANY AND ALL SW'VEYCWS l/TL G A COPY P. O. BOX 909
OF ANOTHER SURVEYORS MAP. TERMS SUCH AS'Ir45PECTED'AAV 1230 TRAVELER STREET
BROUGHT-TO-DATE'ARE NOT N/COAPLIANCE WITH THE LAW.
SOUTHOLD, N.Y. 11971