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HomeMy WebLinkAboutBergen ee ELIZABETH A.NEVILLE ��� d Town Hall, 53095 Main Road TOWN CLERK ® P.O. Box 1179 Southold, New York 11971 REGISTRAR OF VITAL STATISTICS ® O V Fax (631) 765-6145 MARRIAGE OFFICER ` � � °�� RECORDS MANAGEMENT OFFICER �_ VI �,s22,, V`®lig, Telephone (631) 765 1800 -Z VI OF INFORMATION OFFICER `? ,S'� OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 4012-R Residential X Non-Residential Fee $ 10.00 New X Existing Name Of Owner BERGEN, STEVEN Mailing Address 1 4953 COMMONWEALTH AVENUE Mailing Address 2 City St Zip LA CANADA CA 91011-0000 Property Address 1 710 WATERVIEW DRIVE Property Address 2 City St Zip SOUTHOLD NY 11971-0000 Owner Telephone No. 000-000-0000 Tax Map No. section 78.00 block 7 lot 30.000 Cross Street WATERVIEW DRIVE Issue Date: 2/22/00 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) i OFFICE OF THE TOWN CLERK .ccVFFUL4- CD TOWN OF SOUTHOLD `� , t; Application N °/ - a� ELIZABETH A.NEVIJI.F,TOWN CLERK �� '►� � $10.00 - Residential /}� P.O.BOX 1179 SOUTHOLD,NEWYORK11971 0 '.$ $25.00 - Non-Residential -• - Telephone *.( * �1i' • (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. • Fee $ . DATE />/dBv OWNER NAME: O,p. C- , _,c. : ,,g- ) OWNER MAILING ADD ESS: � , i.4"4,,,,, � Q di--c. c4 Lccc?c, ea. _ . /01, OWNER PROPERTY ADDRESS: 7/0 Uv --(//per, Ot 'SO- 41'16- 16(, q 00 -21 OWNER TELEPHONE NUMBER: TAX MAP NO. : Section 7 , OD Block '7 Lot 3o, O O CROSS STREET: L.421-9/i e„,„,, r. TYPE OF SYSTEM: Septic Tank New .k Existing Cesspool New .,,1----- Existing Residential Non-Residential LOCATION MAP: Must be attached hereto before permit may be issued. (Locate building and system; give north arrow and feet of distance, approximately, to building and closest road.) i \ lona u of Applicant ----41— RECEIVED BY: Town le k's 6Office DATE: ,A w PROPERTY LIES IN FLOOD ZONE AE" IMPROVED, WELLS IN DWELLINGS ''BASE.FLOOD ELEVATION 8 SANITARY SYSTEMS IN FRONT YARDS PE8...FIRM MAP No. 36103C0166 G • COMMUNITY No., 360813 i A / EFFECTIVE DATE: MAY 4, 1998 V V A T Ns7.42'0o R V1E w D R..-:-...-61; 12 T. 7346'• E EDGE OF DRIVE L_n,6��6�g�'(QAEE, CEMENT 0----.,.L o W CP's G? O NRO.2 E i 0�� C���L. � 1 500,36 ^N 0 0 J 1 Wv e) \ 1 SEPTIC EXISTING kV us- 0 0 W ,) 4\; NO, • SYSTEM • - ) sr Cc o 0) �) (e s wooa D O v • • z J !i- 36.3' ^ ...Z O eC '�F AdiTWO STORY 4 C Z ',C �O •-- )) NF DWELLING 16.p• 78.0' C7 ec� OWN � ) G.F.8.g1 °41 JZZ �.c Q_ V x}27.2' s2.3 r--� 1 �� �k�� ''.. ,, .0- o„„3 \Q. vi )- \\� Roots(9�� CSI W o� �o�v \ C 1:T2,co o> o EL. 10.5 C�, o� ��e z� N a �� \\\ \C d- z ` � W Q N• o 7 \ �� o) o� 3�� W zi Z� �11 \y c CW O �J nn \\ C V I 1 J m n� \ C U� O3 l'l �1' E ce Z PIPE VACANT ' ' ��� 2 E SHE WELL 2 J Q AT CORNER AREA: 14,842 Sq. \ 0 2 —_ 0.341 Ac. R.d' E 01ao ' S57•42,0014/ N-.--. 1)4 E SHED c� � o • J57 42'00 1U0.00' WELL AT CORNER k 0 VACANT S UH( T K. COT T fv DEs'ARME ,"T OF HEAL - 1'�SERVICES LELI___7 aLoo as.R :,,r,. t. D I Zsr� t f rJ,,•,. .]'� .v A„•0 ,5' Ac:f'l,d�n. , 4 n ���. ,..,::r_'.±±±�, ;,,•c. - �Y.:is i©c�,iio:�stave been °?C:.,u, _,_z...11;4...7.,,..,141.,lz' !., :`$`i T;en.GE e:i_i 2 agencies and found ';GO'.j,tit��' 'LLs\ cri `/�. to , j Z dry CJ3' ,-%i�\�u. T; .;,kiy"„,,,,k,),",,,_ ___y,s��riu7. _ _ 10_, $t tsen A.Costa,t°.k?.;Chief� Ou1ce of Water and Wastewater Management CLEARING LIMIT: 9,500 S.F. = 64% CERTIFIED TO: ' KEVIN MATTHAEI SURVEY OF MARYHAEI E— RURAL� USDADEVELOPMENT DESCRIBED PROPERTY SCTIC, INC. , SITUATE AT EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED BA YVIEW ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT V VV THE TIME OF THE SURVEY. TOWN OF SOUTHOLD GUARANTEES WHOM THE SU I�EYTSDPREPARED, AND ONHEREON SHALL NHS BEHALF TO THONLY TO THE E TITLE COM-FOR SUFFOLK COUNTY, NEW YORK PANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTIONS LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION. GUARANTEES ARE SCALE: 1 ”=40' DATE.` MAY 8, 1999 NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. THE OFFSETS (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TO THE PROPERTY LINES ARE FOR A SPECIFIC PURPOSE AND USE'AND THERE- FORE ARE NOT INTENDED TO GUIDE THE ERECTION OF FENCES, RETAINING S.C.T.M. DIST 1000 SEC. 78 BLK. 7 LOT 30 WALLS, POOLS, PATIOS, PLANTING AREAS, ADDITIONS TO BUILDINGS AND ANY OTHER CONSTRUCTION. II JOB N0. Y983 a i4wi— a' '' '- +, INJ w/ A F REV PROP. STRUCTURES & - at III REV. CERT'S 5/13/99 s'fs JS, ADD FLOOD ZONE, REVISE j 1t. ti 132 , •• • v • hWay SANITARY 7/14/99 '- n Hop= 011 Ba ,, Ale. '' 'x.'46 CORRECT DATUM: 7/22/99 ( a (63�� 8-5330 LOCATE FOOTINGS 10/29/99 4a •dy•• a� ' ,, ' Marc E. Charest, L.S. UNDER CONST. 11/6/99 FINAL 01/07/2000 , Successors'to REV. 01/18/2000 Paul T. Canalizo, L.S. Robert A. Kart, L.S. icense no. 050149 Good Ground Surveyors, P.C.