HomeMy WebLinkAboutHassaldine, Edward /',,,iii, __
• ELIZABETH A.NEVILLE �� 'y�1 Town Hall, 53095 Main Road
TOWN CLERK H P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS v'
MARRIAGE OFFICER ,ji � ��I, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ; LIQ! �a� � Telephone(631) 765-1800
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FREEDOM OF INFORMATION OFFICER ��' southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4223-R Residential X Non-Residential
Pee $ 10.00 New X Existing
Name of Owner HASSILDINE, EDWARD & MELISSA
Mailing Address 1 855 STANLEY ROAD
mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 855 STANLEY ROAD
Property Address 2
City St zip MATTITUCK NY 11952-0000
Owner Telephone No. 631-298-0008
Tax Map No. section 106.00 block 8 lot 12.000
Cross Street BREAKWATER ROAD
Issue Date: 10/09/03 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE �`Z` pry\ Town Hall, 53095 Main Road
TOWN CLERK ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS col
Southold, New York 11971
MARRIAGE OFFICER : O% � Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER0��,gi Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER O.1 I �a�', southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
OPERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10 J or Non-Residential @ $25 Application o.
Permit No. 30'IJ hL
Owner Name ( 1,ua Qnad /14-e f r S.S'q 7'4{55 /G/ '
Owner Mailing Address 855 Sktiri Ce J AG/
uJ Ny' //q.c.1
Owner Property Address 8s-S. 7
/1a.; , c , y rqs
Owner Telephone No. -U?)D k
Tax Map No: /t,v17 Section /76,o Block Q Lot 0/
Cross Street „FY fakku6*r
Please check each that applies: New Construction
Alteration to Exiting System
Residential J Non-Residential
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. (Locate
building and system; give north arrow and approximate distance in feet from system to building
and closest road. New construction may submit copy of survey with SCHD approval.)
C'O . /0/03
Signature of Applicant Date
Received by:
I.
I
• Survey for:
j
ED WARD C. HASSILDINE III
STANLEY ROAD & MELISSA HASSILDINE
+� - - — — — . _ ,,--WATER MAIN Lot 10, "Sunset Knolls"
�'� EDGE OF PAVEMENT At I
POLE GUY ; S8711 00"E 69.70 Mattituck
�w �'� N87.11.00"w Town of
4 N I 755.00' Southold
ftisiP
W h Suffolk County, New York
W
�'�' N R=18.50'
/I 0 L=34,54 S.C.T.M.: 1000-106.00-08.00-012.000
30 0 30
3 I 112 X5196 Q SCALE:1"=30'
R 1 Q NOTES:
co a-
\� I i� 1. AREA = 22,828 S.F.
ICP I3 o O = STAKE FOUND.
•
\ �. 2. • = MONUMENT FOUND,
W
/-1
0 = SPIKE SET, 0 = STAKE SET.
C� 00 I 3. SUBDIVISION MAP "SUNSET KNOLLS" FILED IN
�, THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON
c \\ sr..... s JAN. 05, 1968 AS FILE N0. 5023.
or, ^ �\ a2`' j A I
U 3s•
`•f 1Q^ qq a AUG. 28, 2003 FINAL SURVEY
vJ I
- 22.0' J I 0 JUNE 11, 2003 FOUNDATION LOCATION
—I MAY 20, 2003 RELOCATED PROP. HOUSE
MAY 05, 2003 ADDED CERTIFICATION
'0 2 STORY FRAME HOUSE APR. 30, 2003 STK. FOR CONSTRUCTION
\o — — — & GARAGE -
DEC. 13, 2002 D CERTIFICATION
�`jj OCT. 21, 2002 ND.EPROP.WATER SERVICE
�V 44.0' 22.0'
N p - MI -20.2' OCT. 01, 2002 AMENDED PROP. STRUC.
N4.4 m....
. SEPT.
4.4SEPT. 17, 2002 IND. PROP STRUC.
0 DATE: AUG. 21, 2002
CONC.
PPATIOO JOB NO:2002-453
Ci) ") ° CERTIFIED TO:
Q o a
7 W EDWARD C. HASSILDINE III &
I w MELISSA HASSILDINE
W ULSTER SAVINGS BANK
fi p p o 3 AL
'0in N C FCOMPANY AOFO EW TITLEINSURANCE
Vj O E O
N
-0 oW
Z , N
O
"0 w 414 1 `' N i'
_r,.-
SHED
— o a LINE OFFILEDMAP--� 4»_ -- DAVID H. FOX N.Y.S.L.S. #50234
I FEN N88'4T00"W WOOD FENCE �' - FOX LAND SURVEYING
1 o.q'S 130.29 0E2 S
PO BOX 224
SPEONK, N.Y. 11972
i Lot 1 (631) 325-2902
Lot 38 1 ,
UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY
r��j� n IS A �/IOLATION OFSECTION 7209 OF THE NEW YORK STATE
Subdivision 4�ZSZon EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING
THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL
"Anthony Dris & Helen. Dr-is" SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY.
Suffolk County File No. 8995. CERTIFICATION INDICATED HEREON SHALL RUN ONLY TO THE
PERSON FOR WHOM THE SURVES IS PREPARED AND ON HIS
BEHALF TC THE l E NM LISTED
ULORNM ANT)TAAGENCY
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AND NDIN IN 1T; N LISTEL H REON AND A TNF
A N.E OF LIT NG INSTIL '1 N- CE ATICN�
�� F 1 T FN F .AB 10 AD(`I C 1P.L IN ANT P E: EN W `
SN S
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R
DWG: 2002-453
1