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HomeMy WebLinkAboutBellomo, Debra pr/' - f ' 0114 ./ ':. ELIZABETH A.NEVILLE /_ 4 ; Town Hall, 53095 Main Road TOWN CLERK o P.O. Box 1179 H REGISTRAR OF VITAL STATISTICS i Southold, New York 11971 MARRIAGE OFFICER `` �� �, Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER = �a��i� Telephone (631) 765-1800 Ql 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. 4193-R Residential X Non-Residential Fee $ 10.00 New X Existing Name Of Owner BELLOMO, DEBRA Mailing Address 1 7459 SOUNDVIEW AVE Mailing Address 2 City St Zip SOUTHOLD NY 11971-0000 Property Address 1 400 RICHMOND RD Property Address 2 City St Zip SOUTHOLD NY 11971-0000 Owner Telephone No. 631-765-2496 Tax Map No. section 51.00 block 6 lot 12.000 Cross Street ROUTE 48 Issue Date: 3/11/03 E ih A. Neville Southold Town Clerk (TOWN SEAL) I I .. ... •0 OFFICE OF THE TOWN CLERK IFU TOWN OF SOUTHOLD 0��� �6OGt` Application No. 3 ELIZABETH A.NEVILLE,TOWN CLERK $10.00 - Residential P.O.BOX 1179 SOUTHOLD,NEW YORK 11971 u'� * z' $25.00 - Non-Residential 16 Telephone Q/ N# -• (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 0215/ R Fee $ 1D ,OO DATE Roti-Ch ID 1 a0© OWNER NAME: N.bejjr'0� \\CKYVO OWNER MAILING ADDRESS: 7X59 Spur-dvi t? Pvc • .ouilno(d. . Nq lug1I OWNER PROPERTY ADDRESS: go Zc1imood. 'Cl Som- ►ov{, N 10 9 i i OWNER TELEPHONE NUMBER: 1031- -7 (o5- aq 9 Co TAX MAP NO. : Section 5/ Block b Lot 1 23— CROSS STREET: e-ROLA-}Q„ Lts> TYPE OF SYSTEM: Septic Tank New ✓ Existing Cesspool New Existing Residential V 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.) . :A L �.i' / i Sig'.tur of Applicant RECEIVED BY: WtSlth 1Town Clerk's Office DATE: 1I I,I`0r F f N/F SPASOV TES I ,lI0L1- DA TA RESIDENCE waL ' P F1fORMFD BY Mc.DON 27 APRIL, 2001 ALD GEOSCIENCE CCSSPOOI_> yykLf_ • i r l 78' FfzOM- -_ S EXISTING GRADE k / SURVEY OF - �. DARK BROWN SANDY LOAM OL N 71' 41 ' 30" E 90 156 .67' DESCRIBED PROPERTY BROWN LOAMY SAND WITH HEAVY GRAVEL SM SITUATE I J BROWN TINE I0 COARSE SAND 1411H HEAVY GRAVEL SW _ 23, SOUTHOLD, TOWN OF SOUTHOLD G. 6.7 n 1.9 19.5• 40' SUFFOLK COUNTY, N. Y. I BROWN FINE TO COARSE SAND SW CO - 1 7.4_ so { e ` t�wE STORY a SURVEYED FOR DOUGLAS BELLOMO c.yWAItR IN BROWN TINE 10 COARSE SAND SW ( +rRESIDENCE2 "` DEBRA BELLOMO 14 c FOR 'S.C.D.H.S. USE ONLY N/F DOERING N -- . W RESIDENCE SEMCKEN O �;` • RESIDENCE o 1\44:'-•*:- •, Dra ' 40 c�• SCALE SURVEYED 0 MAY, 2001 = 0 U0 85 GARAGE • . DRIVEWAY U.C. CESSPOOL AREA- 25,592.98 SF • OR 223' a 588 ACRES 0 '''' 125' INSE) (IN FRONT ,c O TOPO FROM TOPO MAPS EAST END AS PER ZONED R-40 CESSPOOL9 RESIDENCE . • LOACTION N/F MARKDAHIS GUARANTEES RRAN EES INDICATED HERE WHOM THE SURVEY APPROX. RESIDENCE O. IS PREPARED, AND ON HIS BEHALF TO THE ^ ONLY Q re u+ TITLE COMPANY, GOVERNMENTAL AGENCY, M U a O LENDING INSATUT7ON, IF LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION. NGUARANTEES ARE NOT TRANSFERABLE TO TEST Ili W ��" ADDITIONAL INS11TUAONS OR SUBSEQUENT OWNERS '}• HOLE MI W UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLA71ON OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW Z. CO... COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. 1.1' • WELL / VACANT n�� S 71' 41' 30" W 99.67' .� SURVEYED BY F. F. EL. 28.0 MIN. %��G F N/F CARRIG o 1-- FINISHED GRADE EL. 26 RESIDENCE v STANLEY J. ISAKSEN, JR. • TM 1000-051-06-012 FINISHED GRADE EL. 25 P.O., BOX,294 ,\\,\\>>`. NE6b` S(Y fOLir,' NY 11956 INV Fl. 2.3. `INV. EL. 23.0 631 i 4` '5835 INV Fl. 24.6 I/a%FT \, J L— .f GUARANTEED TO. Ia 1/a/FT ((''��R. 6. 26 FEB 03 FINAL SURVEY. a, , / /}' INV EL. 24.3 V 6 , 5. 1 AUGUST 02 LOCATE CONC. FOUND. v ; ;DOUGLAS BELLOMO 1EEK4. 22 MAR 02 SHOW PROP. MOUSE. LI E' AND•SU f ' 'SRDEBRA BELLOMO 3" MIN. GROUNDWATER EL. 14.6 �� NYS ` O. `492 i� US DEPT OF AGRICULTURE v MILL 3. 17 JAN 02 REVISE SAN. LOC. RURAL HOUSING SERVICE -„�,- ,-'--"''----^,-tip^' SAFE HARBOR TITLE AGENCY SEP TIC TANA” �c 2. 18 DEC 01 REVISE WELL LOC., ADD WELL/SANITARY OF OTHERS • N.T.s. CESSPOOL NOTE: 1. 30 JULY, 2001 REVISE STR. LOCATION & SANITARY 01C1006 • 4