HomeMy WebLinkAboutBirzolla, Brian ,Ial,t FFO��►c -
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ELIZABETH A. NEVILLE ���_� y1: Town Hall, 53095 Main Road
TOWN CLERK ; y 2 P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER .f. l �1�, Fax(631) 765 6145
RECORDS MANAGEMENT OFFICER � -'/O! ��, fe Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ,•01'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2458 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : BRIAN BIRZOLLA
Address 1 : 869 HULSE LANDING AVENUE
City St Zip WADING RIVER NY 11792
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF # R10-00-0193
Name Of Owner BIRZOLLA, BRIAN
Mailing Address 1 869 HULSE LANDING AVENUE
City St Zip WADING RIVER NY 11792
Property Address 1 300 PAVILION COURT
City St Zip SOUTHOLD NY 11971
Tax Map No. section 88.00 block 6 lot 13.020
Cross Street WATER TERRACE
Building Permit Number Cross Reference:
Issue Date: 11/20/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
1.
. . .,,,, stFFo� c oe ; g C 15
ELIZABETH A. NEVILLE = Gym: Town Hall, 53095 Main Road
TOWN CLERK % H Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS • Southold, New York 11971
MARRIAGE OFFICER �` y1, �i�1', Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER �__-'1O,, **„,,a Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ ',�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: November 3, 2000
Transmitted herewith is a copy of application No. 2546 for a Cesspool/Septic Tank
CONSTRUCTION/ALTERATION Permit submitted by:
Brian Birzolla
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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE +/
DISAPPROVE
Comments: Maintain required setbacks from adjacent wells, buildings,property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED. .
Signature
1/ I / 0 a
Dated
=a
OFFICE OF THE TOWN CLERK
'1.�� �F►D�K
TOWN OF SOUTHOLD %4' O� CQG Application No. ��
FI I7ABETH A.NEVII IF,TOWN CLERK •. �►
P.O.BOX 1179 P =41 Construction
SOUTHOLD,NEW YORK 11971
N Alteration
Telephone ‘�•� �� .
$10.00 - Residential
(631 ) 765-1800 -=y�1 4*,•0' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.zb g
Fee $
DATE / / 3 A2 °
APPLICANT NAME: 6/e/. /91`-/ ?o/A.
APPLICANT ADDRESS: g0 7 U/$ e L .0 / ,- //N j /4 Y
Weal �' � f7 h -y. //79,2--
SEPTIC
/7y, -SEPTIC CESSPOOL/
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
/t'//e1V /1"S7/ c. Tf oAJ
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: R//e4/\/ ge''C_Zd//4'-
OWNER MAILING ADDRESS: ' / A _
OWNER PROPERTY ADDRESS: /� 30o PPV{ iark
3o LA-L,16-
TELEPHONE
TELEPHONE NUMBER OF CONTACT PERSON: / 9/ 7 6/2 C''28
TAX MAP NO. : Section b S 8 Block (SOD 6 Lot 0/ 3- O? D
CROSS STREET: IV-47-C - /2 Ate e_
BUILDING PERMIT NUMBER CROSS REFERENCE: 26 � 5—
Signatu e of ' pplica•
RECEIVED BY: fdlib
'71111'—o-
- erk's Office
DATE: /(/9/C) ,
IT
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WA 7/3?
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SUFFOLK COUNTY DEPARTMENT OP HEALTH SERVICES AND CONSTRUCTION OF S : '' 4CE mirAGE V f
i PERMIT FOR APPROVAL Or CONSTRUCTION FOR A DISPOSAL SYSTEMS FOR , olk• FAMILY RESIDENCE'S
and wN abide by the condlifons sal foal therein and on the rl
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Ila. N
-4, SINGLE FAMILY RESIDENCE ONLY permit to construct. J
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I DATEg-2-2 H.S. -EF. NO. t 0 , •• 4 0 VD Cc VI
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APPROVED ASO AgraftliF /
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FOR MAXIMUM Or Fouk. 4Z-oclus to
EXPIRES THREE YEARS FROM DATE Of APPROVAL, teb:,4
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NOTE, LOT NUMBERS ARE REF1i. ‘0).
ERENCED TO 4 se4s., YPI-11'd
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" MAP:OF ANGEL SHORES- FILED
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IN THE SUFFOLK COUNTY CLERK'S . -5 't;rz. , ' *
$ A -
4 - OFFIeE AS MAP NO. 9729
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/ SURVEY OF PROPERTY
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2.5:''''''.--,,., elli AT BA YVIEW
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AN TOWN OF SOUTHOLD
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SUFFOLK COUNTY NY : i
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74:3fr ,,,,,,,,
4.
I 1000 - 6 8 - 06 - 13.20 ...
ELEVATIONS ARE REFERENCED qt•rt •,41 .
.,. .
I TO AN ASSUMED DATUM. ir..., ‘veAltv ,..„ ,9 pv, ce A
V SCALE; r = 50' _ .
,
.... 4,cy i. -,„ ty JUAE 30, 2000
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1 The locations of wells and cesspools 4:.) Jay /7,'' 247oc. Irev...$,04
- ito
shown hereon are from field abserveMons i (1,(b
I and or from dale obtained from others. A464,91,74
, ,
, .
110?), 0) NEW
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S 409---11 A PAR SLaillr 8 ne 'I' •-'-" ' Uf ' eurnwroi?
WHOSE SIONATINE RS HEREON. ,.
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THE 7. "ALTERED Br i.:1101M. .11:04 :' •
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LoISISEDstihr
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''s 'WROUGHT - ro -• .A7" Ailt?dor AS '''''''''' a LAAr ./ . (631) 7• )IMO • •,- (6311 765 - 1797
AREA 4374SQ
P. 0. BOX - •• •
FT:
. 1230 TRAVELER STREET
if 2 . .
SOUTHOLD, N.Y. 11971
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