HomeMy WebLinkAboutGenovese, Louis ,/°°o..)1 O�,�coG
ELIZABETH A. NEVILLE
110 /yd; Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
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Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
'F Fax (631) 765-6145
MARRIAGE OFFICER � y
RECORDS MANAGEMENT OFFICER "'/"1 jig 1a�/i�Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ''''►��
OFFICETOFNN THE TOWN CLERK
SOUTHOLD WASTEWATER R DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2392 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JEANNE GENOVESE
Address 1 : 130 GARFIELD AVENUE
City St Zip SAYVILLE NY 11782
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 #C10-00-0007
Name Of Owner GENOVESE, LOUIS
Mailing Address 1 130 GARFIELD AVENUE
City St Zip SAYVILLE NY 11782
Property Address 1 580 SKUNK LANE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 97.00 block 3 lot 11 .006
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 9/08/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE I z y\; Town Hall, 53095 Main Road
TOWN CLERK 0 • % P.O. Box 1179
% h Z Southold, New York 11971
REGISTRAR,OF VITAL STATISTICS t r,
MARRIAGE OFFICER ` 1i �� ��
Fax(631) 765 6145
:
RECORDS MANAGEMENT OFFICER �_4Ql �b .'1� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ °���
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: August 18, 2000
Transmitted herewith is a copy of application No. 2481 for a Cesspool/Septic Tank Construction
Permit submitted by:
Jeanne Genovese
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:
ignatur,C2) e
T'/Z1O
Dated
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OFFDSE OF THE TOWN CLERK 11',Stf OCK/� J
TOWN OF SOUTHOLD ��,' • `Q/� �$: Application No.
ELIZABETH A.NEVILLE,TOWN CLERK Q `zy
P.O.BOX 1179 ... Construction
SOUTHOLD,NEW YORK 11971 z p Alteration
Telephone .0,� IQr��' $10.00 - Residential
(516) 765-1801 �l44 ��'� $25.00 -Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION -- ,
Itf.r TIV 'ET►
for
CONSTRUCT ION or ALTERAT ION PERMIT 8 ' 1 8 au
SEPT IC TANK or CESSPOOL 400thold town Cie*
Permit No.
Fee $
DATE liOn
APPLICANT NAME: 1,0_4Ae___ 6e4 Ve ---
APPLICANT ADDRESS: v-lv'y' .'t f- 13 o C 1 C,C(/� >1v
SaVlLe 1 (7 —
SEPTIC CESSPOOL f
DESCRIPTION OF PROPOSED CONST UCTION OR ALTERATION lam” G S U� JY-
h61, 1 1y�. ).e. - 4-6V`1l dVAC-l( iw �d- g - 3 ear
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: /UL(r J e_k i £ e ' j-C
OWNER MAILING ADDRESS: I' D 6�ql LL& Prile .
avi Vi '1`e iUi
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OWNER PROPERTY ADDRESS: (ASO S -u./7L , c(,c °,('
ALI
TELEPHONE NUMBER OF CONTACT PERSON: 1, 3 , '" CC?'" 81 -2 3
TAX MAP NO. : Section qi Block 3 Lot ) 1 L
CROSS STREET: i iN ,
BUILD"NG PERMIT NUMBER CROSS REFERENCE:
ignatur f Applicant
ilL
RECEIVED :errfrAMI
w Clerk's Office
DATE:
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1 .. USE,SIYI6LE FAMILY -I
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"' \ NF MID6LEY RE51DB�0E '^1
U5E�EARN!WORK 5FED5
(YELL-NON DRINKABLE/ WB•1-WATER LOCATION OF
EXISTING WATER
\ EL.•71.5 WELL i
AtS 4' II
.ICO0�_ N 1"j4'9�E ... I
I`CYL,S ,d, .28.4 �`
LOT AREA•113542*RFT.• _'
PROPOSED �'•�• a
AREA•
4600 SLIM. off •, W•
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Fi.•22b ' tj>.��
ryryry EXIST.FE►AGE AID TO TIE
' E, IN DISREPAIR Yd{'`
NO STORM DRAINS 84C. 6'1
REQUIRED BY TOM
4.IOO,T--� „ FAMILY LOCATION OF
`.+C-PF1 PROPOSED RESID6K.E EXISTiN6 WATER
PARKING AREA HATER WELL
5 VEHICLES
Q
EL253' _k
Full
I 41i : .•\ W
Y. 5RW'POrD TAW
' FUTURE SOX
In
� l�ASIRioN
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a' (2)DEEP LP.10 SOIL BORING
4' EL.•2.3.T' EL.•2O3'
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S '536.T4
VACANT
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) SITE PLAN
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50 25 0
gRAP•nG SLALE
WATER LINE(S)MUST BE I PECTED By THE
SUFFOLK COUNTY DEPT.OF HEALTH SERVICES.
CALL 852-2097,48 HOURS IN ADVANCE,
TO SCHEDULE 1NSPECTION(S).
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERV,--
APPROVED FOR CONSTRUCTION ONLY
H.S.REF I._0-i,•-iy FLOW A"
TYPE�. er-trWMAPYL _ '--.
This approval is granted for the caWntlica of EWry
disposal and water supply tactless pursuant to • VS and �",.�-• _
7 of the Suffolk Canty Sanitary Code and Is not. elpened 0.2'
nor implied approval to discharge from or CC PN dM LOAM
struaure(s)shown THIS APPROVAL EXPIRES THREE(I) 3,
YEARS FROM THE. •
AUG . 41,I I . / . •
9 1.r.!t. �/
DATE / =•^ ,,7/
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