HomeMy WebLinkAboutLevine, Melvin ,I�,�o�Os11f FOL,tcoG
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ELIZABETH A. NEVILLE ���_� # ; Town Hall, 53095 Main Road
TOWN CLERK C - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �+' Southold, New York 11971
MARRIAGE OFFICER :
toy
ee Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER ,*oI -0„.
FREEDOM OF INFORMATION OFFICER _ ���
OFFICEOF THE ppTOWN
LLDDCLERK
SOUTHOLD WAS OTERUDISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2397 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MELVIN & LILIAN LEVINE
Address 1 : C/O C MESIANO
City St Zip EAST MORICHES NY 11940
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 #R10-00-0075
Name Of Owner LEVINE, MELVIN & LILIAN
Mailing Address 1 201 EAST 79TH STREET
APT 6D
City St Zip NEW YORK NY 10021
Property Address 1 710 NAUGLES DRIVE
City St Zip MATTITUCK NY 11952
Tax Map No. section 99.00 block 5 lot 12.003
Cross Street
Building Permit Number Cross Reference:
Issue Date: 9/13/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE ��'= G'l� Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER `. 1i ��� �1 Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER '/Ql �a0,le Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER
40441' S
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: September 7, 2000
Transmitted herewith is a copy of application No. 2486 for a Cesspool/
Septic Tank Construction Permit submitted by:
Melvin & Lilian Levine by Catherine Mesiano
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.
Thank you.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following/recommendations:
APPROVE
DISAPPROVE
Comments:
ignature
91440
Dated
OFFICE
TOWNOFSOTOWN
UfHOLD Q\%S�FFU(�`D�j Application No. tR
ELIZABETH A.NEVILLE,TOWN CLERK z $10.00 - Residential
P.O.BOX 1179 .n ��
SOUTHOLD,NEWYORK 11971 � $25.00 - Non-Residential
Telephone *el 0-1C OA/ St'
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
S7`fZg 7TERM�,�/
PIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE 2 13iloo
t `
;,20( r 79 aC
OWNER NAME: 011elvtik mot-
LSV y ;u� /Oa .2' -e 4'33
OWNER MAILING ADDRESS!(0 C. Me51c,_4,4
t IY1 It Po,ti.l. L•-. E. r&or lctie..s 13Y 11440
OWNER PROPERTY ADDRESS: 1 10 n (aaa..tt,Q� f
OWNER TELEPHONE NUMBER:
TAX MAP NO. : Section Q 9 Block 5 Lot l a.3
CROSS STREET:
TYPE OF SYSTEM: Septic Tank New X Existing
Cesspool New 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
ohiA
Signature of App icant
/32 /11-e-‘
RECEIVED BY: (� Y �v (. v //F -
Town Clerk's Office
DATE:
7 -4095-/
SURVEY OF PROPERTY .
SITUATE: MATTITUGK N
SEPTIC. DETAIL FFnaosEr,
TONN: SOUTHOLD not to scale °"
SUFFOLK COUNTY, NY r,�f,o
EL Il t log ma 2
cover M.• 110
IMIA
over IOb
SURVEYED: JAN. 12, 2000 �,,.min I' 03_--
•
AMENDED: MARCH I6, 2000 epd inq 103= 5eP C m"`e`
AMENDED: MARCH 22, 2000 S r,—,.._ v,,..,,' n Ptok I' P
AMENDED: JULY 27, 2000 n'clIo.
SUFFOLK COUNTY TAX # n ;�tlnn 3r<,,,,a wife,
1000 - aa - 5 - 123
CERTIFIED TO:
MELVIN LEVINE
LILIAN LEVINE
COMMONWEALTH LAND TITLE
INSURANCE COMPANY t
% � Test Hole
_.----
go066i. not to scale
des-.t.Ada„-kvgi..:__ ,lyto.ro6 - Lace,
b
•
- - - SEPARATION DISTANCES FOR WELL
._-••.
AND CESSPOOLS REQUIRE 40 FEET OF
e • g WATER IN WELL. COUNTY RECORDS
• m OF NEIGHBORING WELLS INDICATE 40+ raltit
good ' ' -1 FEET OF WATER IN THEIR WELLS . heavy i'
�ip' ,s fzo Towel
c •
. - exist.
Iseptic
1 — . 6r1
i 9'
. 0. / Haber
.L • \ test
hole �O
," Send t
a In
:O.
gavel
\ / 4
\ 201
400• 1 \
I ;
eXlst. E Q) \ __
yeptic ; , w�
� t00
1 co
1 \ �0,e pd�•
' I . . \� 0 \\ stop' Pglrking 60 0'�0
Q '< •_ area = croaches cp O� O
I d
prop „)
D„yelling cO •
Or � O� •
-under . '��\ OtD et
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prppose n' O
°e.(5 V!
S TO
, - , 4. 0' i
Well , ) ,_ -, v
1
5„ 1�5;1
S$090
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CO X \ ‘
c'�r
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'PLEASE NOTE
. OLK COUNTY DEPARTMENT OF HEALTH SERVICES septl� �� 'BII'"g it is the applicant's responsibility to
PERMIT FOR APPROVAL OF CONSTRUCTION FOR A
betwmaineen
adequate sanitary distance
SINGLE FAMILY RESIDENCE ONLY StWeon a 1 Water supplyand S@Wage
disposal facilities.
II ATE LI-2-&-0U HS REF.NO.(10-00-007 _ �,:.e._._.
• PPROVED 1 _.Ili A A �•��-
��''OF NE/47=
FOR MAXIMUM OF B •MS �0'''S �k C EhCF `O
EXPIRES THREE YEARS FROM DATE OF APPROVAL 1 Uj > 13 I, Onbearing ad alteration o surveyor
a aY
map Dearing a licensed land"suryevors seals,"
1 ( �� + violation of section 7209, sub-division olsthe
1 i1r {.q[�-"'+'p, *, Nen York State Education Lan
G \ e. V, .ter^^` 1hy^�+ i "Only copies from the original of this survey
NOTES: • r e� ` 1a4% / stamped seal shall to valiayor 5
true
L —�i► .— oe� Copied
• • 1 ' /� e , �A / "Certifications indicated hereon signify that tn.s
MONUMENTF,L No.51 t 4 i survey was prepared , accordance with the.
• fisting code of Practice for Lana Surveys adopted
• .\� / Dy the New York State as SDciation of Professional
Q • VOO rJ °° Land Surveyors. Said certifications shall run Doty .
PIPE �v ••.••• LAND /0° o the person for whom tnr survey m prepares
/ and on his behalf to the title company, governmen
tat agency and lending institution listed hereon and
AREA = 31325 S.F. or 0.72 Acre assignees
of
e "toinstitution
da;°o a institutions
JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN STREET N.Y.S.LIC.NO.50202
GRAPHIC, SGALE 1"= 40' RIVERHEAD,N.Y. 11901
111111 369-8288 Fix 369-8287 REF.—TIOER\PROS\99-312A
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