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HomeMy WebLinkAboutFoote ,� FOFFOLAP eoi- JUDITH T.TERRY � � yl Town Hall, 53095 Main Road TOWN CLERK ; ria P.O.Box 1179 w i Southold,New York 11971 REGISTRAR OF VITAL STATISTICS `®y ��'��� Fax(516) 765-1823 MARRIAGE OFFICER /f' RECORDS MANAGEMENT OFFICER : .� #001 Fax (516) 765-1800 FREEDOM OF INFORMATION OFFICER �„ ,.• � OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 3515-R Residential X Non-Residential Fee $ 10.00 New X Existing Name Of Owner FOOTE, NANCY L. Mailing Address •1 P. O. BOX 156 Mailing Address 2 City St Zip MATTITUCK NY 11952-0000 Property Address 1 790 WILLIS CREEK ROAD Property Address 2 City St Zip MATTITUCK NY 11952-0000 Owner Telephone No. 516-369-5590 Tax Map No. section 115.00 block 17 lot 17.013 Cross Street MEADOW BEACH LANE Issue Date: 9/26/96 Judith T. Terry Southold Town Clerk (TOWN SEAL) OFFICE OF THE TOWN CLERK .c\\VFO1. - "-= �/ Town of Southold CQ �� Application No. Judith T. Terry, Town Clerk �� O 1 Town Hall, 53095 Main Road 8 �r �,• =4*, $10.00 - Residential — - P. 0. Box 1179 (X3 ' f G s; ? �`' $25.00 - Non--Residential Southold, New York 11971 O *� '••0���'� Telephone (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ 0 DATE volq„6 OWNER NAME: (Ua t... -D OWNER MAILING ADDRESS c)a Q-) y, ) OWNER PROPERTY ADDRESS: • 7 / U L,c5 t ///' 6z /C OWNER TELEPHONE NUMBER: 36)? -S-5-610 TAX MAP NO. : Section //5--- Block / 7 Lot / 7,D/3 CROSS STREET: (Y),_,A,,,,„ C3 c� ✓�-t TYPE OF SYSTEM: Septic Tank New 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.) / r Sig `tune of Applicant RECEIVED BY: Town Clerk's Office DATE: • . • . , o o . . _,„,.... . ,......„ , . , . goung Young planning ) A Engineering .u%., �� ' O liktrueying ?� • 61v- y P.. v •Fj s0 y 7Z ti�.� V_ot 12 \ \ / \ C. "CO PRO 0N0 t6 DEEP '-r-L„ --97— 1014'/VE'PY _� ,....co 8111 PR', —' \\ \ `f -'I 1, 1 N \ . N ; 5„ E I I .�•e�. tP 35 �,W A� 0,11 f cP, 0 \ LS �� N :7S'�20 366 �I-fro.-- � `, ��11‘.............‘ll Stti%-� �\ 69-0 11 t \ r \\ 1, , , , \ 6 /1 f PI i�1 I \ Y • / 1 \G/ Y c' I ` \�S'A o .\m\\ , ,1•1 '?���111 f\�� N �J 1 rn Lu W Ce z ox �\ �•h SOF \\\ 20 , )/ \1 \O. o� . \o II I W I wx �.�y• ,' , \ y'-�� \ o� "'syo \ \0 I t I U 1,111 Z O I ~a IoW �0''' V !I_ �� 11\u t'�yo \ �' I N • I '.ilii ,' 1 8,` \ 11\eo „.A \--WS-- L v Y' w e \ \ 1 0 IIy,",1 r,,•,1____ 5_0.5' O I F O m ` Q �II C},��i'CQ<? \� \ \�• 1�m, �IN _'�_— I . I Aril U >'F" LOGI I `tiy4 e0 , `.r .1/2'.' 1,3 19N lo. (10 00' I swum C, Z •• 306•�5 I n1 O 01 Cln 3w�r `�� /14366. �`% / / WN O oO 3- I CE NAY OG�cONg1RVCj oct ON 7,...__CE 43. / C9.1-4 ?LAO. 00(ttN . 1 I �� f6NC 1.24D I I `ok. �4 .\ , . NOTE: 1. ♦= STAKE FOUND '0 = STAKE SET 2. ELEVATIONS SHOWN HEREON ARE FROM ACTUAL SURVEY AND ARE REFERENCED TO N.G.V.D. (MSL 1929). 3. FIRM ZONE "A4" BASE EL. = 8.0 CONTIGUOUS WITH 8 CONTOUR. , 4. AREA = 45,744 S.F. 5. SUBDIVISION MAP FILED IN THE OFFICE ,OF THE CLERK OF SUFFOLK COUNTY ON AUGUST 21, 1987 AS FILE NO. 8377. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES CERTIFICATION SURVEY FOR: "I AM FAMILIAR WITH THE STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES AND WILL ABIDE BY THE CONDITIONS NANCY L. FOOTE SET FORTH THEREIN AND ON THE PERMIT TO CONSTRUCT." APPLICANT'S SIGNATURE. LOT NO. 13, "HARBOR VIEW AT MATTITUCK" APPLICANT' At: MATTITUCK Town of: SOUTHOLD STREET ADDRESS. Suffolk County, New York CITY: STATE: ZIP CODE' TELEPHONE NUMBER: Suff. Co. Tax Map : I 1000 1 115 1 17 1 17.13 District Section Block Lot Young & Young, Land Surveyors '-- ' JULY 10, 1996 400 Ostrander Avenue, Riverhead, New York 11901 -.' '' JUNE 100JUNE 24, 1996, 1996 _ 516-727-2303 MAY 29, 1996 J f FEB. 28, 1995 JAN. 18, 1995 - NOV. 22, 1994 Alden W. Young, P.E & L.S. (1908-1994) �� OCT. 11, 1994 _ L ei DATE :JUNE 10, 1994 Howard W. Young, Land Surveyor .'- e / SCALE :1"= 50' Thomas C. Wolpert, Professional Engineer JOB NO. :94-0305 Kenneth F. Abruzzo, Land Surveyor John Schnurr, Land Surveyor J - SHEET NO. :1 OF 1 O� y (F0960467.DWG) OO d e UNAUTHORIZED ALTERATION OR COPIES OF THIS SURVEY MAP NOT BEARING DISTANCES SHOWN HEREON FROM PROPERTY UNES CERTIFICATION INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY THE LOCATION OF WELLS(W),SEPTIC ADDITION TO THIS SURVEY IS A THE LAND SURVEYORS INKED SEAL OR TO EIOSTING STRUCTURES ARE FOR A SPECIFIC O IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERNMENTAL AGENCY AND LENDING o TANKS(Si)a CESSPOOLS(CP)SHOWN VIOLATION OF SECTION 7209 OF THE O EMBOSSED SEAL SHALL NOT BE CONSIDERED O PURPOSE AND ARE NOT TO BE USED TO ESTABUSH INS117U1ION USTED HEREON,AND TO THE ASSIGNEES OF THE LENDING INSTITUTION HEREON ARE FROM FIELD OBSERVATIONS y NEW YORK STATE EDUCATION LAW TO BE A VAUD TRUE COPY PROPERTY UNES OR FOR ERECTION OF FENCES CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS AND OR DATA OBTAINED FROM OTHERS