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ELIZABETH A.NEVILLE ���O' y�: Town Hall, 53095 Main Road
TOWN CLERK ` C - P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS 4'1 Fax (631) 765-6145
MARRIAGE OFFICER t th `.
RECORDS MANAGEMENT OFFICER � Ql 11 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ����
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2283 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : NORTH BAY PROPERTIES
Address 1 : 32645 MAIN ROAD
City St Zip CUTCHOGUE NY 11935
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 #R10-00-0032
Name Of Owner ABBOTT, JOHN
Mailing Address 1 PO BOX 167
City St Zip MATTITUCK NY 11952
Property Address 1 8871 OREGON ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 83.00 block 1 lot 34.000
Cross Street DUCK POND ROAD
Building Permit Number Cross Reference:
Issue Date: 4/14/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE I"_� % Town Hall, 53095 Main Road
o P.O. Box 1179
TOWN CLERK %
t y Z ,t Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER �` y l%., $ Fax (631) 765 6145
RECORDS MANAGEMENT OFFICER �_�`l .a0�I� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ••� ,,r,,'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: March 28 , 2000
Transmitted herewith is a copy of application No. 2371 for a Cesspool/
Septic Tank Construction Permit submitted by:
North Bay Properties, Inc
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 recom ndations:
APPROVE
DISAPPROVE
Comments:
ignature
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Dated
OFFICE OF
TOWN OF
/'1" CO tK�� Application No. 7j
TOWN OF SOUTHOLD ••
ELIZABETH A.NEVILLE,TOWN CLERK •
P.O.BOX 1179 Construction
SOUTHOLD,NEW YORK 11971 • •
�=+ ; Alteration
Telephone '� �Q� ' $10.00 - Residential-
Telephone
(516) 765-1801 = 'l �'�� $25.00 -Non-Residential
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iv',
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
W WED
APPLICATION 14149 2e 2009
for 1thob
101vn Qat
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE '3\fa(3'0(l
APPLICANT NAME: 6 (UAA -Q.S
APPLICANT ADDRESS: :) �
SEPTIC _CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: t mortar Ilk t id& ! C I•■i
OWNER MAILING ADDRESS: I3 MAN RO flbI�" •, Sohr)
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OWNER PROPERTY ADDRESS: BSI '�� aftiIgSa-
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TELEPHONE NUMBER OF CONTACT PERSON:Mau1& tAACE-`Ye-
TAX MAP NO. : Section Na Block Q Lot 03
11
CROSS STREET: VtA Pv
BUILDING PERMIT NUMBER CROSS REFERENCE:
/v I
ignature Applicant
RECEIVED BY :
, Town Clerk's Office
DATE: ‘3 �O
ti •
:
SURVEY OF
C LOT 2 - t
, 7 O^// IN .
/V l., A MINOR SUBDIVISION
/Sq/1/v� PREPARED FOR HENRY D011ALESKI'
AT
2.i SOC/ CUTCHOGUE, (OREGON)
• a., To,20". NQ TOWN OF SOUTHOLD
Z • SUFFOLK COUNTY, N.Y.
C.1
rn »^ C. SURVEYED FOR: NORTH BAY PROPER DES, INC.
NA
_ O
60 -4-4.. 8' ^i TEST HOLE DATA
PERFORMED BY: McDONALD GEOSCIENCE
65N ��
EXISRNG GRADE
THO 75 Rreavo�D '—"-I"Neg
THOMPSON ■ __ BROM LOAMY SAM) SR
z.
5r 1 INC eaOrlR ONE IS COARSE sura SW
„P 5E.
ISED-
SPOOL. ,cr ._OT 7 ___ 4•
USC.¢1 PROPOSED-r II e- VACANT
•C•. ' 50%ESPANSI r ,,,
80' LIt. BROMM cur SARO MM 1OX CNA WI SC
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PR0P0SE1 PROPO ..Iii
V __
WELL 1 TENNIS m -�a'
COURT NSD 8ROM.Not TG 15154,5,AM, SA
0llii 75 �+'• Ind I d h n shall nM
A A
-0. ' O= hm h rvey
AX[ PROPO•r 5`-
55' 17' 00" W S 55' 17' 1-0"7W
145.75' 14575' Iowner.
O �—N 37'33' 40" W 1.1000-083-01-034
DMALESKI
I 464.26' ELEVA DONS IN 1929 NAVD
I ar ZONED' R-80
I
I
r—N 37'52' 10" W SURVEYED 3 FEB..2000
A 1 1876.23' SCALE I'=100'
RI AREA-89,350.066 SF
FOR S.C.D.H.S. USE ONLY I 2.05OR ACRES
1— N 42'29'20" W
260.73'
^) 0
C
R GUARANTEED TO
0 NORTH BAY PROPERR£S.INC.
COVENANT ABSTRACT CO.INC
O 7014IV OF SOU1MCCO
) Z
37'22' 40" W 0
476.75'
g
1 a 11E= 525' R 0 A D
0
^REGON SURVEYED BY
Q 'K m5135dd alteration or rdH=HS-rn S.this STANLEY J. ISAKSEN, JR.
rvey is s.violation or Is:::-iI.29 of P.O. BOX 294
CA
Ew sate Ed,._-n0.,ca.. NEW SUFFOLK, NY 11956
V 631-734-5835
•
j Coates of tF.is survey its:tp rt.,''-r^',,
llllll Il. I.,-r,.Sarveyots etala....'s.. shall ./.
not de con.:aured he be M v.,.d true kICEN i LA 152 R� FOR
.PY• ,/NYS NO. 4927
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