HomeMy WebLinkAboutFornasar, Edward 4,.....
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ELIZABETH A. NEVILLE `. Town Hall, 53095 Main Road
TOWN CLERKP.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS wMARRIAGE OFFICER11 Fax(516) 765-6145
RECORDS MANAGEMENT OFFICER 1Telephone (516) 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. 2138 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JAMES V. ZIZZI
Address 1 : P.O. BOX 1551
City St Zip QUOGUE NY 11959
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 #R10-99-0132
Name Of Owner FORNASAR, EDWARD AND JUDITH
Mailing Address 1 169 REMINGTON ROAD
City St Zip MANHASSET NY 11030
Property Address 1 COUNTRY CLUB DRIVE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 109.00 block 3 lot 2.014
Cross Street MOORES LANE
Building Permit Number Cross Reference:
Issue Date: 8/19/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE � �y Town Hall, 53095 Main Road
TOWN CLERK p - P.O. Box 1179
ti 2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS V% Fax (516) 765 6145
MARRIAGE OFFICER 1 hone (516) 765-1800
Tele
RECORDS MANAGEMENT OFFICER q/0 `a �l� P
FREEDOM OF INFORMATION OFFICER . ' "i��
�0 0
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: August 17, 1999
Transmitted herewith is a copy of application No. 2224 for a Cesspool/
Septic Tank Construction Permit submitted by:
James V. Zizzi
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 r ommendations:
APPROVE
DISAPPROVE
Comments:
Signaer-/ --Lj—r-s----
g\ iq ctf
Dated
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OFFICE OF THE TOWN CLERK ,g"�,AMU(
TOWN OF SOUTHOLD i,"�0. V COG Application No.� 0 2--�
ELIZABETH A.NEVILLE,TOWN CLERK `i Construction
P.O.BOX 1179
SOUTHOLD,NEW YORK 11971O
•• WsAlteration
Telephone ij' ��',
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$10.00 - Residential X
(516) 765-1801 -_'y1 � "��� $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 9-I 7 -9 J
APPLICANT NAME: ,J P'M I Es 1! i ZZ /
APPLICANT ADDRESS: /O,.et( /5Y/
_ //1/`/
SEPTIC X CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: _GSI,c,,11,6,e 1/ S/jfr,„hc.c/ feivA 4sm—
OWNER MAILING ADDRESS: /499 /erne iL.. /'YAC iiiihthenreal 030
OWNER PROPERTY ADDRESS: 4/- 2. 1 e' ii--
TELEPHONE NUMBER OF CONTACT PERSON: o S�3 9 7� Z�zz1
TAX MAP NO. : SectionjO9 Block t1g Lot 1/4/
CROSS STREET: inDOy-e-1 l 14 / e
BUILDING PERMIT NUMBER CROSS REFERENCE:
//
•T:ture of Applicant
RECEIVED BY :
Town I Office
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DATE: ( 7 /
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'� 0° \ • SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF
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°\c,OA / sr \ iA5\ ` (n - j��( \ SUFFOLK COUNTY ON OCT. 17, 1978 AS MAP NO. 6736 oi"g •
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O� =�� I �\ • ELEVATIONS SHOWN HEREON MAY BE FROM MAPS OR SURVEYS ios
\ / �9 `, 6't .,� \ /' PREPARED BY OTHERS AND ARE SUBJECT TO FIELD VERIFICATION. gob
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11 �` 2%/ \ FY TO EDWARD
`\-e. ` '�/�8 �"g'ot,-,g1,,1' IIS.,F9 a 4f% \\\� ��� I 11 FORNASAR,• WE HEREBY CJUID ITH FORNASAR & LAWYERS Iii
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o es S „ ,0 'L9 P:O.\Bo 1551
TEST HOLE t`• - \-o'e`o`..9l Cuogue NY 11959 EDWARD FORNASAR & U JDITH FORNASAR = §
°' l�f� 54 76 LOT 21 "COUNTRY CLUB ESTATES" ��`
Mc00NALO CEOSCIENCE E
(JULY 26.1999) SUFFOLK C8IINTY DEPAR •v OF HEALTH SERVICES ESE
EL.9.5 ` SANITARY SYSTEM At Cutchogue, Town of Southold /<k
DARN BROWN FC APPROVALO' CONS�:RUCTIONFORA N.T.S. USE (3) POOL SYSTEM Suffolk County, New York ,§2°
SANDY LOAM 2 0' PIr�11ilT RFE' ¢"i
BROWN LOAMY 'SANO p^JZN �fj�^FLAMILY roFNL'EOTI'Y County Tax Map District 1000 Section 109 Block 03 Lot 2.14 s„:
BROWN FINE 3.0' DATE o-3” l HS REF. .LL. • r! Z HOUSE ___ - ___ „F: ',
TO MEDIUM
SAND /1� I FF 147 C.I. COVER FINISHED GRADE i BUILDING PERMIT MAP 566
70' APPROVED ��=V'.-- 13.2 TO GRADE _ _ _ O'-c
PALE BROWN 12.5i. 12.3
EL 1.9 MED"TO FOR 7.6. FOR MAXIMUM OF B MS ��m _ 0
EXPIRES THREEYEARS FROM DATE OFAPPROVAL IE=10.4 IE=10.2 r------_____ 20' ADDRESS HEALTH DEPT. COMMENTS JULY 27, 1999 X
WATER•1 IE=9 5 BUILDING PERMIT DATA JUNE 11, 1999 "b
PALE BROWN _ _ 1O'MIN. 8'MIN. 9' MIN. F,Y'
FINE TO MAP PREPARED MAR. 23, 1999
MEDIUM SAND .._117__ Exlsnpc roNrauRs (1) SEPTIC TANK EL=5.5 ' ' €�
14.0 —(117)—=PROPOSED CON TOURS
1000 CAL (3) LEACHING POOLS SCALE 1" = 50' '.7
3 MIN.
(12) PROPOSED CONTOURS 300 S.E.S.W.A. JOB NO. 99-0139 OF 1 ag_
D=MONATENT SET • -MONUMENT FOUND A..STAKE SET A.STAKE FOUND GROUND WATER EL=1.9 a
41 oWG. No. 990139 O• 3EF