HomeMy WebLinkAboutFouchet, Michael ,ii
ELIZABETH A. NEVILLE ���'�`O �, Town Hall, 53095 Main Road
TOWN CLERK •
y '� P.O. Box 1179
REGISTRAR OF VITAL STATISTICS v,VSouthold, New York 11971
V O Fax(516) 765-6145
MARRIAGE OFFICER ` Telhone (516) 765 1800
Telephone RECORDS MANAGEMENT OFFICER % % 1 P
FREEDOM OF INFORMATION OFFICER = 491 ' , "11
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2164 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MICHAEL & JUDI FOUCHET
Address 1 : 895 SEAWOOD DRIVE
City St Zip SOUTHOLD NY 11971
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 #R10-99-0101
Name Of Owner MICHAEL & JUDI FOUCHET
Mailing Address 1 895 SEAWOOD DRIVE
City St Zip SOUTHOLD NY 11971
Property Address 1 1075 SHIPS DRIVE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 79.00 block 3 lot 35.000
Cross Street NORTH BAYV I EW ROAD
Building Permit Number Cross Reference:
Issue Date: 10/05/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE i r r owl Ha11, 53095 Main Road
TOWN CLERK = BLDG•DEPT. € P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS % ¢U •THOLD thold, New York 11971
MARRIAGE OFFICER : O Fax(516) 765-6145
RECORDS MANAGEMENT OFFICER `.... D ���I��� Fax
(516) 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: September 23, 1999
Transmitted herewith is a copy of application No. 2250 for a Cesspool/
Septic Tank Construction Permit submitted by:
Michael Fouchet
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.
ycew
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments:
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nature /
Dated
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OFFICE OF THE TOWN CLERK '' OL/re;
TOWN OF SOUTHOLD ,%e% J. Application No
ELIZABETH A.NEVILLE,TOWN CLERK 4
Construction
P.O.BOX 1179 ; IA. ..._
SOUTHOLD,NEW YORK 11971 p ; Alteration
Telephone -.
0 $10.00 -Residential 1 -
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(516) 765-1801 4 ,►'' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE (Va / 9 9
APPLICANT NAME: /l// //1hL tier 4.04 �Lt2) / t-FLA_CH-E %
APPLICANT ADDRESS: $`1 se 4I,JDD6 '7 i v t
ic),(A-T-Ho t_ •) /3 &f /11 7 /
SEPTIC CESSPOOL a/
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
N /es/'den am-In-cc-A
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: /l,{1cl-1i: e c.. 4J1 .TT p / 4j4 iteIte/
OWNER MAILING ADDRESS: , _ ' =` ' - .- "17- gam/ 5-
SO L,_i ttOLb /1/4-) Y 1/9 7 / 'u
1
OWNER PROPERTY ADDRESS: "- / Q ' 6+ Z,
TELEPHONE NUMBER OF CONTACT PERSON: 16c-60/ 3'
TAX MAP NO. : Section 7 q Block 3 Lot r3S—
CROSS STREET: A O .7 J.t Fkf i//6[.J k4A�
BUILDING PERMIT NUMBER CROSS REFERENCE:
1 / / N49-/-(4
Signature of Applicant
RECEIVED BY: /4j -,2__
Town Clerk's Office
DATE: 9/v��i/5
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I am famMar with the STANDARDS FOR APPROVAL
AND CONSTRUCTION OF SUBSURFACE SEWAGE
\(1'.7 i w` Or
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES
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and will Olde by the conditions set forth therein and on!ha
permit to construct
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'''',. /g. NOTE LOT NUMBERS REFER TO 'SUBDIVISION MAP OF
•O,. BAYV/EW WOODS ESTATES'FILED IN THE SUFFOLK
= / COUNTY CLERK'S OFFICE ON SEPT. 9, 1970
�� t� o A Q ��/ AS MAP NO. 5520
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,...1... rya/ Cit;i
,; \Zs,,\ . SURVEY OF PROPERTY
o AT SOUTHOLD
N
6Z.,„0. L TOWN OF SOUTHOLD
l VO WAiiSUFFOLK COUNTY, N.Y. _
woo - 79 - o9 - 35
a1 1 SCALE r' = 30'
1o� ---- j0 APRIL 30, 1999
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2 I ELEVATIONS ARE REFERENCED TO AN ASSUMED `-, '
DATUM o. ac NEW y,
CERTIFIED TO'
ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION - fit. M,Erz kk
OF SECTION 7209 OF THE PEW YYHX STATE EDUCATION LAW. / THE SUFFOLK COUNTY NAT B
EXCEPT AS PER SECTION 7709-S INDM Nl 2. ALL CERTFICATIOMS (, , K , 7 -..- 'C�"t,,,<
HEREON ARE VAUD FAR MS MAP AND COPES THEREOF ONLY FIDELITY NATIONAL TITLE 1tNCE / S. LIC. NO. 49618
SAD MAP OR COPES BEAR TIE IMPRESSED ESSED SEAL Or THE SURVEYOR / COMPANY OF NEW YORK �
WHOSE STRIATUM APPEARS HEREON: O Ii:11 l'J 61 ,.r i I L b u, M• F`Ed`,.ww``YOR '.C.
The locations of wells and cesspools 76 ��!; i'" ' �i
ADDITIONALLY TO COMPLY WITH SAD LAW THE TERM ALTERED sr i; r BO • cc,
ALTBE USED BY ANY AID ALL SURVEYORS UTI/IDN6 A COPY shown hereon ore from field observol//of; i;., „ .•J_'-
V'OicH o-D iRENOTTERMS NCaFUAANCEAWTHHTnELAwAND AREA $ 21,967 sq.ft. and or from da/o obldned from others. 6�,^,(3?]y s„ _�Rav�. ,'So`3�'97ET
99 - 184