HomeMy WebLinkAboutDilworth, Anita 0/00S�FFO(�---.
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ELIZABETH A.NEVILLE t .Z� goy�j Town Hall, 53095 Main Road
TOWN CLERK s 1 P.O. Box 1179
t N 2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS �'� Fax (516) 765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER 4 0� i Telephone (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. 2040 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : SPITALIERE CONSTRUCTION
Address 1 : 54.655 MAIN ROAD
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 #R10-98-0172
Name Of Owner DILWORTH, ANITA
Mailing Address 1 PO BOX 992
City St Zip EASTV I LLE VA 0000
Property Address 1 OLD WOOD'S PATH, PVT RD #10
City St Zip SOUTHOLD NY 11971
Tax Map No. section 87.00 block 1 lot 3.000
Cross Street SOUTH HARBOR ROAD
Building Permit Number Cross Reference:
Issue Date: 3/17/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
aoLfo
•
�OFF°IA'
ELIZABETH A.NEVILLE 01
1' goy Town Hall, 53095 Main Road
TOWN CLERK t 1 P.O. Box 1179
ti Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Z v- Fax (516) 765-1823
MARRIAGE OFFICER Telephone hone (516) 765-1800
RECORDS MANAGEMENT OFFICER .
.-14/0
FREEDOM OF INFORMATION OFFICERI Jig �O� P
•• • Of
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: Marhc 15, 1999
Transmitted herewith is a copy of application No. 2120 for a Cesspool/
Septic Tank Construction Permit submitted by:
Spitaliere Const for Anita Dilworth
•
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:
g ature
Dated
OFFICE OF THE TOWN CLERK ,"'' A`FLK
TOWN OF SOUTHOLD ,��GI"
% w'; Application No. QJ 0
ELIZABETH A.NEVI'I.F,TOWN CLERK
P.O.BOX 1179 _ -:.4. ` Construction
SOUTHOLD,NEW YORK 11971 Z
v n/; Alteration
ct� �
Telephone ----_Vel
Diy r�' . $10.00 - Residential 7
(516) 765-1801 -_ Vl */lb,/ $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT RFS'► /�,�R,.^
SEPTIC TANK or CESSPOOL t44R f 1999
town Clerk Jou(nold
Permit No.
Fee $
DATE 3`/S/q'
APPLICANT NAME: —jp�plt C Sidit lifer e (5))/1-dtie if e ‘.vn
APPLICANT ADDRESS: f6,$3- 711e/4 ) i
sfie-khili7 it/.y" /117/ •
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
Gt1®B '1/ _PtdM-t Z 5-747 Jfa Nfe
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
I
OWNER OF PROPERTY: �j/j.4 Di /W�R --I i_
OWNER MAILING ADDRESS: re, ,.®7( emz. c,r_dvi 1/e U/Es
OWNER PROPERTY ADDRESS: 0 Id \,' ioods Zmurl */C)
So 0-+ IcQ PG.it,
TELEPHONE NUMBER OF CONTACT PERSON: ypdalier.o Co.cs7- 76s-ALP/
TAX MAP NO. : Section 09 7 Block ® / Lot (� 3
CROSS STREET: if v (t /Or" cX
BUILDING PERMIT NUMBER CROSS REFERENCE:
�
` % / �- .
/, '
ig ature of Applicant
RECEIVED BY: ::
Town Clerk's Office
DATE: 3/4 I ”
N/F
LAUGHING WATERS N
• PROPERTY OWNERS ASSOC. N/F DRUM
SALT MARSH
S6,S.
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:7' 10' 30" E 95.12
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N/F LUDECKER
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ry
I N/F
LUDECKER
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N/F
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SAFALOW0.
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PROP. N/F JOHNSON
CESSPOOL -\ JOHNSON
(VACANT)
h
O PROP .
SEPTI
24' k \ TA
735' 711A22' 1 ')1 jH PIv =---N
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00 70' V
o� O
J BEDROOM
37'
3e ••• FRAM
RES.
"R4,4 O Hi,
/>'D to 4?8 L` �'J PROPOSED T
O80
0 Ov WELL FO.
OS RQ FD (A OF
cu 1..
N 74' 24' 50" W z -8=t
32.11'
o oma+
Ilio TEST
N/F 0 HOLE v 1 m
•
McOUEENEY
E IX
S 04' 29' E
18'
TO Fpcm S 88' 51' 40" W 239.46' NaSTONE
MON
LOT# 13 "PARK"
l MAP OF NUNNAKOMA WATERS •
AT SOUTHOLD F
FM! 6088 FILED JULY 9, 1968
v
TEST HOLE DATA
PERFORMED BY: McDONALD GEOSCIENCE
SURVEY OF
EXISTING GRADE LOT# 3
\, ,\\.`,•!\ DARK MOWsavor Law OL IN A MAP ENTITLED
'' MINOR SUBDIVISION FOR RUSSELL& EL/NOR FREUND
AT SOUTHOLD
BROW LOAMY SAND SM SI TUA TE
SOUTHOLD, TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y.
PALE BROMN FINE SAND SP
SURVEYED FOR: ANITA DILWORTH
SURVEYED: 2 NOVEMBER 1998
tr SCALE 1'=50'
AREA 1 = 144,694.81 SF
OR
r,�.PAR'['Iv1L"�`%�'`�'"^Lm SER'✓:CES I
3.322 ACRES
S O�.K COl.^1T
FINISHED GRADE ;rgrt,11M'�ONrORA I
r
,,,,,-.,:,;\1_, I'M/N PEB•'D'T co `,ALL/ ZONED R80
:� PO- _u 1 TM 1000-087-01-23.006
"SW
JA's::;_.�._.._
300 S.F. -.
✓ ,
SIDE WALL I
I I .:SVP {;vF.D 1 I
AREA i s _ ;,i+^CJGMS
LEACHING II FORMAS.:`�` RS F
POOL
EXPIRES THREE YEARS FRCM CIA CE iif AFr R>V A
2' MIN. 8'
CROUNOWA TE
NOTE: NO SANITARY SYSTEMS OR
WELLS WITHIN 150' OF THE
TYPICAL CESSPOOL SYSTEM PROPOSED WELL AND SANITARY
SYSTEM FOR THIS RESIDENCE
N. T S.
r FINISHED GRADE
,,,,,,,/, ELEVATIONS ARE IN ASSUMED DATUM
l'
2'MAX.MA
I/I'/J' - ---1---- 1 --- r/e./I'
0
:'MIN. TO CESSPOOL
1000 GAL. SEPTIC TANK
TYPICAL SEPTIC TANK
GUARANTEED TO
ANITA DILWORTH
SUFFOLK CO. HEALTH DEPT APPROVAL FIDELITY NATIONAL LAND 7/TLE INSURANCE CO.
TOWN OF SOUTHOLD
H.S. NO.
STATEMENT OF INTENT 1Odr
THE WATER SUPPLY AND SE -GE DISPOSAL SYSTEMS
FOR THIS RESIDENCE WILL , 0, TO THE STANDARDS " ..
/�/tel
OF THE SUFFOLK CO. DEP ', • TH VICES L.•dl =
I,, :I vlian.
•/ Z.------1.--- .. crC I ..•.a... Ic to
• ' / .r.ditiot..11 inslitutk s cr >.k>•—q,_nt women.•
TOWN OF SOUTHOLD
Unc.. r:d alta :
_: .;.:<n 1:: this
FOR APPROVAL OF CONSTRUCTION ONLY si.r.,,. .::9 o,
DATE : the 1r:. 'i or'k Sn.l_ Ldur.:J;cn Lao.
APPROVAL :
t h,, , •-...r.,9
E SUFFOLK CO. TAX MAP DES/GINATION tri: t :,1 Banc;. ',hail
DIST SECT BLOCK PCL. no' c<"'i.r... .. .... °r,;d tntw
1000 087 01 23.006 '0„,.
OWNER : SURVEYED BY
ANI TA OIL WORTH STANLEY J. ISAKSEN, JR.
P.O. BOX 294
NEW SUFFOLK NY 11956/
516—V,34-58
.��.,,
I
REV 31 DEC., 1998 MOV. (CENSE' L•ND SURVE - •
SANITARY NYS LI . N>'. 49273 /
98C756