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ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR, OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-6145
Telephone (516) 765-1800
Permit No. 2105 R
Residential
X
Non -Residential
Fee $ 10.00
Septic
X
Cesspool
PERMIT ISSUED TO:
Name : RICHARD C. WRIGHT
Address 1: AIA/NCARB ARCHITECT
City St Zip HUNTINGTON NY 11743
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 #1110-98-158
Name Of Owner HENCHY, BARBARA E MICHAEL
- ----------------------------
Mailing Address 1 119 TULLAMORE ROAD
------------------------------
------------------------------
City St Zip GARDEN CITY NY 11530
-------------------- -- ----------
Property Address 1 2040 CALVES NECK ROAD
------------------------------
------------------------------
City St Zip SOUTHOLD NY 11971
-------------------- ------------
Tax Map No. section 70.00 block 4 lot 41.000
Cross Street YOUNG'S ROAD
------------------------------
Building Permit Number Cross Reference:
Issue Date: 7/06/99
----------------------------------
Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 24, 1999
a \ G -S
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-6145
Telephone (516) 765-1800
Transmitted herewith is a copy of application No. 2193 for a Cesspool/
Septic Tank Construction Permit submitted by:
Richard Wright for Barbara and Michael Henchy
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:
Signa e
Dated I Zqq
21 June 1999
0
OFFICE of the TOWN CLERK
Town Of Southold
Elizabeth A. Neville, Town Clerk
P.O. Box 1179
Southold, New York 11971
Re: APPLICATION for
CONSTRUCTION of a SEPTIC SYSTEM
Proposed Residence for
Mr. A Mrs. Henchy
2040 Calves Neck Road
Southold, New York
Ms. Neville:
On behalf of the owners Mr. and Mrs. Henchy I hereby make
application to the Southold Wastewater Disposal District for
the construction of a septic system.
1. Signed APPLICATION for the construction of a septic
system.
2. Copy of property survey and proposed sanitary system
design stamped with the Suffolk County Department of
Health Services approval of a septic system (Ref.
No. R10 -98 -158).
3. One copy of our property survey dated revised
17 June 1999.
4. Mr. Henchy's check No. 325 in the amount of $ 10.00
made out to the Southold Town Clerk for the payment
of FILLING FEES pertaining to this application.
Please process our APPLICATION as quickly as possible. Do not
hesitate contacting me if there are any questions regarding
this submission.
CARB
CC: Mike and Barbara Henchy
RICHARD C WRIGHT
AIA / NCARB
A R C H I T E C T
9 EAST CARVER STREET
HUNTINGTON VILLAGE
NEW YORK 11743
TEL 549 1700 • FAX 549 1914
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
ELIZABETH A. NEVILLE, TOWN CLERK
P.O. BOX 1179
SOUTHOLD, NEW YORK 11971
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
Application NoC2/ 93
Construction /
Alteration
$10.00 Residential
$25. 0 -Non-Residential
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
Permit No.
Fee $
APPLICANT NAME:
APPLICANT ADDRESS:
SEPTIC TANK or CESSPOOL
DATE 21 JUP6 ,
SEPT I CK -CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR A++En"T 0-1S
OWNER OF PROPERTY: $A'RMA A-kv 00*6L
OWNER MAILING ADDR
OWNER PROPERTY AD[
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO.: Section /U Block 4- Lot 41
CROSS STREET: " v K S D_
BUILDING PERMIT NUMBER CROSS REFERENCE:
W. P! R 110 - 58
Signaturt of Ap lica t
RECEIVED BY: Mm_Ne 3
Town Clerk's Office
DATE: v U ►1 2 4" IM3
11530
Suffolk County Department of Health Services
Office of Wastewater Management
Suffolk County Center
Riverhead, New York 11901
RE: Proposed Residence
Mr. and Mrs. Henchy
Calves Neck Road
Southold, New York
HS REF. NO. R10-98-158
Gentlepersons:
14 June 1999
We would like to have our Suffolk County Department of health
Services Permit for a Single family - 4 bedroom residence
updated pursuant with the actual proposed building footprint.
The location and design of the proposed septic system have
not changed from that which was originally submitted and
approved. We are requesting this in order to obtain Building
Permits from the Town of Southold.
Enclosed for the Department's use in this regard are the
following:
1. One copy of the originally approved survey.
2. Three copies of the updated survey which have
been signed and sealed by our surveyor.
Please do not hesitate contacting me if you have any
questions regarding this submission.
ours
®rg fhN#A 1IN C A R B
CC: Henchy
RICHAR C C WRIGHT 9 EAST CARVER STREET
AIA / N CAR B HUNTINGTON VILLAGE
NEW YORK 11743
A R C H I T E C T TEL S49 1700 FAX 549 1914
SURVEY OF PROPERTY
51 TUATE : SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK GOUNTY, NY
SURVEYED Oct-11-qb
SUFFOLK COUNTY TAX #
1000-10-4-41
CERTIFIED TO:
MICHAEL HENGHY
COMMONWEALTH LAND TITLE
INSURANCE COMPANY
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NOTES:
■ MONUMENT FOUND
0 PIPE FOUND
AREA = 38,43q 5F OR 0.88 ACRES
REFERENCE DEED: L11202 P 500
eL _ 16,6
E-09
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not to scale
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JOHN C. EHLERS LAND SUF
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.Y.S. LIC.,NO. 50202
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U tM fereen for one• tI, eurve .816 4,01
oM on ole 01 -all o tM tet le [before• e.•ernYn-
tol epnc, Me IoM In Irdtllul len Illt.b hereon. .rd
to the ao leM4e of tM �ehe lne 1. tllul len. c.rtiflce-
tleno .r. net t-0.1.01. to .felt$. -.1 1h.lnutl M.
I
.Y.S. LIC.,NO. 50202
SURVEY EY OF PROPERTY SEPTIC, DETAIL_
SITUATE: SOUTHOLD
not to sale
TOWN OF SOUTHOLD
SUFFOLK GOUNTY NY
SURVEYED O9-II-qB 112. 113.3 f3.7
AMENDED 10-22-98 112.'e ��,,,,,'�'';'
AMENDED 06-1-1-qq
SUFFOLK GOUNTY TAX # a
1000--70-4-41
CERTIFIED TO:
MIGHAEL HENGHY Test Hole
GOMMONWEALTH LAND TITLE
INSURANGE COMPANY snot to sale)
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NOTES:
■ MONUMENT FOUND
O PIPE FOUND
AREA = 38,439 SF OR Obb ACRES
REFERENCE DEED: L11202 P 500
ORAPHIG SGALE 1 "= 30'
0 •' 1
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r.
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neo peer lop a llcenee0 lendrsurveyor a eel is e
v lolet ion of se[t ion ygp5, au0-....alone 2, of the
Ne„ yore Stele Edvicet ion tev.-
"pnly copies from the orlglnal of this survey
staZperked vltn an original of the land euryeror a
ed $asl $hell be considered to of valla true
co0lee"
"Ctr[IIICat lana lnolcated here," eI,nll, ]net tole
survey vee pre0ered In a ordence mien the tv-
Isting Code of Practice fore Land Surveys ado0tea
d, the New ydre Stale eseoclatlen of Profess )one]
Land Surveyor$. Seld Gerd' ],:Ilona enol] run only
e, the parson for vnoa Ina survey Is prepared,
end on his pahalf to the title <,apenr. gvvtrnmen-
lel agency and landing the hated hereon, no
t0 ane seslpnsea of the lending Inatltutl,n. Carllllca-
tlons era not trans fers0Im to additional Institutions
N.Y.S. LIC. NO. 50202
JOHN_C. EHLERS LAND SURVEYOR
6 EAST MAIN STREET
RIVERHEAD,N.Y. 11901 REFERENCE # 98-0226
369-8288 Fax 369-8287