HomeMy WebLinkAboutNeville, Elizabeth //���
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ELIZABETH A. NEVILLE '� ;S. GS• Town Hall, 53095 Main Road
�� 'yj, �
•�o P.O. Box 1179
TOWN CLERK
Cl) x Southold, New York 11971
REGISTRAR OF VITAL STATISTICSt
MARRIAGE OFFICER
Q yC Fax (516) 765-6145
RECORDS MANAGEMENT OFFICERfo aO�,'�� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER z 1 * �o..
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2129 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : VINCENT TIRELLI
Address 1 : 745 LOVE LANE
City St Zip MATTITUCK NY 11952
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 #R10-99-0131
Name Of Owner NEVILLE, ELIZABETH
Mailing Address 1 4330 OAKLAWN AVENUE EXT.
City St Zip SOUTHOLD NY 11971
Property Address 1 365 MAILLER COURT
City St Zip SOUTHOLD NY 11971
Tax Map No. section 70.00 block 9 lot 34.000
Cross Street CUSTER AVENUE
Building Permit Number Cross Reference:
Issue Date: 7/28/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
/�,o��S�fFO�,�Co -
ELIZABETH A.NEVILLE ��Z` %,‘ Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
y Z k Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER ; Fax(516) 765-6145
` hone (516) 765-1800
Tele
RECORDS MANAGEMENT OFFICER `;'y�IJ�! �40�1�� P
FREEDOM OF INFORMATION OFFICER At
--• 0/8°
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: July 27, 1999
Transmitted herewith is a copy of application No. 2215 for a Cesspool/
Septic Tank Construction Permit submitted by:
Vincent Tirelli for Betty Neville •
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:
'gnature
Dated
y
OFFICE OF THE TOWN CLERK 0,14`81
1•° fl
TOWNOFSOUTHOLD ?' _ Application No. gaAs
ELIZABETH A.NEVILLE,TOWN CLERK '
P.O.BOX 1179 II Construction
SOUTHOLD,NEW YORK 11971 g L 0
00
Alteration
Telephone i
O.: $10.00 -Residential
(516) 765-1801
411* ,' $25.00 -Non-Residential
-- -"I,,,,,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 7/ 2- f / '
APPLICANT NAME: 7 k-, f ) ; V , ,., C e t
,
APPLICANT ADDRESS: 7 Y ! Lo v 2 (. q- /S e ? e J
,lit A-,7 r r<,c k t ( 1 i ' (<J '`F
SEPTIC CESSPOOL
DESCRIPTION OF
OF PROPOSED CONSTRUCTION OR ALTERATION Arg w a��
D 1-.en I t .-.1V` o J g 'e
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: '' �'''''""""" =-�/ ,. 7T // '
OWNER MAILING ADDRESS: _ _ _ ''`f' `"��
43ao ,'_ qw _ 1
•Sou k.Id
OWNER PROPERTY ADDRESS: /3 ei/ y NE vta E.1111120k
3G,5 G1v,w - ( . ii ? 7 /
TELEPHONE NUMBER OF CONTACT PERSON: 6169/7 66- 6 73 ti
TAX MAP NO. : Sect'on 7() Block 0 9 Lot <.,
CROSS STREET: 67 Q4 f.----(,,
BUILDING PERMIT NUMBER CROSS REFERENCE:
Sign1/,,,,_. -V J G
ature of Applicant
RECEIVED BY:
75
ofir9 Office
DATE: 7/ /a
DEPT.C Lot numbers refer to "Mop of Smithfield Pork"
Tiled in the Suffolk County Clerk's Office on
Dec. 27, 1966 os File No. 4770. SURVEY OF PROPERTY
'99 JUL 16 R15 :C4
TESTNIKEA T SO UTHOLD
lb .ege
OUSTER AVENUE TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
Brew
%a "'b "'� 1000-70-09-34
3 SCALE: 1'=40'
JUNE 14, 1999
q Palo brow
r awlSte~aSW CO
wn SUFFOLK COUNTY DEPAR1 ENT OF HEALTH SERVICES
°eaaw.I
u,
r.,,�+as I 22 ,..
i PERMIT FOR APPROVAL OF CONSTRUCTION FOR A .
e7NGLE FAMILY RESIDENCE ONLY
N Ir (vacant)
DATE -7-2 A
_� g H REF.NO. 0_'9_0,3
21738' APPROVED A a\OF i
• el 21 4'
N 84.58'
20" E o FOR MAXIMUM OF BE•;••
Soy •.....
EXPIRES THREE YEARS FROM DATE OF APPROVAL
Nel ta.6' / O ',
o T, F�-3 . y*r. :' ,-
well 25 PLEASE NOTE
�ti.
O ,� I m Minimum distance between well
15 w (� a '"� t . ��.r and cesspool is to b2 150 feet.
21 z .
i (dwelling) / (' •
away Q
well over 150' is. ie• Q
O '�� T O
ii)
Se
el 21.9' - y
o
----T"_ _ 235.86' el 20.e
�Z e„a.;_ S 84'58'20'' W 26
,,,,„4
_ 20 . ,
(dwelling) AREA = 22,882 sq. ft. c(. NEW y
P�
C.P. location unknown S't as 1.METraf��
I am familiar with the STANDARDS FOR APPROVAL well & o t p
AND CONSTRUCTION OF SUBSURFACE SEWAGE ',i,
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES °Med i
_ and will abide by the conditions set forth therein r�r e'� N.Y.S. LIC. NO. 49618
and on the permit to construct. ANY ALTERATION OR ADDrTION TO THIS SURVEY IS A VIOLATION f9 fir`s
'aer lrti� ORS, P.C.
The location of wells and cesspools shown hereon EXOF SECTION As PER72COTHE 2N09W SUBYORSTATE 2. AL CERTIFICATIONS LAW. 4, i;,1 . ;020
ore from field observations and or data obtained EXCEPT AS SECTION 7209—SUBDIVISION 2. ALL
from others. HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF P. O. O9
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STREET I99-231
I Elevations referenced to on assumed datum. 7Al/ia 1 w bll.1 WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N.Y. 11971
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