HomeMy WebLinkAboutMiddleton, Kevin •
.�,� OFF 0tir
ELIZABETH A.NEVILLE O Town Hall, 53095 Main Road
TOWN CLERKr` P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Z Fax (516) 765-1823
MARRIAGE OFFICER `�
RECORDS MANAGEMENT OFFICER ?,4 �� Telephone (516) 765-1800
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FREEDOM OF INFORMATION OFFICER � �/ jig
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2006 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : KEVIN MIDDLETON & MARIE JONES
Address 1 : 2393 UNION BLVD, 3A
City St Zip ISLIP NY 11751
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 #R10-98-118
Name Of Owner KEVIN MIDDLETON
Mailing Address 1 2393 UNION BLVD, 3A
City St Zip ISLIP NY 11751
Property Address 1 MAIN BAYV I EW ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 87.00 block 5 lot 23.010
Cross Street VICTORIA DRIVE
Building Permit Number Cross Reference:
Issue Date: 2/18/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE 14‘, COGy�r- Town Hall, 53095 Main Road
TOWN CLERK c 1 P.O. Box 1179
% Southold, New York 11971
REGISTRAR OF VITAL STATISTICS % rr, ,
MARRIAGE OFFICER Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER : y50 �0Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER — 1 l '0�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: February 11 , 1999
Transmitted herewith is a copy of application No. 2090 for a Cesspool/
Septic Tank Construction Permit submitted by:
Kevin R. Middleton and Marie Jones •
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 reco ndations:
APPROVE
DISAPPROVE
Comments: £atur
� 1IA tic
Dated
OFFICE OF THE TOWN CLERK
TOWN OFSOUTHOLD „ic�v C�G� Application No. ��
4
ELIZABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 : Construction v
SOUTHOLD,NEW YORK 11971
Alteration
Tele hone ,j� 0"./ $10.00 - Residential
P .
(516) 765-1801 -_.. 1 l ," $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 - // ` 99
APPLICANT NAME: Y� v i"1 /Q, dtd d 1e+ o 4,4d Part e J� '��
APPLICANT ADDRESS: z3 ?3 d4,°” k,1 �A- �C, frig i�Y //75 f
SEPTIC /CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION r_0„1,_34t-ue4(d-
04-- sele-tie, 4- Ce�a-104Q[
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Keo,., , /f'trdd Je4 -
OWNER MAILING ADDRESS: 2.393 61 uc), 374-
511 07
OWNER PROPERTY ADDRESS: 1,1 00/ d Jou 4, m I0
TELEPHONE NUMBER OF CONTACT PERSON:( 5-1 6) 277-- 67 _)—
TAX
7jTAX MAP NO. : Section /P m c' Block 5 7 5 Lot .2 . )
CROSS STREET: v ) ,—
BUILDING PERMIT NUMBER CROSS REFERENCE:
_14
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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, 4 • / �' .• DEPARTMENT OF IMALTH SERVICES
. , u;,` . , : -•Wil' 4 4 ` ,•iu FOR APPROVAL OF CONSTRUCTION FOR A
,04 • y, d TINGLE FAMILY RESIDENCE ONLY
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moo=
4 :C 7 ' \ fele Si FOR • I I OF c EDROOMS
��'j,FT ;3�� ' ham. +a•r . . -.3 . • FROM DATE OF APPROVAL
V.
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3 I s
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TEST HOLE*i 9 ak TEST MALE M Y D•rk Mow
N, PQ'.o b p 0 'w�INN OL 0.5'
Sob 6 ; �: Dar*brown
4°0*4'e• EXCA ATION INSPECTION ' OL •
Q9- /! AC ?j.� I=pR SANITARY SYa Ek �� y / � .
R µ ALTH DEPA�' 1' Dow �It brown Ire .3•
�- cause wad i� SOWN 4A►wird ac
VA "w• g,I340Norm drp Ur
+M7� Io�,,,�T 1�T �r �,,, l
"sand Willer b brown
'1" "�•�C7TrA� OTEOTEy CT{A'' r 0) e• r sand
b 'MO by slept at He• Services Poe brown
sc
P20 c,..yds �'// rN9v�rc o4 rrA soars* 8'
NOTE, 11,6
REMOVE ALL 9106IVIDUS SOL
BELOWN4G AI IR Water ill pd. Webs Is brown
NOM W SHAD d�ACKFI[1 sand
mem �b row Pt
SP
LOT NUMBER REFER TO 'IN410R SUBDIVISION' r.; •N,.•t 4 h,..
MADE FOR JAMES W. DAWSON r' g. 1—Lo o etc ll•"/ 7a.►l IX /4,
e/ 14..d•d
3.0 /r,sbect 9raecel e'/%o
ciao,' Wl i •✓1 1,,, a w.
I pro ! with the STANDARDS FOR APPROVAL rp�•e s- fmli o.;
AND CON RUCTION OF SUBSURFACE SEWAGE /f u.3 war' 9' L.Po�Je�)y f 3 o �f v
DISPOSAL SYSTEMS FOR SINGLE FAMIRL Y RESIDENCES Sep /' 'f/0.4.IE 54'
and will abNe by the conditions set forth therein and on thee%aka _ ra0k 2 _F 3, f P b g�,A C L.
permit to construct. -— =— _ w ed
GRADING PLAN (h/yn••* e1'P•01••4))
____g_.__ =ptOO confovr
F�ND,Q�• s - °"`P el`v SURVEY OF PROPERTY
•
FOR AEI' TRUCC770NAVAkABLE AT
Fropecomaro r.PAWL NO.31100.1 00190 NOTE• ,c
SLBS(WACE SEWAGE DISPOSAL BA YVK W
SIGN
ELEVATIONS ARE REFERENCED Bye JOSEPH FISCETT7 p.E: TOWN OF SOUTHOLD
TO N.G.V.D. MOBART ROAD
SOUTHOLD, MY.1197/ SUF�LK COUNTY, N.Y.
The locations of wells and cesspools (5161765 _P954 - 87 - 05 - 70
shown hereon ore from field observations r "= 40
and or from data obtained from others. NOTE. ��Pt OF New�o N/A Y 19, 1998
�Q�F :Co4, 9 , J UAE 23, 1998(TOB)
•
5 JUL Y 15, 1998(prop.has&pod)
• A, Aug. l4, 1998 (revisions i
' AREA = 1 113 acres to tie ifs _R Sept. ;r�: test hole #2 )
:. �� Jan. pY• s1
ANY ALTERATION OR of SECTION 7209 OF T E� TO MS SURVEY YORK STATE EDUCATION TION LAU. •A VIOLATION +O• 0525 0 c�,�/ ' . 2t.Merzar#
EXCEPT AS PER SECTION 7Eg9-SL�NSi�lf Z ALL CERTIFICATIONS OpO� ��� ,�! o� ,5,:ve
HEREON AAE VALLI FOR TINS MAP AND COPES THEREOF PLY F ESSIONP , •, .' :• Ly p
SAID NAP Oft ATGE•APPE�IRSTIE IMPRESSED lE?E L OF THE SURVEYOR l ,�` N.Y.', .IC NO. 49618
. -EC•�rri S -flo7'
AOOITIONMLLY TO COMPLY WITH SAD LAM TIE TERM ALTERED Br' w
NUST BE USED NY ANY AND ALL SUMMON MONS A COPY 1 O ; +J0 4vs�s QJ
OF ANOTHER SURVEYORS MAP. TERMS SUCH Aa 7MPECIED'AAO P.
73ROU IT-TO DA TE'AAE MOT N CONPLMANLE WITH THE LAW. 1230 ";• '`:i ••, Is' ,• ET
SOUTHOL•