HomeMy WebLinkAboutGurriere, Raymond 4 fill'Of F04
ELIZABETH A.NEVILLECo�t%.' Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
N Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS I=. Fax (516) 765-1823
RECORDS MARRIAGE OFFICER NAGEMENT OFFICER ( Telephone (516) 765-1800
FREEDOM OF INF INFORMATION OFFICER '�°/ slk%, P
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1960 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : RAYMOND & DEBORAH GURRIERE
Address 1 : 2200 GRAND AVENUE
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 #R10-98-0009
Name Of Owner GURRIERE, RAYMOND & DEBORAH
Mailing Address 1 2200 GRAND AVENUE
City St Zip MATTTIUCK NY 11952
Property Address 1 MILL LANE
City St Zip MATTITUCK NY 11952
Tax Map No. section 100.00 block 5 lot 3.000
Cross Street OREGON ROAD
Building Permit Number Cross Reference:
Issue Date: 11/02/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE �' �0 t. �. To i a11, U9�loll oa. _�
TOWN CLERK -� �'.O. Box 1179
Siutho . i p111971
REGISTRAR OF VITAL STATISTICS T
MARRIAGE OFFICER 1, Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER ���1 P* ' ,s•'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: October 21 , 1998
Transmitted herewith is a copy of application No. 2036 for a Cesspool/
Septic Tank Construction Permit submitted by:
Raymond and Deborah Gurriere
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 reccoommendations:
APPROVE
DISAPPROVE
Comments:
gnatur
to 1Z3/5'6
Dated
•
OFFICE OF*THE TOWN CLERK „ ,,,,,,,,
Town of Southold C5\0F U( (26?
Judith T. Terry, Town Clerk �j►� Application No. Jl0
Town Hall, 53095 Main Road ;Z ; Construction .
P. O. Box 1179
Southold, New York 11971 sits yc$ Alteration
Telephone ��O $���',”' $10.00 - Residential
(516) 765-1801 _ 1Jit,,��, ' $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 ( a1191(
kqi,A,0,4 d( 9' Oorl r APPLICANT NAME: e,
APPLICANT ADDRESS:
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Ra y 012D q- 10a0 r4 erl"�,,-�
OWNER MAILING ADDRESS: 90 Gr44,4 ✓ Vein/We)
/14d1-1-11)(42-) LU)' Il15Z
OWNER PROPERTY ADDRESS: I'I'I I (
TELEPHONE NUMBER OF CONTACT PERSON: (/6107V Sia6PoriC) V,377 00"-e)
TAX MAP NO. : Section /00, Block -5 Lot —3
CROSS STREET : Ofyi 1;2.0Q
BUILDING PERMIT NUMBER CROSS REFERENCE:
0111:
/.. „.1/
Signa !re of Applicant
RECEIVED BY: OA Jb
Tow Clerk's Office
DATE: I(i)I a i \ �,�i
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o ___ __ Q PQ Young & Young, Land Surveyors a li
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES ``) 400 Ostrander Avenue, Riverhead, New York 11901 VI!
`` 516-727-2303 iiia
Dung
PERMITFOR APPROVAL OF&ON.^'FRUC FIL'rfti FAO' Ft%� 8�• `l' Sal!
SLNGLE FAMILY RESIDENCE ONLY
IIltltlg DATE '"1 '� O '�s _J� AldenHoward°W.9Young&Land S�urveyo994)
HS REF.NO. ! O 7C 7 9 �.
Thomas C. Wolpert, Professional Engineer XI
., , o F Kenneth F. Abruzzo, Land Surveyor :jr,planning APP:..OVED -__ _ •/�r^ . � �s \,,,,, John Schnticrr, Land Surveyor
FJR i L X ''U CF -ED, OMS yc+ 4,114
�nginrrring O,- \0 1
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L R :. :k:L L t.A s� tz1 .OS A.L
$ur;ing NOTE: i bl
�,� 1. ■ = MONUMENT FOUND ffY� bi
\ g'S iI 2 2. O = MONUMENT SET
Z 11�' '�� 9C� 3. = STAKE FOUND 2
�' \ j �- 9-y. 4. AREA = 5.0001 ACRES �g
G p, / . , - ,-,. . cS a 5. LOT NUMBERS SHOWN HEREON ARE REFERENCED TO SUBDIVISION -
�, y� �' °� • �' "WOLF PIT POND ESTATES" FILED IN THE OFFICE OF THE CLERK OF ill§
cA 4° \ . !, /� /Y�` / F SUFFOLK COUNTY ON JUNE 21, 1990 AS FILE NO. 8963.
v J' 1 °./ 6. ELEVATIONS SHOWN HEREON ARE FROM TOPOGRAPHICAL MAPS Fee
\ 0 2 iso• �Oyg / ����' `0C) PREPARED BY US REFERENCED TO MEAN SEA LEVEL DATUM AND Y
Z �, Z \ s,, 1- PGS F,O AO?° ,, t3 ARE SUBJECT TO FIELD VERIFICATION. S'iii
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G / ANG RO �S 04 $. c' .0
Plpi
/ , L o°) e 1� SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES CERTIFICATION 15511
�\ Z 7J ,' 150' MIN �� " 1 S5 s # "I AM FAMILIAR WITH THE STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE ging
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(19 \ .'.' o >��° \ --�1� 6��� �! SET FORTH THEREINSEWAGE DISPOSAL YSTEMS FOR AND ON THE 1NGLE PERMITAT�OLY CONS CONSTRUCT." AND WILL ABIDE BY THE CONDITIONS BN
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N�ct‘ 1��- y� F // V' STREET ADDRESS: to A
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+/ 015. `_, , //' SURVEY FOR: _
�''' , RAYMOND GURRIERE JR. & ilg
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�'°� Z DEBORAH M. GURRIERE
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_z_. °� At: MATTITUCK Town of: SOUTHOLD °
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DARK BROWN 0.o Su f f. Co. Tax Map: 1000 100 5 sI
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� I l CLAYEY LOAM 1.o. District Section Block L•t >
M BROWN $5g;
9I Se h cP LOAMY CLAY 30 CERTIFIED TO: - by
91574. -31% ,gyp^/ •, sem, B RAYMOND GURRIERE, JR. vai
n ,L E> FINE TO
DEBORAH M. GURRIERE 3
CO• I COURSE SAND FIDELITY NATIONAL TITLE INSURANCE COMPANY o
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PALE BRONM
00 couasE soANo ./L d/ - DATE : JUNE 13, 11997 geyjr
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)c 17.0• SCALE :1"= 100' lei"
\ SHEET NO. :9 OF125 D
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(GU970325.DWG)