HomeMy WebLinkAboutRiverhead Bldg Supply (2) Pam
JUDITH T.TERRY t, ® ; Town Hall,53095 Main Road
TOWN CLERK gt P.O.Box 1179
PPY
0 O '�� Southold,New York 11971
REGISTRAR OF VITAL STATISTICS 1 Fax 765-1823
MARRIAGE OFFICER =� � ��I�� Telephone(516)(516) -1823
RECORDS MANAGEMENT OFFICER
765-1800
FREEDOM OF INFORMATION OFFICER ,�• ��I
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1317 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : RIVERHEAD BUILDING SUPPLY
Address 1 : PULASKI STREET
City St Zip RIVERHEAD NY 11901
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #R10-95-0043
Name Of Owner RIVERHEAD BUILDING SUPPLY
Mailing Address 1 PULASKI STREET
City St Zip RIVERHEAD NY 11901
Property Address 1 PEQUASH AVENUE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 103.00 block 12 lot 7.000
Cross Street TRACK AVENUE
Building Permit Number Cross Reference:
Issue Date: 4/17/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
/3 7 7
$( # (,G-
JUDITH T. TERRY Z Z ....c.It
Town Hall, 53095 Main Road
TOWN CLERK ® rP.O. Box 1179
U' ,� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = V® �.% Fax (516) 765-1823
MARRIAGE OFFICER ` AT 1
RECORDS MANAGEMENT OFFICER __��71J 4t $0 Telephone (516) 765-1801
1
FREEDOM OF INFORMATION OFFICER „,,,,,drrrr )
OFFICE OF THE TOWN CLERK -7 ";,/,',"/ N
TOWN OF SOUTHOLD <�
0,
` c �' \
TO: Southold Town Building Department '{, �,
FROM: Linda J. Cooper, Southold Town Clerk's Office .5;,0-\\ ° /Y
�; : - /
DATED: April 11, 1995 v \�. ,�-
Transmitted herewith is a copy of application No. 1366 for a Cesspool/
Septic Tank Construction Permit submitted by:
Riverhead Building Supply •
Please review the application and location map and advise if the project
has received Suffolk County Health Department approval and if this office
may issue the permit.
Please complete the form below and return it to me.
Thank you.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE t�
DISAPPROVE
941/j70 r
Comments: ,r ���, e -- -®O iG�
,v- _,... 4. -
„,,eill
....., , - .. - _,... _ _o/
_._.,
Signa•Sire//
f-/ — .t
Da
iik: ,,. ,
.,L,
ii. ,
OFFICE OF THE TOWN CLERK ,.''""""'%
Town of Southold .0'•' VULir
Judith T. Terry, Town Clerk `,••'00 . �01/y Application No.1------
.
6 , ,
Town Hall, 53095 Main Road Z !G . Construction
P. 0. Box 1179 ; _ _;` =m
I=3 -= - ^' • Alteration
Southold, New York 11971 . V) W$
Tele hone ‘y0,y Q �'� $10.00 - Residential �'
P
(516) 765-1801 ----_ 411 J t %, ' $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE 4)' (qC-
APPLICANT NAME: I U el( L ' 3I) ..—fit)-v1.4)1061 'Rd P(7)..1
APPLICANT ADDRESS: %.Jt1tSlC.i c•-i-.
'-'21 i i-rah 1J.1
SEPTIC CESSPOOL •
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued. '
LOCATION OF PROPOSED COTRUCTION OR ALTERATION:�� --
OWNER OF PROPERTY: yZWi, u
161) l61 ?D
Li
OWNER MAILING ADDRESSi,� 7 LArg►c► <4
OWNER PROPERTY ADDRESS: `Z - 151. JC i
TELEPHONE NUMBER OF CONTACT PERSON: --(a,-(p 32 ,
TAX MAP NO. : Section 103 Block (a„ Lot 0I
CROSS STREET: 4)L-ezeA-- C,
BUILDING PERMIT NUMBER CROSS REFERENCE:
am 64 L
d w`1,..,
nature of Applicant
RECEIVED BY: , L/u/c-e4_- . '
rown Clerk's Office
DATE: l 7
R ,
, TimothyL._Corwin
I am familiar wilh the STANDARDS FOR APPROVAL Corwin Construction •
AND-CONSTRUCTION OF SUBSURFACE SEWAGE ,,0.-..G o.{
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES rye 11 15 Lakeview Drive
and will abide by the conditions set forth /herein and on the Riverhead, N.Y. 11901
permit to construct. ,
: cv1E1 P 3( 11- 111'.,... , ,
The locations of wells and cesspools pCEInir
�� 1995 TRA CK Q SURVEY O
shown hereon are from field observations MAR
and or from data obtained from others. O
S.C. DEPT.OF
HEALTH SERVICES 71.644.
MAP OF
c P N4 4•--e'40'W
(DWELLING) o ,PEQ UA SH ACRES -
ELEVATIONS ARE REFERENCED - ;u 0 FILED MAR. 80,1972 FILE NO. 5894
TO AN ASSUMED DATUM / 6 I N A T C U T CHO G UE
n TOWN OF SOUTHOLD
�oN
S 44 42 40" E 191.14 • SUFFOLK COUNTY, N. Y. .
-- �S'' °pe�► '�� 1000 - 103, - 12 - 07
. SUFFOLK COUNTY'DEPARTMENT OF HEALTH SERVICES aikSCale 1" = 40
FOR APPROVAL OF CONSTRUCTION ONLY. / 4 Feb. 14, 1995
flax 7/995 /act..4,f ve/./.,-ICP)
DATPA R 0 J 19% R� . N0► Vit' S-O� B I 1 °a .
,7–/ '#. ,,fail ;
APPROVED/ 8 /_Z-a • ! (PROP. DWELLING) c P
O0 I.r0Y .5ePf„ _ y /43'-#—
GP sy5/e D ���
AREA = Al,324sq.f!. l _we�I CERTIFIED TO'
se,/ I RIVERHEAD BUILDING SUPPLY
/ 2 / t
saee 6.6 - I ,
' ` ' (DWELLING: / — 57 ,r Se fr
- 4 Sfa KP
// na ph s e R M ANY AL 7ERA 770N CR ALVN7KW TO 1715 SLINEY ISA)OLA TON
OF SEC7KW 7209 O°77E FEW YL1%C STATE EDUCA 7�R LAW,
9_o-rr• EXCEPT AS PER SECTION 7209-SUBDNISRN Z ALL LER177CA7KWS
- ' GS .5 1f7EaN ARE VALID FOR 7715 MAP AAD COPES 77fFEOF ONLY F
r 20 __ -�--
' SAD MAP OR COPES BEM 77E YPRESSED SEAL OF 77E SURVEYOR
, J If/'. WHOSE SIGNATURE APPE RS NOON/ illATONALLY ro COAPLY IBMIBMSAD LAW 77E TERII'ALTERED Br
MOT BE USED BY ANY AAD ALL SLRVEYARS U7lf!M A CLP)'
OR'ANOTHER SURVEYOR'S IMP. TERMS SUCH AS WSPECTED'MD
" sof TROUSNT To-DATE•ARE NOT N CC FU4 NM 77E LAW.
0 m
12 itve II pl oi ,q LAND-,s ,
d (shai/ow) N _ - "y •�c�o T2c9�
1, r o ® PN ePI i , lD 1 f 2, 6,,,, c!\4:\
0\
v.
. 0 40 inIe wa.T y tiZ2-.;T j
384 52' _ N 50° 16' 30" W ,,, p�/e k ., :-..� 79.Y.S. :LlC. NO. 496/8
` FNa . 189.02' \A n - / +'�
FN° n ' 'ECa �_ EYORS, P.C.
FLEET NECK ROAD '`E 5161 .765 5020
f ' alms ' O. BOX 909
-MAIN ROAD
®iOdll6`rf ���we�i /a-C0-' ,,,k (DWEL b1NG, SOUTHOLD, N.Y. 11971
;, o+ - - 88 - 448