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JUDITH T. TERRY ' F; Town Hall, 53095 Main Road
tZ P.O. Box 1179
TOWN CLERK ® fir q,
REGISTRAR OF VITAL STATISTICS .�` Southold, New York 11971
c� O i� Fax (516) 765-1823
MARRIAGE OFFICER
i® j/e1� Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 825 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : BRUCE AND BARBARA PETRUCCI
Address 1 : 2140 BAYSHORE ROAD
City St Zip GREENPORT NY 11944
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 4/8/92.
Name Of Owner PETRUCCI, BRUCE AND BARBARA
Mailing Address 1 2140 BAYSHORE ROAD
City St Zip GREENPORT NY 11944
Property Address 1 BURGUNDY COURT
CHARDONNAY WOODS ESTATES
City St Zip SOUTHOLD NY 11971
Tax Map No. section 51 .00 block 3 lot 3.013
Cross Street SOUND VIEW AVENUE
Building Permit Number Cross Reference:
Issue Date: 5/01/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
telliii "' Vii...!=::s
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1)� Os �9./ ��
��r` Town Hall, 53095 Main Road
JUDITH T. TERRY o
`� 4� P.O. Box 1179
TOWN CLERK 'N: C) f�i
, 1...,;11.5 .�� ,44 �� n, : y Southold, New York 11971
�� ��� Fax 516) 765-1823
£ � o c
�_- �® �®��� Telephone (516) 765-1801
,274,40
'' LG. PF OFFICE OF THE TOWN CLERK
TOWN OF wou't owJ TOWN OF SOUTHOLD
To: Southold Town Code Enforcement Officer
From: Linda Cooper, Southold Town Clerk's Office -
Dated: April 13, 1992
Transmitted herewith is a copy of application No. 847 for a Cesspool/
Septic Tank Construction Permit submitted by: -
Bruce & Barbara Petrucci = •
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 Dc
•
DISAPPROVE
Comments: o--, Sci to . .
A\ SVI\1.....
\CO,: CNA- L......,
Signature
‘A \11\\,I-- .
Dated
U1.1 t7
JUDITH T. TERRY r w;.,1 . • r`'r" Town Hall, 53095 Main Road
TOWN CLERK t+ter_;' 1 � "; r , h P.O. Box 1179
REGISTRAR OF VITAL STATISTICS C.C1 '._ Southold, New Yor11971
�7 ,..� " � j.; Fax (516) 765-1823
MARRIAGE OFFICERf >=Vin, Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Southold Town Code Enforcement Officer
From: Linda Cooper, Southold Town Clerk's Office
Dated: April 13, 1992
Transmitted herewith is a copy of application No. 847 for a Cesspool/
Septic Tank Construction Permit submitted by:
Bruce & Barbara Petrucci •
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:
Signature
Dated
1
,OFFICE OF THE TOWN CLERK SWFJ(y,;•
Town of Southold �, _ ‘
O Application Nog
Town Clerk
Judith T. Terry, �.:.
Town Hall, 53095Main Road o - • Construction
P. 0. Box 1179 ' �� ' y
Southold, New York 11971 Alteration
Telephone Z �1��✓ Residential V
(516) 765-1801 1-101' Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE (Apr, \ 3 I eta l �--
APPLICANT NAME: YUC 2. clncl gvloQvC_ PeltUc C i
APPLICANT ADDRESS: ,- ysbie Road
veei1o\t*, .y \\(1414
SEPTIC CESSPOOL ✓
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
k- W .1kM � ( � � >ti �LCI � G
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: eyconct, (6.c1v01/4 RAY occ
OWNER MAILING ADDRESS: LAs1.-)0(c oac4
CreenrY , N y 119Lk 4
OWNER PROPERTY ADDRESS: Lky \J it Cou_vc - Ctr,avclovwc,y mods tke.s
Sou , M1\0.11
TELEPHONE NUMBER OF CONTACT PERSON: 5tlp-1-1-1'1- Cj53L-}
TAX MAP NO. : Section Ocj 1 00 Block 03.®D Lot co 3, 013
_ CROSS STREET: Cx,layick �1nC�v�on�o �1
BUILDING PERMIT NUMBER CROSS REFERENCE:_ !!
Signature of Applicant
•
RECEIVED BY: tail`, '"5z_,1
To -n Clerk's Office'
DATE: 11 1 ? , i q q
m/o Chardonnay Woods Q Southold {
Al
Filed September 28, 1989 as Map No 8822
t'
PARCEL ZONED A A. BO RESIDENCE
AREA OF PLOT 4o,000 4•/- S.F.
S.F.
PROP, 1st FLOOR
1 s
A( 00.OS'30" E. PROP. 2nd FLOOR 4.4.e S,F,
3LB3' S.F.
PROP. BASEMENT 1.--,, c,
PROP. GARAGE a S.F,
,ASSUMED .DATUM.
,----6a THERE-ARE NO SURFACE NA TERS
fig° IVI THIN 300 FEET OF THIS PARCEL.
06-• THERE ARE NO WELLS WI THIN 100
�c�'• FEET OF THIS PARCEL.
<a,.... (LOT /4�GP � AREA = 40,000 SF. or 0.918 ARCES
— Unauthorized alteration or addition to a survey map bearing a Proless+onal Land
�9• Surveyor sSea/+s a violation of Section 7209,Sub Section 2,of the New York State
O JC t, Education Lew
i3rz��E QE�QJGC 1 O LOT A
Guarantees or certifications indicated fiction signify that this survey was prepared m
J Z 1 ao gLaV SILO C.E Qccordance with the existing"Code of Practice"for Land Surveys adopted by the
ESS Cr)°? p.
�� b4 1 New York State Association o!Professional Land Surveyors" Said guarantees or
C"'t 12E�a Po{LT �`' 9�_ - �m beto shall run o opa y,the person for wham the nd survey's ng and on his
/ 1A behalf,to the title company,governmental agency,end institutionlendmglisted
/� S 1 V ¢„— S. 4 PeeP ^ 2Q ` I hereon and the assignees of the lending institution Guarantees or cerb/ications are
...It L.,.
not transferable to additional rnstitu(+oris lir subsequent owners
_ A= 44.55'42' + 4
.� ti
ATER SUPPLY AND SEWAGE DISPOSAL R = Sv.v� I k Copies from the"ORIGINAL of this survey prop not marked with an ORIGINAL"of
HS FOR THIS RESIDENCE WILL CONFORM /l 6 SO / 11V. L =..'2/ the Surveyor's'REDGIN INKED seal or EMBOSSED seal shall not be considered
E STANDARDS AND SPECIFICATIONS OF a to be a valid true copy
ES�K COUNTY DEPARTMENT OF HEAL TN o* .o�E 5T ''''ilk i�•i v r O
n
T/ _'-'C� a..e- 5 1 o yP oc QA 5 4j�9 i`P, 1
APPLICANT'S SIGNATURE
Z., •�1 ' `fin' V
' =20'27 30' t[w
(� n t R=/75.00' d.7
h.. L =62.49'
/ So'
S0T 3734(X Low` -
b�� v S io't3boE2.00' •
-
•
S. 1937DO' W. /.
agnLsc373r1,°'5'711011
1P' ; Ai� ��
ItrrSau;� Ft1�Ur a�� c LOT /zro
��
b
0
COUNTY TAX MAP NO 1000 - 051,00 - 03 00 - 003 0/3
CERTIFIEDTOP,R0�E PET RuGL1
:UFFOLK COUNTY DEPT, OF HEAL TH SERVICES �nR»e 12 P R U c-1 1
FOR APPROVAL OF CONSTRUCTION ONLY Po PERS A>35Teo�T
DAT H.S. R f-, NO,/IL ' _
APPROVED+C /SL'\�� nL>'ti� •
SINGLE FAMILY DWELLING ONLY SURVEY OF LANDATc
EXPIRES 3 YEARS FROM DATE OFAPFa�J�W'f�L.. NORTH SOUTHOLD
1 lO7�f ID,t�� TOWN OF
� II
SOUTHOLD
114,,,,,„....-;:n4 L.,7441r
+ SUFFOLK COUNTY NEW YORK
/hereby certify that this map was made Edward A. Bullock, Jr.
BY: EA.B
APR 2 1992 CHABLIS PA TH from an ectua/surveycompleted by me on Professional Land Surveyor&Engineer DRAWN: J•P.S 02/23/89
fao ws�E1 `(6d,+,,,,,GitQ Q...95..S. . . as Mew Avenue
Pon Jatior Station SCALE. I"= 40'
N Y P L s No 49214 New Yortt-473 11776, FILE NO: /000 - 5I 3 - 3.3
S.0 DEPT. 'F NYS PE No 651a-473 6332 HFAI TH SFRVIr.Fc
,UFFOLK BLUEPRINTING - •