HomeMy WebLinkAboutGaffga, Jesse ofFour
JUDITH T.TERRY �o yt Town Hall, 53095 Main Road
TOWN CLERK H = P.O. Box 1179
v. $ Southold, New York 11971
AEGISTRAR.OF VITAL STATISTICS 46,1Fax� � Fax (516) 765-1823
MARRIAGE OFFICER ;?JOl ,),,W Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER - l
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1408 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JESSE GAFFGA
Address 1 : P. O. BOX 124
City St Zip CUTCHOGUE NY 11935
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.
Name Of Owner GAFFGA, JESSE
Mailing Address 1 P. O. BOX 124
City St Zip CUTCHOGUE NY 11935
Property Address 1 ROW OFF GRAND AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 107.00 block 2 lot 4.000
Cross Street
Building Permit Number Cross Reference:
Issue Date: 10/27/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
,'.�,o�OS�ffO(�4oG- / V
t1
JUDITH T.TERRY Town Hall,53095 Main Road
TOWN CLERK % y Z P.O.Box 1179
REGISTRAR OF VITAL STATISTICS ��, Southold,New York 11971
MARRIAGE OFFICER l � Fax(516)765-1823
RECORDS MANAGEMENT OFFICER 0.( *a0•0 Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER ���•, ,wi"
Ir
F f
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD •
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office 2 3 19A5
DATED: October 23, 1995
Transmitted herewith is a copy of application No. 1461 for a Cesspool/
Septic Tank Construction Permit submitted by:
Jesse Gaffqa
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: , J (JCZt I
/ Oopre fr
Signatur
Date
OFFICE OF THE TOWN CLERK ,•s" " •
Town of Southold , f7
Judith T. Terry, Town Clerk �` � l/ Application No.
Town Hall, 5305 Main Road ��' ° y� Construction ✓
P. 0. Box 1179 • _ z
• G' �" � • ^' Alteration
Southold, New York 11971
Telephone .y0��' �Q�. •� $10.00 - Residential
(516) 765-1801 �l 4 ' $25.00 - Non-Residential
•
, .
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. R F c.E/ to
FD
OCT
Fee .$ oe_sou �C� �_
DATE (0'8\-)-- 4-) 47O// 7 f'eo
OCT °wil
2Q CIrk
APPLICANT NAME: TSG5Se C� fl South,_ /gps
APPLICANT ADDRESS: pO U1( C J4cibL.,g_ N 1 1
00f
k
SEPTIC C— 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 : C"NA,T F3 ,
OWNER MAILING ADDRESS: ( C) Irk.• IP/ e c5K /tit ( tt35
OWNER PROPERTY ADDRESS: r"$1"4 ���� orP Gr,,‘,4 pvt,
'M C6 .F1 l
TELEPHONE NUMBER OF CONTACT PERSON: 73Y-6C°Y3
TAX MAP NO. : Section (' U �1 Block Lot ��O Y
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
gna e of Applicant
RECEIVED BY : ,�
Town erk's Office
DATE: /0 " ,3 ' c15-
•
P� V,
co
/rj‘((t-' O0 \
0
ri
70
rnN
r+
qO� �X
�
_5CG omaC
c O z p 4 -4,
a �•�
\
IEs1 co =
, F; �c+ fir,•
� \ 2p4'6
� � . r
,a5 2 I
N 38 u8'5
E ' \\0. D o
rn
P•
/ !• E.L. 45.5 °t III 56�oo‘\S Z o
`o AREA I _ •
., t er1 y Z 't 0,1
no,N or . e°\yn ►J. I - 1� r~ N
Joh° A' '\ CP o
4"4, N
'- —05 ,50 e- 11 po0SE0 DRIVEWAY •., 'o' r
N 1 PR 51 `G P. P ..D O
-T ; N PROPOSED 1 2 -\1 k- J'I-qt.
�i F E, J 1
o;
I I WEL 1g AA i31 PROPOSED N
> 1 I ' Ss'61
S EM oo cci1
4 t1 Ow Or o P odyn 99.8_,_ '1I �'I A`' n `'�..
y
A
�` ` John`(VACANt� N 'Ito \ t ..
b
j tzt t 1 20,00 S 78.0B.50" W o
,,,, ti-
- x p0 52 t'1 220.52 EL. 44.7 20.00
r
r
x z_'I 2
UI
��- '' '/ ST FENCE` of EL_ 42.1 ,p$�J'0 `N ;c)
r5 78
,How or {O Simons Lot 3 i
�.
' ` Stephen I (VACANj, 00 �o
' 1 NOTE:
- DP' 1. ■= MONUMENT FOUND A= STAKE SET
Fr DE�1N 1 2. LOT NUMBERS SHOWN HEREON REFER TO SUBDIVISION MAP -
"GREGORY SIMONELLI" FILED IN THE OFFICE OF THE CLERK
r` C. OF SUFFOLK COUNTY ON SEPT. 20. 1995 AS MAP NO. 9743.
` ; 3. ELEVATIONS SHOWN HEREON ARE FROM TOPOGRAPHICAL
i:. 1?, ? MAPS PREPARED BY US REFERENCED TO MEAN SEA LEVEL
{, DATUM AND ARE SUBJECT TO FIELD VERIFICATION.
" DEPARTMENT OF HEALTH SERVICES CERTIFICATION SURVEY FOR:
HE STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE
MS FOR SINGLE FAMILY RESIDENCES AND WILL ABIDE BY THE CONDITIONS JESSE J. GAFFGA &
T ON THE PERMIT TO CONSTRUCT."
JENNIFER A. KRUSE
At: MATTITUCK Town of: SOUTHOLD
Suffolk County, New York
STATE: ZIP CODE:
-- -- --- Suff. Co. Tax Mop : I 1000 I 107 I 2 , P/_04__._
District Section Block Lot
CERTIFIED TO:
& Young, Land Sur yYrs _•, t JESSE J. GAFFGA
.,f �f>~.: JENNIFER A. KRUSE
ger Avenue, Riverhead, New 'br ll`7"7 V. I' I. FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK
516-727-2303 ` i
en W. Young, P.E & L.S. (1908-1994) �r L t.. l DATE OCT.: 5, 1995
Howard W. Young, Land Surveyor r.,:-.yr _. • -�'� SCALE : 1"= 60'
-.las C. Wolpert, Professional Engineer.'F ''' JOB NO. : 95-0868
"enneth F. Abruzzo, Land Surveyor i`.:.'+-II'' .V,:"'' ':`. SHEET NO. : 1 OF 1
John Schnurr, Land Surveyor (GA950868.DWG)
-
COPIES OF THIS SURVEY MAP NOT BEARING DISTANCES SHOWN HEREON FROM PROPERTY UNES CERTIFICATION INC1C.'.'TD HER!O7 SHALL RUN ONLY TO THE PERSON FOR MOM THE SURVEY THE LOCATION OF WELLS(w),SEPTIC
O THE LAND SURVEYOR'S INKED SEAL OR O TO EXISTING STRUCTURES ARE FOR A SPECIFIC O IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY.GOVERNMENTAL AGENCY�µµD LENDING TANKS(ST)k CESSPOOLS(T5)SHOU
EMBOSSED SEAL SHALL NOT BE CONBDERED PURPOSE AND ARE NOT TO BE USED 70 ESTABUSH INSTITUTION USTED HEREON,AND TO THE ASSIGNEES Cr THE LENDING RIIBWBON. HEREON ARE FROM FIELD OBSERVA TIC`
TO BE A VAUD TRUE COPY. PROPERTY ONES OR FOR ERECTION OF FENCES. CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEMENT OWNERS. AND CR DATA OBTAINED FROM OTHER: