HomeMy WebLinkAboutRotelle, Steven 'SFOL4-
ELIZABETH A. NEVILLE
10 yd; Town Hall, 53095 Main Road
TOWN CLERK • o - • P.O. Box 1179
C4,4 Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Pri
MARRIAGE OFFICER ��1,, Fax (631) 765-6145
•
RECORDS MANAGEMENT OFFICER �_ lAlig *��•��'i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2797 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : BRUCE ANDERSON
Address 1 : PO BOX 2003
City St Zip BRIDGEHAMPTON NY 11932
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 #R10-01-0262
Name Of Owner ROTELLE, STEVEN & ESTHER
Mailing Address 1 7 INDEPENDANCE COURT
City St Zip MADISON NJ 0000
Property Address 1 KING STREET
City St Zip ORIENT NY 11957
Tax Map No. section 27.00 block 3 lot 4.002
Cross Street OLD FARM ROAD
Building Permit Number Cross Reference:
Issue Date: 5/17/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE Town Hall, 53095 Main Road
TOWN CLERK - ; P.O. Box 1179
,y, n� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Oy � ,,�� Fax (631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER =_'*O1 �a�,ii Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER ,s” southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
• ' APR I 0 2002
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: April 10, 2002
Transmitted herewith is a copy of application No. 2901 for a Cesspool/Septic Tank Construction
Permit submitted by:
Bruce Anderson, Suffolk Environmental Consulting, Inc.
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.
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 /
;/0 Z
Dated
•
OFFICE OF THE TOWN CLERK O��C�O/L� _
TOWN OFSOUTHOLD ' C Lft Q _ •
Application No.
ELIZABETH A.NEVA)F,TOWN CLERK 91 0 V
P.O.BOX 1179 : Construction ✓
SOUTHOLD,NEW YORK 11971 'Z►
Alteration
�i
Telephone ,f�O r $10.00 - Residential
(63-1:) 765-1800 -_l * ,0', $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ Q
/ DATE r d Z
APPLICANT NAME: 4 • `' ��'y""'�k*�•'t1
APPLICANT ADDRESS: ,/"- d• ��X 20 o 3
'73.04/Gt 4irjek sa.-4 yv 11' //93 'L-
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION /t/1 '
i --ate 4 .1
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY:fiG( L- Civ 72oi�-c
OWNER MAILING ADDRESS: -7 42...eee.,c C.._+
OWNER PROPERTY ADDRESS: k '
,,� s(c
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section 27 Block 3ll Lot 4i• Z
O/4
CROSS STREET: �v 7z. c—
BUILDING PERMIT NUMBER CROSS REFERENCE: (4. — O — 0 2 Co Z—
4rei, .A . A
Sig ature •f Applicant
RECEIVED BY:
Town Clerk's Office
DATE: '41 (0(07,-
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TEST HOLE 'DATA SANITARY SECTION
OCT. 15, 2001 it1
MCDONALD GEOSCIENCE
EL=13.5 0.0
DARK BROWN
SILTY LOAM
1.0
BROWN
LOAMY SILT
3.0
BROWN FINE
TO COARSE C.I. COVER
SAND WITH HOUSE TO GRADE
20% GRAVEL FF=13.5
9.0
PALE BROWN
FINE TO FINISHED GRADE
COARSE SAND EL=11.5 EL=ii.7
W/ 10% GRAVEL
11.8 i.o•MIN
EL=11.7} I 20 MAX
WATER IN PALE E=9.5 _ 1----1BROWN FINE 1E_9'3 4
IE=88
SAND WITH IE=8.7
TO COARSE 410
ea'
10% GRAVEL ti.:,
I
17.0 3.0'MIN. I
GROUND WATER I .
EL=1.7
SEPTIC TANK CESSPOOL
1000 GAL.
AL