HomeMy WebLinkAboutFicner, Steven ELIZABETH A. NEVILLEG'yd Town Hall, 53095 Main Road
•
TOWN CLERK O - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
�� Fax (631) 765-6145
MARRIAGE OFFICER :� �i `. �1
RECORDS MANAGEMENT OFFICER VS* iNg �a�����'1� 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. 2800 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : STEVEN & ELIZABETH FICNER
Address 1 : PO BOX 576
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 #R10-01-0240
Name Of Owner FICNER, STEVEN & ELIZABETH
Mailing Address 1 PO BOX 576
City St Zip MATTITUCK NY 11952
Property Address 1 MAIN ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 140.00 block 3 lot 26.002
Cross Street MAPLE STREET
Building Permit Number Cross Reference:
Issue Date: 5/17/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
FFOL4. a 0 6
ELIZABETH A. NEVILLE ti= Gyd Town Hall, 53095 Main Road
TOWN CLERKo - P.O. Box 1179
ti Southold, New York 11971
REGISTRAR OF VITAL STATISTICS 1
MARRIAGE OFFICER . ,fi �����, Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER '_�Ql ���'•0 Fax
(631) 765 1800
FREEDOM OF INFORMATION OFFICER _ ��� southoldtown.northfork.net
1'r OFFICE OF THE TOWN CLERK
r p APR �� TOWN OF SOUTHOLD
L .rnwpsi :714@,uthol Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: April 12, 2002
Transmitted herewith is a copy of application No. 2904 for a Cesspool/Septic Tank Construction
Permit submitted by:
Steven Ficner
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: fi
Signature
D /4&
Dated
OFFICE OF THE TOWN CLERK 4OL/c' ;- Application No.G�
ELIZABETH A.NEVILLE,TOWN CLERK 0 ;
P.O.BOX 1179 •� Construction 1`
SOUTHOLD,NEW YORK 11971 ; O T Alteration
Telephone
‘20A. 01 $10.00
• $10.00 - Residential
(516) 765-1801 '-y�l '
$25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT RECEIVED
SEPTIC TANK or CESSPOOL APR = 2 2002
Permit No. Southold Town Clerk
Fee $
DATE
APPLICANT NAME: 54-CVPt- S. FIcf?„e-r El/214 J+ H. F€cn (..
APPLICANT ADDRESS: po 130y 57c ,
Mfct. IU V 1195
SEPTIC CESSPOOLX
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
at_i Icl t ncJ, CZ k)f co Worn
LOCATION MAP: Must . • attached hereto before permit may be issued.
LOCATION OF PROPOS:: CONSTRUCTION OR ALTERATION:
OWNER OF PROPEL, : j�-.QVC.Iw S EL/21;6e-4\ w4. cn-el
OWNER MAILING AL ..)RESS: P Q boy 57,E
OWNER PROPERTY , DDRESS: M f}I r). 1-2Q0.8
M i 4-u <k IJ y l 1(450--
TELEPHONE NUMBEL<° OF CONTACT PERSON: c 9F - 3 81 cl
1000
TAX MAP NO. : Sc..tion 40 Block 63 Lot al'p. �.
CROSS STREET: HAVIe .}-R Glue. -f tjiCkham 1Vence
BUILDING PERMIT i ; MBER CROSS REFERENCE:
Signa ure of Applicant
RECEIVED BY:
own Clerk's Office
DATE:
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CERTIFIED TO:
COMMONWEALTH LAND TITLE INSURANCE COMPANY [
STEVEN S. FICNER 1
,.
ELIZABETH M. FICNER I
, .
c.01\50
(04-1k
uFoLic. C.":Y,IN,'7.v •41-- ,---r-:,:-Erl•-- 0:7- HE1:. ;1-1
PERMIT f7on:.,.:7..'"i-),"„vid_ r.)1.- :1i,..7,77.uc.:77!or,i
,...! ....,... ., ._ ,K:L., ,31 e'
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NOTES:
...• :-. E WITH THE MINIMUM •
1. ELEVATIONS ARE REFERENCED TO AN ASSUMED DATUM ,
SURVEY'S AS ESTABUSHED
EXISTING ELEVATIONS ARE SHOWN THUS:4:4...P t)1,› // 3( 00,;!.... L; . . . -PROVED AND ADOPTED
S,
..PORe-. 14-U- EW YORK STATE LAND
EXISTING CONTOUR USES ARE SHOWN THUS:----40 -- --n,..., LI t, .
2INI
. MMUM SEPTIC TANI( CAPACMES FOR A 1 TO 4 BEDROOM HOUSE I 1.006-W, 11.-OrE:F 4 re)LCl '•;- ' .• ', If-_''' .<
. . .,Jtl‘' a' 6
1 TANK; 15' LONG, 4'-3" WIDE, 6'-7" DEEP , ., • ,-‘ ,
3. MINIMUM LEACHING SYSTEM FOR A 1 TO 4 BEDROOM HOUSE IS 300 ttAigiaDAMEW 11111 c, .t. , 4 4, ,
1 POOL,; 12DEEP, 13. dia.
.PROPOSED D(PANSION POOL Fon MAXUi.; OF ct •
•-• E3EDROOMS ), • -
. ..4.3
/•
PROPOSED LEACHING POOL t
EXPIRES THREE YEARS Fi",),.01.4 DATE OF APPROVAL '\\11111.3':11'17'
I ,
g „
. ,
M PROPOSED SEPTIC TANK N...
,
4. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD
.,
OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS. N.Y.S. Lic. No. 49668
UNAUTHORIZED ALTERATION OR ADDITION
TO THIS SURVEY IS A VIOLATION OF
SECTION 7209 OF THE NEW YORK STATE ..
EDUCATION LAVg.
COPIES OF THIS SURVEY MAP NOT BEARING Joseph A. Ingegno
THE LAND SURVEYOR'S INKED SEAL OR
EMBOSSED SEAL SMAU_NOT BE CONSIDERED Land Surveyor
TO EtE A VAUD TRUE COPY.
. CERTIFICATIONS INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED, AND ON HIS BEHALF TO THE
TITLE COMPANY, GOVERNMENTAL AGENCY AND Title Surveys - Subdivisions - Site Pions - Construction Layout )
LENDING INSTITUTION LISTED HEREON,AND
TO THE ASSIGNEES OF'THE LENDING Nen-
TLMON. CEFMRCATIONS ARE NOT TRANSFERABLE. PHONE (631)727-2090 Fox (631)727-1727
THE EXISTENCE OF RIGHT OF WAYS OFFICES LOCATED AT MAIUNG ADDRESS
AND/OR EASEMENTS OF RECORD, IF .
ANY, NOT SHOWN ARE NOT GUARANTEED. 1380 ROANOKE AVENUE P.O. Box 1931
RIVERHEAD, New York 11901 Riverhead, New York 11901-0965
•
21 -50 ..
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