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ELIZABETH A. NEVILLE ��= 4 Town Hall, 53095 Main Road
TOWN CLERK 4 o P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER `. 1i N" ���, Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER � 7Q1 1 �a�.a�iii 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. 2809 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MR GLEASON
Address 1 : 8 BRINKMAN COURT
City St Zip HUNTINGTON NY 11743
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 #R10-02-0025
Name Of Owner GLEASON, MR
Mailing Address 1 8 BRINKMAN COURT
City St Zip HUNTINGTON NY 11743
Property Address 1 NEW SUFFOLK AVENUE
City St Zip NEW SUFFOLK NY 11956
Tax Map No. section 110.00 block 8 lot 34.000
Cross Street GRATHWOHL AVENUE
Building Permit Number Cross Reference:
Issue Date: 5/17/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
%StfFOL,�c_`
y0
ELIZABETH A.NEVILLE �� G'y ; Town Hall, 53095 Main Road
TOWN CLERK % C - P.O. Box 1179
y Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER Fax
iNg #01.0 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ ,���� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
2 20u2 TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: May 2, 2002
Transmitted herewith is a copy of application No. 2916 for a Cesspool/Septic Tank Construction
Permit submitted by:
Ann Berger
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:
J i
Signature
Os vz— c�
Dated
OFFICE OF THE TOWN
CERK
TOWN OF OUTHOLLD ,,' '� ��FF��K Application No.aj I
F1.17ABETH A.NEVILLE,TOWN CLERK ; %'
P.O.BOX 1179 ;L Construction
SOUTHOLD,NEW YORK 11971 g
Alteration
Telephone *to'
$10.00 -Residential _
(516) 765-1801 _ j * �'�� $25.00 -Non-Residential
• ---
TOWN
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
RECEIVED
APPLICATION
MAY 1 2002
for
CONSTRUCTION or ALTERATION PERMIT %enfoldTClerk
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 4/1
APPLICANT NAME:
APPLICANT ADDRESS: 0 L30 A-,./ SOK
--4„.-64/e/7),, / 17 -43 •
SEPTIC CESSPOOL `
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
/(4A)/
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS: J i2,,L./G-jy7,r-X/ C�
/1 /77 s, o,/,
OWNER PROPERTY ADDRESS: /Ai -S���jJL•L� v�J
TELEPHONE NUMBER OF CONTACT PERSON: 4 (C'3") 73 4-- S 2-
TAX MAP NO. : Section 1/6 Block LO 2 Lot 3`'
CROSS STREET: �orA-/i
BUILDING PERMIT NUMBER CROSS REFERENCE:
-7
.7-
-Z7
Gl' Si nature of"�Cpplicant
RECEIVED BY:
Town Clerk's Office
DATE:
1 wd 0
E 1 ,406.89' :, � , ;� 0
site, � a
►rill I
FOUND FOUND FOUND D STAKE FOUND „1 q` 17 7 N
CONC. MON. WOOD STAKE PIPE "if jr-
131.80' 73.73' y
--'" ,- BAR 119.04SET . „3.07' 575 • 0' „5.90 • Ni -,•,,,-,..--•,04.4
♦•'
1
n M \ `QTY
_ f STONEl'I.
n � 4 - • -OSED SEPTIC. SYS 0
PROPOSED DEVELOPMENT AREA -6t
6 * (I) 1500 6ALLON SEPTI T \ T)
O ' (� S DIA. X V HI �' ' OO 5 ..,, !' _ , ',I
AREA = X18,007.51 sq. ft. `• ' / co
(TO TIE LINE) $.005 d I♦ -
SANS 00 5 �' ;
••••;- 7--g TONE , /'
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outfit 1 I
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PROP05ED '' \J
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WATER LINE Mf APRON ,e 1 �r; ; •
OLD HARBOR ROADAi 1 ,
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41, ENTRY_ (/ /E:; '4'i rterr g 'fs , ^ QI•
DRIVE A 1
moi-- �-+.� ' f } 4 //v.'
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€410,4. ,./1‘__!:$11 ir A',*44', if-5;•; I -
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TEST HO ` ;x y �* lr a„
- LOCATION _ '' ''• '� 1
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PARKIN6. y 1)/A
`n DISTURBANCE ZONE
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• RADIUS I- LIMI •
I" •' • YELLS FOUND. . '• OI
- - sEI�I5P05
PROPOSED STAIRS TO
WITH �Y4XE
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5 -1-EM FOR A POOL •
4` GARDEN .rHEt7 _ DECKING ON GGA WOOL
W1TH A f3 6R�EENHOUSE - POO�, _ TO
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A• - •• : ,.; STRUGTUR , / MOS(I) 1-•.• 6AL. SEPTIC TANK (5 ♦ .k r } ''';
TEST HOLE .f„ , ; , a' , 411
LOCATIONx '
/ �' �sf , ;,:/ PROPOSED NON—
r, ;r �I D I STUR5ANGE ZONE
PARICIN6 .` ci
, I
F �
#1111.111.-0 L.IMI v ! 4,RADIU5 I • O WELLS FOUND GLE IN6 "," T' I • OOT PIUS l h e 46- .INF, ( s,,,,4--- f e ,11 :,I t' y i a. •� PROPOSED STAIRS TO SEAL
.- — •... 1 c,-.-y K t- •.,.tea E. •5 ,.}. — r .
t" 6aARDEN SHED.- �, 3. , y ,a.+ 4 FEET WIDE WITH % X6
��Y DIaF'OS ,,.
,r.
5 -TEM :FORA POOL ® - j DECAMP ON GGA WOOD
WITH A BA - 4' 0 > 3 STRUCTURE, WITH REMOVAB�
i
(I) I••.. 6AL. SEPTIC TANK (5 • MENTAL , n„ c`'� OF 6 . STAIRS TO BEACH
b ,
(I) FT DIA X 4 FT HT POOL �,' M= SEE DEATAIL5 SHEET #2' House
LEACH I Nb POOL-f' ) , 1 � ;t �- , "� FERMI (I EU SHORELINE
TREL.L`J5 :1A 0. • // V• STRUCTURE I.
1-1
4 I}' �"'1
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FOUND 319.11' IiJ �
CONC. NON. fOt7tUb ` '
tilON 1,5•s:
7
N 73'0• ' - 0" W
,TillIlIll,r, ..- - ,.
WATER LIN - fi UST =E TED BY THE
Q
WELL N/0 SUF • OUNTY D�°PT. OFN HEALTH SERVICZ..
yo . PETER • ' 'H' ' CALL 852-2097, 48 HOURS IN ADVANCE.
TO SCHEDULE INSPECTION(S).
8, 1 a
k.2 L 53
N to
N
PARTIAL SITE PLAN 1
SCALE: 1 " = 40,_0..
FOUNp
NOTE CHANGE(S)
CONC. LION. �
by }
3E .of Selvices
w
p
tSUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES N
o PERMIT FOR APPROVAL OP CONSTRUCTION FORA ALFREI
cMARIAN!
38 SINGLE FAM LY RESIDENCE
. - �es t. I $Q . (572'00'30"E DEED)
o
0 S71'58'30"E
DATE4Jc )H.S/F1 .1«. g\., -0� -uQ-;s- o;-
APPROVED Ali __J 414 .15 PROPOSED CONSERVATT
Q _P
FOR MAXIMwj OP b BEDROOMS AREA = 526,649.58 sq
an '�• A3 - 12.090 ac.
rk, k EXPIRES THREE YEARS FRO:, OA?E OF APPROVAL a
Cr!
e a ' ~� % W PROPOSED
VI �A
0
Cs1 (•4eO 7UNDEROROUND
� 1 4 * - .-1 M WATER LINE PROM
A2uliorPow p M OLD HARBOR ROAD
VI - ' /M /IA. i5 rt...