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ELIZABETH A. NEVILLE / 0 V'• Town Hall, 53095 Main Road
TOWN CLERK y ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS W i Southold, New York 11971
MARRIAGE OFFICER :�,tiL � Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER x__701 iNg *_&‘•6i� 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. 2827 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : BAYBERRY BUILDERS INC
Address 1 : PO BOX 311
City St Zip WADING RIVER NY 11792
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 #R10-02-0087
Name Of Owner BAYBERRY BUILDERS INC
Mailing Address 1 PO BOX 311
City St Zip WADNG RIVER NY 11792
Property Address 1 LIGHTHOUSE ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 54.00 block 3 lot 26.001
Cross Street OLD NORTH ROAD
Building Permit Number Cross Reference:
Issue Date: 6/21/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
•
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ELIZABETH A. NEVILLE ��� # ; •Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS usto T
��,�' Southold, New York 11971
MARRIAGE OFFICER � ,fi � Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER � �! �� �� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
.°8
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: May 29, 2002 •
Transmitted herewith is a copy of application No. 2929 for a Cesspool/Septic Tank Construction
Permit submitted by:
Bayberry Builders, LLC
.
Please review the application and location map and advise if the project has received Suffolk County
Health Department approval and if this office mayassue the permit.
•
Please complete the form below and return it to me.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed*e application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments:
‘4,
Signature
S------Z'c../c)2—
Dated
,4"
OFFICE OF THE TOWN CLERK ,.1C5AVUL v i;
TONOFSOUTHOLD ;'� l �1`G Application No. RI
W
ELIZABETH A.NEVII.I.F,TOWN CLERK O
P.O.BOX 1179 _•� Construction
SOUTHOLD,NEW YORK 11971 0 T
i Alteration
Telephone �eZri $10.00 - Residential 1.7
(516) 765-1801
'' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCT ION or ALTERAT ION PERMIT
SEPTIC TANK or CESSPOOL '
Permit No.
Fee $
DATE 512-VD D ),
APPLICANT NAME: (341 - alit( I '5 1-1,
APPLICANT ADDRESS: Pb ) 311
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
CON1 3 f s 1_ f4 yrs 1°Ne6
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONST UCTION OR ALTERATION: Q 01411•514
OWNER OF PROPERTY: C'( )(341I F S r p r
OWNER MAILING ADDRESS: 2S 6z3-K. 4,rheiwit
X40 l2.IJ�r i`►(`� 1172-
OWNER PROPERTY ADDRESS: U4 yr}^tnex,t' e )(2e/ L -#4
---so-Li-11,20 �-
aq
TELEPHONE NUMBER OF CO5N +TACT PERSON: (03'6 i24, b r7 S-a
TAX MAP NO. : Section kifiget Block 3 Lot O)-(o. I
CROSS STREET: al CI N
BUILDING PERMIT NUMBER CROSS REFERE E:
i• natu a of Appli t
RECEIVED BY: •
Town Clerk's Office
DATE: 5129 (02-
.
t
S.C. TAX MAP NO DIST. 1000 SECT. 54 BLOCK 3 LOT P/026.1 FILE NO. PROJECT NO. 02-0183,��� FJ- t.e 8
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i .a t_ a t. ' 1 I t DARK
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I.t I ‘,/..0 1 l II I' I c} LOAM
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c LOAMY
+ BROM
SILT
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COARSE
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A p 3/ISIZc702
In PROPOSED DRYWELL
77 �� �do, EL 57.5
8' DIAMETER 8' DEEP
(DRIVEWAY RUN-OFF FOR -3
A 2" RAINFALL EVENT)
a b
I 01
gyp �:. iiC4 .....,?
"X •
~
t ' 2FepL\,>RI
3 . h p i
EXISITNG WELL `9� OFarygs�� /
O /7�6 s ,y,
Mat /
® / PROP. WELL
L1
. %L
(APPARENTLY FOR A i`
O PREVOUS AGRICULTURAL USE)
�J
G�
�G1 I
-7 PROPOSED WELL MORE THAN
•p 150' FROM NORTH. EAST &
til WEST PROPERTY LINES, AND
sip MORE THAN 150' FROM
PROPOSED SANITARY SYSTEM
11
*p (1)° E,
AN
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s
SUFFOLK COUNTY terAwirtataaFm•TMiwiclig
PAMQ.Y RICSIDICNOIWILY
1 /2_woz_ 72110.;fo-.-e -oty1-
/
- POI MAXIMUM 1313DROMAS
OF.4 \
/
mess THREE YEARS FROM ..0) A...4
/�teoRrAL *` n_,....)
1is
ti .: , � \\'
NOTESt n1
PRQPOSEp:ELEVATIONS UNDERLINED \;,
CONT-CURBBASED UPON "5 TOW SEWER MAPPING"
DYER ELEVATIONSINDICATED BASED UPON
A6TUAL ELEVATIONS' ‘9a
H,W.J. ALL RIGHTS RESERVED, .MAPA ENDED S/I5102 TO SHOW USE c$ STREET.
Unauthorized alteration or addition to this documen i r. f Section 7209 of the Nee York State PROJECT:
tetOcettfon Law. O r
.Csrtifkations indicated hereon •shall run ant . :