HomeMy WebLinkAboutRose, Kathryn •
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ELIZABETH A. NEVILLE ����� OGy�; Town Hall, 53095 Main Road
TOWN CLERK % - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS v' Southold, New York 11971
`1C �� Fax (631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER =__7�l �a��i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER r,�� southoldtown.northfork.net
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2830 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : KATHRYN ROSS
Address 1 : 1710 PIKE STREET BOX 12
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 #R10-02-0090
Name Of Owner ROSS, KATHRYN
Mailing Address 1 BOX 12
City St Zip MATTITUCK NY 11952
Property Address 1 1710 PIKE STREET
City St Zip MATTITUCK NY 11952
Tax Map No. section 140.00 block 3 lot 19.001
Cross Street MARYS 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 ,e cosV Town Hall, 53095 Main Road
TOWN CLERK o % P.O. Box 1179
REGISTRARea OF VITAL STATISTICS V
_ Southold, New York 11971
$ Fax(631) 765-6145
MARRIAGE OFFICER �,. y,L ' �/
RECORDS MANAGEMENT OFFICER -__It9 �a���� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ ���� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK _ " "
TOWN OF SOUTHOLD
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TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 4, 2002
Transmitted herewith is a copy of application No. 2933 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Kathryn H. Rose
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.
* * * * * * * * * * * *
I have reviewed the application and locati map of the project cited above and make the following
recommendations:
APPROVE /2 /0 -0)-- po'a
DISAPPROVE ✓ has`` /e.e.e 'e ` .
``` SC DSS S
Comments: Maintain required setbacks from adjacent wells,buildings, property line:'5i'water
Bodies. EXCAVATION INSPECTION REQUIRED. V.4,-,109,14.vvt-oa
Ilire,,e,1,:0 ?e,. /yt',. . 4€
. �%
Signature
400V02—
Dated
OFFICE OF THE TOWN CLERK ' �1•'C�C�U �' _ 3l
TOWN OF SOUTHOLD 'J ` CQG ) l
Application No. 'n I
cc/
FT.T7ABETH A.NEVTT.T F,TOWN CLERK
441
P.O.BOX 1179 : ;L Construction
SOUTHOLD,NEW YORK 11971 ` 0 T
Alteration
Telephone �,j%,O 0tiIi• $10.00 - Residential
(631) 765-1800 __ l l
,�' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE C/y O 2—
APPLICANT NAME: A47?/Ls/A/ it
APPLICANT ADDRESS: /7/ 0 f X/ke SX /1
it4A- rvc A- All //91-7--
SEPTIC .-- CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION Ad4freo.r.‘A,7
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: /147 4' /,./ 4", As//
OWNER MAILING ADDRESS: /7/o e ) 2-
A4 At-
MA- 7 i-v G A- Aiy //15-Z--
OWNER
/qszOWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: ')/- Zit" - 969y
TAX MAP NO. : Section /1/4) Block a 3 Lot /9. /
CROSS STREET: MA-1--)(S A0A-1)
BUILDING PERMIT NUMBER CROSS REFERENCE:
Q. Rem__ • .
IC- 11-12Signature of Applicant
RECEIVED BY: :1`-ti Z ;� �'�
Town Clerks Office
DATE:
•
MATTITUCK HIGH SCHOOL
+150' TO ATHLETIC FIELD
CESSPOOLS CESSPOOLS WELL +150' TO WELLS
150' 120'
102' TO D OR CESSPOOLS
WELL •
'
Fri
PIKE IF STREET °
TIE DISTANCE
/ 490.36' \ N' 74°22'00"E 153.39'
29.9' `y •
WELL FUND PROP. FOUND _
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.aWELL CM
Z E 0.3' / �
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= 0 Q�0 o COVERED r n
3FO4 STOOP o
A
Nov
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26 7�--I_ 43 TO WELL
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16.0'--f-14.0' �• , ,
0_ N r
CESSPOOL 2-STORY 25.3'
PROPOSED WOOD FRAME -23
O ^N RESIDENCE �7'9
ST HOLE a 2-CAR 3-
LO. -TION "��� 21.6=-, 3 e' w
AH
73
g' 18 S'-4 �8.2'- I GARAGE w •
•1.9 SCREENED CELLAR N v
N/F GREENBERG ,o PORCH ENT. STOOP ', F)� z
0" --1 1.0'— v
"'P _. ,. #- -•--16.2'---- QR0Q 73
�� A A
PROPOSED
A-A SEPTIC TANK EXISTING x-17.9— X01'
go SANITARY IN THIS10p N/F ZAHRA
AREA TO BE PUMPED N
CESSPOOLPROPOSED AND BACKFILLED O
TEST HOLE DONE BY CESSPOOL o
MCDONALD GEOSCIENCE
ON 24 APRIL 2002 45' c O CESSPOOLS
N
ORIGINAL GROUND - FOUND O
DARK BROWN SANDY LOAM OL S 73°52'30"W ' 151..23'
_�
1'
BROWN LOAMY SAND SM N/F MASSEY
NO WELLS OR CESSPOOLS
3.5' WITHIN 150' OF PROPERTY LINE.
IN THIS AREA t
GUARANTEES INDICATED HERE ON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED, AND ON HIS BEHALF TO THE
TIRE COMPANY, GOVERNMENTAL AGENCY
LENDING INSTITUTION, IF LISTED HEREON, AND
TO THE ASSIGNEES OF THE LENDING INSTITUTION.
GUARANTEES ARE NOT TRANSFERABLE TO 1
ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS.
PALE BROWN FINE
TO MEDIUM SAND SP UNAUTHORIZED ALTERATION OR ADDITION TO THIS
SURVEY IS A VIOLATION OF SECTION 7209 OF 1
THE NEW YORK STATE EDUCATION LAW.
COPIES OF THIS SURVEY MAP NOT BEARING
THE LAND SURVEYORS EMBOSSED SEAL SHALL
NOT BE CONSIDERED TO BE A VALID TRUE
. COPY.
TM# 1000-140-03-19.1
17'
GUARANTEED TO:
KATHRYN H. ROSE
FOR SCDHS USE ONLY
SURVEYED: 7 MARCH 2002
SCALE 1"'= 30'
AREA = 18,904.90 S.F.
OR
0.434 ACRES
SURVEY OF
DESCRIBED PROPERTY
SITUATE
MATTITUCK, TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
SURVEYED FOR: KATHRYN H. ROSE
SURVEYED BY
STANLEY J. ISAKSEN, JR. •
P.O. BOX 294
NEW SUFFOLK. N.Y. 11956
631-7. 4-5835
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_ ,Apiriw, —, / ,
CENSED % A 0 SU' YOR
NYS Lic. o. ` 4927 k
1. 17 May 02 correct Easterly PL. 02R1 1 10 '