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ELIZABETH A.NEVILLE �� 4/". Town Hall, 53095 Main Road
TOWN CLERK ; P.O. Box 1179
tb. i Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ® ��
MARRIAGE OFFICER �1 Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER .. "O,g Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ••, ,,,,��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2507 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : POSILLICO CONSTRUCTION CO.
Address 1 : 31 TENNYSON AVENUE
City St Zip WESTBURY NY 11590
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 # R10-00-0131
Name Of Owner POSILLICO CONSTRUCTION CO
Mailing Address 1 31 TENNYSON AVENUE
City St Zip WESTBURY NY 11590
Property Address 1 AUGUST LANE
City St Zip GREENPORT NY 11944
Tax Map No. section 53.00 block 4 lot 44.038
Cross Street PHEASANT PLACE
Building Permit Number Cross Reference:
Issue Date: 2/06/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
,0 as-07
6 LS.lJ� 4 �Y9FF®`�° �,
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ELIZABETH Aa iNEVIE ,� �st� �� N% Town Hall, 53095 Main Road
TOWN CLERK �C n' �� P.O. Box 1179
REGISTRAR OF VITAL STATISTICS—7:7—A--- i 411$ Southold, New York 11971
MARRIAGE OFFICER ' N �� Fax (631) 765-6145
RECORDS MANAGEMENT°OFFICER T �__�®� ��®�iie Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER
��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: ' Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: February 1, 2001
Transmitted herewith is a copy of application No. 2595 for a Cesspool/Septic Tank
CONSTRUCTION/ALTERATION Permit submitted by:
Posillico Construction Co., 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: Maintain required setbacks from adjacent wells,buildings,property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED.
inature U
a1s(at
Dated
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OFFICE OF THE TOWN CLERIC /rex:,
TOWN OF SOUTHOLD 9�CJ (
�• Application No.
ELIZABETH �S`/✓C
A.NEVILLE,TOWN CLERK v
P.O.Box 1179 ,F _ ; Construction
SOU1'HOLD,NEW YORK 11971 %
frlAlteration
Telephone `�v,�/ �Q�••�• $10.00 - Residential
(631:) 765-1800 =-�"1' �;,�� $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION •
,o... _ . _ _ ._ . .
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE //3//0/
APPLICANT NAME: PSS///60 5/YuC4 1-, moo. , c
APPLICANT ADDRESS: ' /
Wesi-6k y/ Nl /' '
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
57�c. 7;ki A L , Pey `s ,- r ilaa(
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: •
OWNER OF PROPERTY: P'sj/l e-t, is /ve-tz-O`ti-.
OWNER MAILING ADDRESS: 31 ��^h/s-.- ,-e
/Os gm /1/y PS-90
OWNER PROPERTY ADDRESS: LGA.-e
TELEPHONE NUMBER OF CONTACT PERSON: C5/0 333 - O6 b6
TAX MAP NO. : Section 5-3 Block 7`' Lot 4/9 3 5
CROSS STREET: PA-easa.,/ glee
BUILDING PERMIT NUMBER CROSS REFERENCE: .
Sign re of Applic t
•
RECEIVED BY: ��{ 0_,¢
own C rk's O ice
DATE: •
L
al
•
JOB No AUG-36 ' -- TAX I.D. No. 1000-53-04-44.38
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EXCAVATION INSPECTION REQUURED o co
FOR SANITARY SYSTEM co
' HFA, TW nPl' ycla
. • , C LINTY DIPARHENT OF MIAMI T •' ..<
PIM?Ntilt,APPROVAL OPQONIntr['!!ON von
SIMILE l►AMLYISMININCE ONLY
P1An & -G-00 _ 4;,. No. '11 # a b l 3/ I - ttx
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vim
MAXIMUM OF .!:,►,. 94.0 —
..-t_." C.T1 91
EXPIRES T YEARS '
�' N 31°32'30"W 135.65' -tom =�
rrirf 72e
•,r V IN AbbUNICUITMUNI 237) C)
2] GROUNDWATER BASED ON TEST HOLE '' --1DUG 5/13/98 LOT 19 TO ASCERTAIN CHANGES LOT 34 6 i) -"
IN WATER LEVEL SINCE APPROVAL OF FILE MAP. OCC RES PW ..-...1
3] GROUND WATER ELEV 90 0
4] 3 POOL SYSTEM 4'IN DEPTH
BOTTOM LP 93 0 2 EX POOLS 3'IN DEPTH
5] GRADE ABOVE 6"CONC COVER LP 98.5
6] TOP SEPTIC 98 0 GRADE ABOVE 6"CONC COVER 99.5
PROP ELEV[97 5] EXISTING 97.5 FILE MAP No. 9107 6/3/91
Unauthorized alteration or addition to this document is a violation of Section 7209
of the New York State Education Law SURVEY OF: LOT 36
Certifications indicated hereon shall run only to the person for whom It is prepared
and on his behalf to the Title Company,Governmental Agency and Lending
Institution listed hereon,and to the assignees of the lending institutions or M/O AUGUST ACRES SECTION 1.
subsequent owners
Copies of this document not bearing the professional's inked seal or embossed AR S HA M O MA Q U E TOWN OF SOUTH O L D
seal shall not be considered a valid true copy
The offsets[or dimensions]shown hereon from structures to the property lines are
for a specific purpose and use and therefore are not intended to guide the erection of SUFFOLK COUNTYNEW YORK
fences,retaining walls,pools,planting areas,addition to buildings or any other +
construction
Thhe existence e guaranteed f right of ways and/or easements of record,if any,not shown are SURVEY DATE: 5/2/00 SCALE: 1"=50'
nCERTIFIED ONLY TO: , ��� fro
POSILLICO CONSTRUCTION ' ' DESTIN G.GRAF
, J' 4 ;. LAND SURVEYOR
CP-
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.wr ,.F,�tfi
73 Woodlawn Road
SEr r Rocky Point, N.Y. 11778
By DESTIN G GRAF N.Y.S. LIC No. 500,.7 •`:�'Aile 516-821-3442
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