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ELIZABETH A. NEVILLE 11 �`�d; Town Hall, 53095 Main Road
TOWN CLERK ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ,t Southold, New York 11971
MARRIAGE OFFICER ` �,1� Fax (631) 765-6145
�
RECORDS MANAGEMENT OFFICER ?�® �
,ssZZ, ��,•III Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER `7-s' IiI
OFFICE OF THE TOWN CLERK
SOUTHOLD ValiVERNATERTIMICSIEDSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2582 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : GULL POND INC
Address 1 : C/O C MESIANO
City St Zip EAST MORICHES NY 11940
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 #R10-00-0287
Name Of Owner LATHAM, C.T.
Mailing Address 1 PO BOX 608
City St Zip ORIENT NY 11957
Property Address 1 510 GULL POND LANE
City St Zip GREENPORT NY 11944
Tax Map No. section 35.00 block 3 lot 7.000
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 5/17/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
, 80,
p�®v c(L ; MAY 5 ?MI
ELIZABETH A.NEVILLE �� �� �"y " Town Hall, 53095 Main Road
TOWN CLERK ; y ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Rs-� Southold, New York 11971
MARRIAGE OFFICER 4,L � ���, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER -'/®d ��®��i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER *oi
01
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: May 14, 2001
Transmitted herewith is a copy of application No. 2670 for a Cesspool/Septic Tank
CONSTRUCTION/ALTERATION Permit submitted by:
John Casillo/Gull Pond Inc. for T. Latham
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.
2riature --
e
Dated
•
aOFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD ,'' O CQGy; Application No..2G7 Q
,ELIZABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 Construction
SOUTHOLD,NEW YORK 11971 Z
^' Alteration
• ctr
Telephone !,j, �Q��i�, $10.00 - Residential',, �—
(516) 765-1801 ' l N
- 10 $25.00 -Non-Residential
•
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. -
Fee *$
DATE 51/ i6 /
APPLICANT NAME: Q C S I (___L U / en 0 c_c, Dv 1v b' t h,) C .
APPLICANT ADDRESS:C/o (1) , e50.;i0) 'to 1'l U.L PO .
• MDSL, LL4-6;5 ► N4 ) !AL10
SEPTIC t, CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER, OF PROPERTY: (
OWNER MAILING ADDRESS: q2.5 5 LP c -''kej4nv L ?O (,O66
OWNER PROPERTY ADDRESS:\ 3& i PVA
OkVtid ,
TELEPHONE NUMBER OF CONTACT PERSON: C. rLI (e 3i-?7?-? c/
TAX MAP NO. : Section 5 5 Block .3 Lot 7
CROSS STREET: Mg,,;V„ (..b
BUILDING PERMIT- NUMBER CROSS REFERENCE:
)1)/1-t4
Lt.C�
c lel
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
I t
SURVEY.
I OF LOT 1 SEPTIC DETAIL p119pose• 1•
N not to scale DXEL'
_MAP OF FORDHAM ACRES, SECTION ONE ,�
FILED MARCH 1, 1962 FILE No. 3519 - E IV::W ,r\ EL-]5 existing grace a 2 1
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SIT/U��A�TE:: REENPORT my� j inv- cover �fivs 17v0
TOP 7N: SOUTHOLD - cover iSvB 6 f 900 gal
SUFFOLK COUNTY, NY su otx CQ N �ItP � O �� �
it.Ft sept lc in pich
! .CAU ��1� • leaching
- in D tank f/A'Der ft
SURVEYED 12-0I-2000 � ��T01!APPiW-A� � � � P I7 pop is- 1,,I,,,_
/3 per
/� q/ 2 Deep
Rwal ^�iY��7 0 B Die EL-3 8
SUFFOLK COUNTY TAX tt �� (�ICJ<H�LY i'° C o eepa�ae an ground water EL- 1 e
1000-35-3-7 \
,�lo-bo�aa�
CERTIFIED TO DA7£ ��H '� y ��
GULL POND INC APPROVED a
COMMUNITY ABSTRACT CORP 7, SED800ih3 m 0 m
STEINART TITLE INSURANCE COMPANY FOR MMi5:1161�F �-+ FF�C�V L ° �j� p a
EXPIRES THR:=YEA FROM L+A i E 0f AP C
v r_1(-.-
COMMUNITY
Tee, \ , P i.',8N
9
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Test Hole �� Ore°\°�\ E � /C�
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TO COARSE
SAND �' r ,r, ., .r-t-,-,r—r,
\\ E7fCAVATION INSPECTION REQUIRED
��� \ FOR SANITARY 3YM
�a \ v5 \��AI BY HEALTH DEP
ENT
q' \ ,r' �,,of NEt
NOTES �'Aco �� ' ,int\�C Eb�/o.s. > —;"—..i
ELEVATIONS REFERENCE SUFFOLK s �f� 9��� 0.,._<(
o? t c')j f sD 9�
COUNTY TOPOGRAPHIC MAPS(NGVD'260 ,`,�`� F&'"cP.9- `* ri
*;(SlAREA = 25364 SF OR 058 ACRES °� V' y '_':11.'�; ° ate •r u. 3¢;
PROPERTY APPEARS ON FEMA FLOOR �1� ' �d'�
3610360176 &TO BE IN FLOOD ZmN�A .. i ,D '''►�`Ln ND Jt`fI„"°7:4,Z.77779;:'777:"7::
o .too;}�s JOHN C. EHLERS LANDSURVEYOR
GRAPHIC SCALE I"'= 30' , ,,yc\0� \� 6 EAST MAIN STREET N.Y.S LIC.NO.50202
ME 1\\�0 3 RIVERHEAD,N.Y.11901
369-8288 Fax 369-8287 REF.-\\Hp server\d\PROS\20-256B pro I