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ELIZABETH A. NEVILLE 8 ��`` Town Hall, 53095 Main Road
•TOWN CLERK ; n, P.O. Box 1179
c,02 'tREGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER m� r 2,1; _��11, Fax (631) 765 6145
RECORDS MANAGEMENT OFFICER ®d ` �����i�l
' 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. 2555 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JAMES D. BALDRIDGE
Address 1 : 1970 BAYSHORE ROAD
City St Zip GREENPORT NY 11944
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 #R10-99-0196
Name Of Owner BALDRIDGE, JAMES & DONNA HURST
Mailing Address 1 1970 BAYSHORE ROAD
City St Zip GREENPORT NY 11944
Property Address 1 6155 HORTON'S LANE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 54.00 block 7 lot 18.006
Cross Street ROUTE 48
Building Permit Number Cross Reference:
Issue Date: 4/17/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
el
ELIZABETH A.NEVILLE .=FK -'. �; Town Hall, 53095 Main Road
TOWN CLERK ® �-.� r '"'`M' \ P.O. Box 1179
REGISTRAR OF VITAL STATISTICS `
\ � <,�, b- , ,a,.,,�, �, � Southold, New York 11971
MARRIAGE OFFICER :®�¢ 1, Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER ��/� ss�� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER `Ls' ��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: April 13, 2001
Transmitted herewith is a copy of application No. 2644 for a Cesspool/Septic Tank
CONSTRUCTION/ALTERATION Permit submitted by:
James D. Baldridge &Donna Hurst
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 V
DISAPPROVE
Comments: Maintain required setbacks from adjacent wells,buildings,property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED.
/Signature
/i3 °`I
Dated
4-0
/`
OFFICE OF THE TOWN CLERK "I ���R/re-
TOWNOFSOUTHOLD ,•� �J QG Application No.�
ELIZABETH A.NEVILLE,TOWN CLERK
P.O.130X 1179 :,F4 • ? Construction
SOUTHOLD,NEW YORK 11971 o •
T
to ,,1 Alteration
Telephone • `080 V �•'� ' $10.00 - Residential O�
(63t) 765-1800 = ! Y ' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee •$
DATE OV- /3 - 0 /
APPLICANT NAME: •--I G.w•e-S R.LotvLd ,P
APPLICANT ADDRESS: /g ?D i3o.�C Sl.�se �ZG(
altisQ ,yaw+ P y i t?0 •
SEPTIC ( CESSPOOL I
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
nS ` 1 -�wu-i lam/ w-e.tt`
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: •
• OWNER OF PROPERTY: -J o..(jv kcs-c N -wwc. 14-wc s r
OWNER MAILING APQRl�S : �bs�
me a� amass ee,��x•
OWNER PRQPERTY ADDRESS;
So�• Ql� w >towlc
•
TELEPHONE NUMBER OF CONTACT PERSON: 1/7? - ts36)
TAX MAP NO. : Section/000 Block O 0 ? Lot ltf• 6
CROSS STREET: /2-i e_ g'
BUILDING PERMIT NUMBER CROSS REFERENCE: .
•
/4"-" Signature of pplicant
A-1\
RECEIVED BY: '//
To� e s:�'•ce�AP-
DATE:
P-DATE:
�
Cs� ��o, SURVEY OF r PROPERTY
4\' (--\ 0, SITUATED AT
'Si)- SOUTHOLD
z ,f \� TOWN OF SOUTHOLD
SUFFOLK. J�°'�{ T��' A,�, SERVICES J `#4,
a, o� SUFFOLK COUNTY, NEW YORK
� S.C. TAX No.' 1000-54-07-18.6
K F'O, .f .OVAL OF CONSTRUCTION FOR A • -,A ..
' C. �°F� .' RESIDENCE ONLY s , ��,_ SCALE 1"=513'99
i .� e°� JULY 9, 1999
��� "RSP. O. �(�,5a1,00/� • \..A. SEPTEMBER 27, 1999 ADDED BUILDING ENVELOPE
` �s, AREA = 45,501.68 sq. ft.
•
,� - .
�•�,r, �y �\ 1.045 ac.
s u'
O MAXIMUM U O BEDROOMS ..�G ,�Q� ��,t� /, ;� � ��• �O
EXPIRES THREE YEARS FROM DATE OF APPROVAL o�,� Q11 Coy 15Q' O . ,� NOTES:
1. ELEVATIONS ARE REFERENCED TO AN ASSUMED DATUM
GG�� EXISTING ELEVATIONS ARE SHOWN THUS:.S0.0
Q�•5�, �V //' �� .` 2. MINIMUM SEPTIC TANK CAPACITIES FOR A 1 TO 4 BEDROOM HOUSE IS 1,000 GALLONS.
�t `'_Vl"P' d�'"4. 1 TANK; LONG, C WIDE, S FOR
OEEP
/ / 5' ( /0 Y7�� S, 9$ 3. MINIMUM LEACHING SYSTEM FORA 1 TO 4 BEDROOM HOUSE IS 300 sq ft SIDEWALL AREA.
(�'-et/f S t�� 5 �// _ �S �l .. `.., •\\' �� y Q��! 1 PO,OLL; 12' DEEP, 8' dia.
(((( G�4J' ¢QQ° / S. / lib I \ , .e \'. C PROPOSED EXPANSION POOL
��� / - • C `�� PROPOSED LEACHING POOL
ts
,,yy _ A�_-,:
4¢ '-;_;-, -- ° Qe� ® PROPOSED SEPTIC TANK
10
�9 ,�v. /� `_j�_�._-, t `�'v �tPi ` % 4. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD
0 /- /, _ C -1. •' OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS.
st
_ -*__,,
r / p0 o4. TEST HOLE DATA
0
,• 4. p �"'� (Its' HOLE DUG BY McDONALD GEOSCIENCE ON JUNE 2, 1999)
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�F / CERTIFIED TO: Ys--' ;
-6.4b \ JAMES D. BALDRIDGE Jam;=f •` tr
R+ I DONNA M. HURST
4, COMMONWEALTH LAND TITLE INSURANCE COMPANY
1p0
`fS' �.�� UNAUTHORI7F0 ALTERATION OR ADD(I10N PREPARED IN •�1TDANCE WITH THE MINIMUM
O D. *1„_ TO THIS SURVEY LS A ViOLATK)N OF Sr ... e- i - -" _
Oo+ „1 s"-..ANDDADOPTED •
•C �Q. SECTION 7209 OF THE NEW YORK STATE -
EDUCATION LAW YORK STATE LAND
.ap°"� 0� �4 �,.� , Joseph A. Ingegn
i�QI G�, COPES OF THIS SURVEY MAP SNOTEA BEARING Aij'
t�' GQ BABOSSEDO SEAL.SHALL'NOT BEECCONSIDERED �� �@ • N
G4� �. TO BE A VAL10 TRUE COPY. r C' N Ail
?S ciN Land Surveyor
CJI'0 CERTIFICATIONS INDICATED HEREON SHALL RUN '°•l ,C • '�` �O -
(--) SO ONLY TO THE PERSON FOR WHOM THE SURVEY iN'
W. IS PREP 0) AND ON HIS BEHALF TO THE si
TRTE COMP GOVET$iMENTAL AGENCY AND �� .40
�r s Title Surveys —Subdivisions — Site Plans — Construction Layout
5 TO
THE�1NS51I ONOFDSTMTEb �.'...N.A D_ .. .1�
TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE"
.9(Inby 4,66'• PHONE (516)727-2090 Fax (516)722-5093
THE EXISTENCE OF RIGHT OF WAYS A Q�0
4 �( OFFICES LOCATED AT MAILING ADDRESS
AND/OREASEMENTSSHOWRECORD, IF CUA• E�
ANY, NOT SHOWN ARE NOT GUARANTEED. .Y.S. Lia No. 49668 One Union Square P.O. Box 1931
Aquebogue, New York 11931 Riverhead, New York 11901
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