HomeMy WebLinkAboutHeffernan ELIZABETH A.NEVILLE � � 4...3: Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS 1,v Southold, New York 11971
MARRIAGE OFFICER �� 4 e1 Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER �,_ ®�( „it Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER - '/o•1
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2528 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : SUZANNE & DENNIS HEFFERNAN
Address 1 : 3 GAINES DRIVE
City St Zip FARMINGVILLE NY 11738
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 #R10-00-0092
Name Of Owner HEFFERNAN, SUZANNE & DENNIS
Mailing Address 1 3 GAINES DRIVE
City St Zip FARMINGVILLE NY 11738
Property Address 1 CASES LANE EXTENSION
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 109.00 block 5 lot 14.047
Cross Street WOOD WAY -
Building Permit Number Cross Reference:
Issue Date: 3/27/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE �iy d: Town Hall, 53095 Main Road
TOWN CLERK % H Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS � � Southold, New York 11971
MARRIAGE OFFICER sfi �1 Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER �, ®1 **®.•1Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER •_, ,,,i
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: March 13, 2001
Transmitted herewith is a copy of application No. 2616 for a Cesspool/Septic Tank
CONSTRUCTION/ALTERATION Permit submitted by:
Suzanne & Dennis Heffernan
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.
Si ature
3 �t� � c� t
Dated
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0�Ir,<4OFFICEOFTHETOWNCLERK iGUfj` j`i
tTOWN OF SOUTHOLD
Application N
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ELIZABETH A NEVILLE,TOWN CLERK
P.O,BOX 1179 Construction
SOUTHOLD,NEW YORK 11971v rn
Alteration
Telephone ,�� � 6,'� $10,.00 -Residential
(516) 765-1801 _ ®1 , �,to $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 Hard I - ••
APPLICANT NAME: Soyinrr -{4e rnn
APPLICANT ADDRESS:
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
upc) Alfir I bed,09.N
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Smn -0 kr1Ai.5
OWNER MAILING ADDRESS: 3 anncsl�rive)
4 d Vtn;MM v1)l.p
OWNER PROPERTY ADDRESS: ((i• W nc •JAL .SI/�
CL/1r j1f t J
TELEPHONE NUMBER OF CONTACT PERSON: 769- Wyt
TAX MAP NO. : Section 'KA Block 06•,v o Lot Q 1'-1, 01-1-7-
CROSS
yCROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
• Signatur4( Applicant
RECEIVED BY :
Town Clerk's Office
DATE: •
_\II I i _ JUrrULM LUUIN I T UN AUL,. LO, WO/ MO MHP- IVU. coJL - "'"--"""•^^- �' -rte' "' •--✓-----"-'"--" --'"� e _
I' BROWN LOAMY John Schnurr, Land Surveyor
un�� • VERTICAL DATUM = N.G.V. DATUM (M.S.L. 1929) SILT
� � • (M-L)
'If ELEVATIONS SHOWN HEREON ARE FROM MAPS OR SURVEYS z5' �J
PREPARED BY US AND ARE SUBJECT TO FIELD VERIFICATION. PATINE RowN SUFFOLK� �[��E A E1t1If'F,S 1 ,
Manning • PROPERTY LOCATED IN FIRM ZONE AE BASE ELEVATION 8 , AS
( ) COARSE
SAND PERMIT FOR APPROVAL OF CONSTRUCTION U TI®N FOR A
'�' SHOWN ON THE FLOOD INSURANCE RATE MAP, MAP N0.
Engineering EL=5 4 -- 9.6'
;�f; 36103C0163G, PANEL NO. 0163—G, LAST DATED MAY 4, 1998. WATER IN SINGLE FAMILY RESIDENCE ONLY
g'urueging
PALE BROWN O`K�� �r
T
FINE TO �/�
COARSE SAND
DATE Hs �j®, 1!✓
(S W.)
170' APPROVED _ t /
(NOTE TEST HOLE BY FOR MAXDAUM OF B 040MS
MCDONALD GEOSCIENCE)
• I HEREBY CERTIFY THAT THE WATER SUPPLY AND.SEWAG a `
DISPOSAL SYSTEMS FOR THIS PROJECT WERE DESIGNED BY ME OR
UNDER MY DIRECTION. BASED UPON A CAREFUL AND THOROUGH
now STUDY OF THE SOIL, SITE AND GROUNDWATER CONDITIONS, THE
Or for WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS, AS PROPOSED,
SPLITrr1 erl y Cabron CONFORM TO THE SUFFOLK COUNTY DEPARTMENT OF HEALTH
RAIL FENCE FENOE s TO (GOLF E SERVICES CONSTRUCTION STANDARDS IN EFFECT AS OF THIS PATE.
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S TOR E LAW E EGDE ti�
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On �� a •ROPOSED L l W/CAP KE ON * -4 [
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52 S' /ALV_ _ /o / 1 , �•isO o ,` sD�. c P �, �` HOWARD W. YOUNG, N.Y.S. L.S. N0. 45893n(APpROX o ` 1 ` ' w �' THOMAS C. WOLPERT, N.Y.S. P.E. N0.1pI � l3O,c- . .1 ? y-• '-/ / 40.oIPRDPD•
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CD o to ti -- / o /� Am „ o W�� /1 &'4,4s, ...,1%440,7,4;...› Too `, °,y _ CERTIFICATION
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p I r ly '9� � Q I 1
N N o= YYYlI , WE HEREBY CERTIFY TO DENNIS HEFFERNAN,
�4. �,, p d o ate."' TEST yQLEI , nEIUN 11 v� SUZANNE HEFFERNAN & FIDELITY NATIONAL
5730" / N �I Alibi t Z �� (-) �C 0 q I / O O g9PROXoN,_4619 31)
��! 8g) TITLE INSURANCE COMPANY OF NEW YORK
WOOD rY 50 OOwI�I E p jw."�i . ` 4 J, ^ THAT THIS SURVEY WAS PREPARED IN ACCORDANCE WITH THE
Y(�s IL. I I ° / '' 8 v�.{ `EP. CODE OF PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW
PEpGE '9) moi' I \� sYORK STATE ASSOCIATION OF PROFESSIONAL LAND SURVEYORS.
il //I
LutNG 51. 1ib
Li
oN , I / DISTUR ANC D GROUND 1 1 / \ �Cf NE•
WITHIN 150• p 80'05,5p" w �( LINE 1
CD N (S3O.32521 / \,lN32�.s2' 1S80'07� 714.91 26.5351E 3 * ', ,*
N — L co '�^ C.P o P 376.46' I 1 --.4. ,fill,6 L5 /,,oh:QD Ii (; ., li,.
O 3 , Z / N o.P. 0 SBA EZONE 'AE'_ 1 / ± .� fin/ tf�/ JOHN SCHNURR, N.Y.S. L.S. NO. 49517 / A.
Q ❑ ELEV. 8 ry/� HOWARD W. YOUNG, N.Y.S. L.S. NO. 45893 `�'► 0
J o •p Q i S.T n O I % ^ 1885'05'5p„w
Lr_ a Henry W or forme .� '7' 4' ` %tANos4 '
o StosiukiewicZ rly :It) SURVEY FOR ,
Q. (Dwelling) & Others - o DENNIS HEFFERNAN & SUZANNE HEFFERNAI
iN
/ CENTERLINE OF GUTTER AND/OR LOT 1 MINOR SUBDIVISION OF
/ QNED FROM
/ WEST DEED DES RIPTIONS ANDI SURVEYS "FRANK H. CASE”
o J BY OTHERS. V At Cutchogue, Town of Southold
0 Cl)„ O WELL Suffolk County, New York
-Q aLLI - County Tax Map District 1000 Section 109 Block 05 Lot 14.47
w
V BUILDING PERMIT SURVEY
SECTION SEWAGE DISPOSAL SYSTEM
I / i IPIIIIr47T-141p.r°I•-(4'c"1rNsX.c0NIT eRv cvcTFIA FFR 15 7nn1