HomeMy WebLinkAboutSeifert (2) oFFOL4 —
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ELIZABETH A. NEVILLE 1 : Town Hall, 53095 Main Road
TOWN CLERK y a P.O. Box 1179
REGISTRAR OF VITAL STATISTICS +�� Southold, New York 11971
MARRIAGE OFFICER �y* 4. /� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER , 0( -to 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. 2527 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JOHN SEIFERT
Address 1 : 93 LONE OAK PATH
City St Zip SMITHTOWN NY 11787
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 #R10-01-0040
Name Of Owner SEIFERT, JOHN
Mailing Address 1 93 LONE OAK PATH
City St Zip SMITHTOWN NY 11787
Property Address 1 725 WHITE EAGLE DRIVE
City St Zip LAUREL NY 11948
Tax Map No. section 127.00 block 9 lot 24.000
Cross Street PECONIC BAY BLVD
Building Permit Number Cross Reference:
Issue Date: 3/27/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
-_ 0%g4FFOUr ST)I�,
ELIZABETH A.NEVILLE ,�� ®G'y4: Town Hall, 53095 Main Road
TOWN CLERK y 1 P.O. Box 1179
REGISTRAR OF VITAL STATISTICS V 6 Southold, New York 11971
MARRIAGE OFFICER �` y `��1�, Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER =-_�Ol4. �°„00 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER 1
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: March 9, 2001
Transmitted herewith is a copy of application No. 2615 for a Cesspool/Septic Tank Construction
Permit submitted by:
John Seifert
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:
Signature
3/1 2� 6 (
Dated
i
OFFICE OF THE TOWN CLERK •'►► �F►DlK
TOWN OF SOUTHOLD
' % Application No. g-6
►'
Ft.17ABETH A.NEVILLE,TOWN CLERK
Construction
P.O.BOX 1179 : � � ;' :
SOUTHOLD,NEW YORK 11971 v • m
Alteration
Telephone 4-/ $10.00 - Residential �—
(631) 765-1800 ,,►,,o $25.00 -Non-Residential
• ,,,,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE M M2-C-O I 2-°0
APPLICANT NAME: --So\--kN SEI=PERT
APPLICANT ADDRESS: 13 Lv N PITH-
Sm , +hfowiV N-\j
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
/Ve-W 6.)r1,5' 7 Leo Ad
•
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: •
. OWNER OF PROPERTY: -Joe-1AI S f pT-
OWNER MAILING ADDRESS: 93 I-0avOA-I'C, P6-Th
w,, iV• y t / 1 E 7
OWNER PROPERTY ADDRESS: 1 aS Lt/h i /-2 Ect)/-c. D ri ✓2
re- /` YIigs-1
TELEPHONE NUMBER OF CONTACT PERSON: ((,31) 86 -c-/S-1-/O
TAX MAP NO. : Section a 1 Block 9 Lot 02 4/
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFE NCE:
Signature of • pi►Iicant
RECEIVED BY:
r Ton Clerk's Office
DATE: 3 1 (D /
TEST HOLE NO. 3 J((1 NOTE: THIS PROPERTY DESIGNATED DISTRICT 1000, PLOT PLAN
°° o SECTION 127, BLOCK 9, LOT NO. 24 ON THE FOR
1- LAND AND TAX MAP OF THE COUNTY OF SUFFOLK: LOT NO. 24
TOPSOIL (A
IV
HEAVY LOAN, o (.31
CP% _ GOLDEN MAPOF
FESTATES
CLAY �® V 0 •oo Iv 0
AT
LAUREL
,,
TOWN OF SOUTHOLD
,...............„„__ E, 0 2, e.
`'s �y ^� SUFFOLK COUNTY, NEW YORK
�0 �O lP /� SUFFOLK COUNTY FILE NO. 7770
cn O 740 JPGP� ��• ��oq ��• L FILED: AUGUST 30, 1984
2 v W GUARANTEED ONLY TO:
ca LA,„ TEST 1 OL l�Q. IIATA AND LOCATION 2 Q JOHN SEIFERT
EST S R•M M '4F GOLDEN VIEW '� TARA SEIFERT
z e� THE TOWN OF SOUTHOLD
t J '� Rp¢o�N � �s SUFFOLK COUNTY HEALTH DEPARMENT
i �"- ��X26 �� a�' t� PROJECT NO. 10126
��
SURVEYED: FEBRUARY 11, 1996
¢� 35illk PLAN PREPARED: JANUARY 17, 1996
a. 0, ...1' < Go oR''F �/L PLAN REVISED: JANUARY 29, 2001
o q oe
i £4 ' �'I .cam^. �/ .Nom ��o-o eR 4,6* .<v:
•� I HEREBY CERTIFY THAT I AM UNAUTHORIZED ALTERATION OR
ft, - G a o '�„ A PROFESSIONAL LAND SURVEYOR ADDITION TO THIS SURVEY IS A
+`�•�' u^' �, •� a .� �c•� S o LICENSED TO PRACTICE IN THE VIOLATION OF SECTION 7209 OF
�� ,Y, SES tP Yy 5 ems, STATE OF NEW YORK, AND THAT THE NEW YORK STATE EDUCATION
w�-, �r \. R •
�O o • �Oe e Noq .o THIS PLAN IS BASED ON AN LAW COPIES OF THIS THIS
' 2 e 6 .` ACTUAL FIELD SURVEY UNDER MY SURVEY MAP NOT BEARING THE
u ELL (13 6�a �` .g. v ��'
15.1\
� %-3 �p QR0?' tr IMMEDIATE SUPERVISION I LAND SURVEYOR'S INKED SEAL OR
ZC' O'( F� 0 FURTHER DECLARE, TO THE BEST EMBOSSED SEAL SHALL NOT BE
(3 • OF MY PROFESSIONAL KNOWLEDGE CONSIDERED TO BE A VALID TRUE
'"a c'" r� ZO J AND BELIEF, THAT THIS PLAN IS COPY.
:Xl. '�" QEF , ^O A CORRECT AND ACCURATE
Id a ? � N, y 5 r p `r - 0 _I REPRESENTATION OF CONDITIONS
6:a k n ypact'' •�:.•t„ O �. a9' ' , O EXISTING AS OF THIS DATE HEREON
^� aid" -Ip ;;Jq o µ0� ��. CERTIFICATIONS INDICATED HEREON
id. ft
:� ���4 y„ F,'�„°`y.� -c� RC' o SHALL RUN ONLY TO THE PERSON
f•-s.) ;71 ^V` ,” O -c+ O O`�" �j �r� THE OFFSETS (OR DIMENSIONS) FOR WHOM THE SURVEY IS
ti s'o •O ��4. •<Y SHOWN HEREON FROM THE PREPARED AND ON HIS BEHALF TO
..... • • " �'r;' '=� ^ "7",..-2,
`� STRUCTURES TO THE PROPERTY THE TITLE COMPANY, GOVERNMENTAL
' - '�` „-,p„,„�"•� zi' `` ��J L 2 p 3 �, LINES ARE FOR A SPECIFIC AGENCY AND LENDING INSTITUTION
�'�,' •S'E,`i'�r i^!j a �� �O ��-. PURPOSE AND USE AND THEREFORE LISTED HEREON AND TO THE
t<s,,�, t-•, "£ �O �`� ARE NOT INTENDED TO GUIDE THE ASSIGNEES OF THE LENDING
:s"''4” �^ Pl�,� ; t" 4 •° �Z� ' ,BEST n' V, ,,\'( �` ERECTION OF FENCES, RETAINING INSTITUTION CERTIFICATIONS ARE
ti:t-; • �L �.[� ® /L D CP,\` �2� WALLS, POOLS, PATIOS. PLANTING NOT TRANSFERABLE TO ADDITIONAL
--} ri ao� I ` �P G) •OO AREAS. ADDITION TO BUILDINGS INSTITUTIONS OR SUBSEQUENT
01--:,J--- - n-o 2 0, 1( 2 ` AND ANY OTHER CONSTRUCTION OWNERS
.s.a .,� '• ' L. O Roe t l'�-% ,
.; 4 ' ` "s di o �Q•P- . U �`" ' ', �o O DONALD G. DEKENIPP L.S., P.C.
°� _` , r " 5 R`'S , -1; Q PROFESSIONAL LAND SURVEYOR
' ON 222 GREENE AVENUE
-% NOTE SNOWCOVER;THIS`DAIE SAYVILLE, N.Y. 11782
!TOTE: ELEVATIONS SHOWN ARE SCALED FROM I ;r1(Vt^~£:` - ABSTRACT OF TITLE AND EASEMENTS FOR SUBJECT PARCEL
SHEET NO. 8-33, TOPOGRAPHIC MAP OF ,, 1.:•1 ,; T
,_ t,,':` AND ADJOINING PARCELS NOT PROVIDED FOR THE (631) 589-5350
!/�+,- FIVE EASTERN TOWNS, SUFFOLK COUNTY, N Y d 2 ` DOESNOTTHE EXISTENCE OFN OF THIS SURVEY S SAME ENCE OF EASEMENTS
i (631) 589-4292 (FAX)