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ELIZABETH A.NEVILLE �� Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS t)' �4��/, Fax(631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER =__ 1alls ��®�l�
Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER
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OFFICE OF THE TOWN CLERK
SOUTHOLD 1TE[ SAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2639 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : I . SPERLING
Address 1 : 285 SUMMIT DRIVE
City St Zip MATTITUCK NY 11952
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 #R10-01-0074
Name Of Owner SPERLING, I .
Mailing Address 1 5 OAK TRAIL ROAD
City St Zip ENGLEWOOD NJ 7631
Property Address 1 285 SUMMIT DRIVE
City St Zip MATTITUCK NY 11952
Tax Map No. section 106.00 block 1 lot 38.000
Cross Street CENTRAL DRIVE
Building Permit Number Cross Reference:
Issue Date: 8/13/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
• ili Of Fatt .:• 0(t°3 91
ELIZABETH A. NEVILLE ,010- 0*� Town Hall, 53095 Main Road
TOWN CLERK 1 ( ) " % P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ``� O ,+I Southold, New York 11971
MARRIAGE OFFICER Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ��_��� s2 ��®�iof Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ---- ,..,..s0`zs' i'�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: -Linda J. Cooper, Southold Town Clerk's Office
DATED: August 9, 2001
Transmitted herewith is a copy of application No. 2727 for a Cesspool/Septic Tank Construction
Permit submitted by:
I. Sperling
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 J
DISAPPROVE
Comments:
Signature
66.....-----
____79
gi ‘b1oI
Dated
OFFICE OF THE TOWN CLERK ,11' �FHLk •,
TOWN OF SOUTHOLD ��3 Q�J CQG Application No.X) 7
ELIZABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 Construction 1L/
SOUTHOLD,NEW YORK 11971 p • rn Alteration
Telephone oyg, �Q�i11 ' $10.00 -Residential
(63'k) 765-1800 -:�l. ���''� $25.00 -Non-Residential
• -, I,,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION * p_ c e I v E D
for
AUG. 9 2001
CONSTRUCTION or ALTERATION PERMIT
Clerk
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE OI
APPLICANT NAME: _ §P E Iq,L (.<II�Z
APPLICANT ADDRESS: �� - "-r't-ft `T
WiOr T r Tyr f/y
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
S / k--6 FA)-4-1/7
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:.ION: •
OWNER OF PROPERTY: ,
OWNER MAILING ADDRESS: 5 0,410 x-O-i(..... fib cep _&
076 /
OWNER PROPERTY ADDRESS: Z f S-L )2-e Alf J&
'1?T-7-77—tee<
TELEPHONE NUMBER OF CONTACT PERSON:
(7-0) Se.-6 41T7
TAX MAP NO. : Section /04 Block 0/ Lot 3%
CROSS STREET: GPac/711-4-C_
BUILDING PERMIT NUMBER CROSS REFERENCE:
Si. • - iof App icant
RECEIVED BY: •
Town Clerk's Office
DATE: •
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CA.�''1'AIN KIDDI.
04. •off
KI FILE No. 1 672 FILED JAI
Y " � 'Ck- cs0 ,9 xi_Ccc,. 5IP 6�OP N SITUATED,
sikl' QV i o�;; 1 os MATTITt;
7/ ,-- 7 7 7z22�s, TOWN OF SO'
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j','?�e`�� SUFFOLK COUNTY
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0\-1� '�'v'%'��//j �3A�°�� S.C. TAX No. 1000,�:
0 X161, / 7/ '3380\ SCALE 1 r►
\ 7 7 7 /%/ ' 424 NOVEMBER 9i
7 77 7 7 '_446 MARCH 5, 2001 ADD'
i �� i �� �/ / /// , ,450
' �' / i' / i ' / / / / / ' /, X52
7 7 / / // / 546 AREA = 37�'
__ -- � � i � � / / / / // 77 558
-� 7 7 / / / // / / / x,60 0.a
i i i /7// /•/// / 2
7 i' //// / i\i 66 64 NOTES:
7 7 � �7
/ / /// 7 / i ;70 1. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATL'
i
7 7�7 i ' i'/j/ / / / j\/j .-72 EXISTING ELEVATIONS ARE SHOWN THUS: 90.01.
i / / /,/,// / / i ii X74 EXISTING CONTOUR LINES ARE SHOWN THUS:-
42' i'i / / // / / / / i 76 PROPOSED ELEVATIONS ARE SHOWN THUS: Ti.
44- 77 --- 7 / / / // z / 7 / i i X78
6- i — .- / / / / / / / / __ —80 2. MINIMUM SEPTIC TANK CAPACITIES FOR A 1 TO 4 BEI,
4 - ' i - i / / ' / / / / / 7 / --82 1 TANK; 8' LONG, 4'-3" WIDE, 6'-7" DEEP I i
50- j i / / /// j// //7 , —84 3. MINIMUM LEACHING SYSTEM FOR A 1 TO 4 BEDROOM'
52, 7 7 7 .7 7 // / //// / /// / / 8868 1 POOL; 12' DEEP, 8' dia.
54� — �' / / / / / / / / /' / /i ;I
;�... PROPOSED EXPANSION POOL
558 7 7 j//// / //// // - 9092 199
Q ..
67 / / / / / // / // / / / 60.,.. 7,- 94 '�, �j,� PROPOSED LEACHING POOL ;624. � / / / / / / / / ,17\.. w. _ �9F �i '�' 1
64----
66-- 7 - - 7\' / / / / / / `, / � I \�$ x'98 C O WA PROPOSED SEPTIC TANK
8. -- � / / se w
70 , ' / / / /g / ? I \, F O N 4. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HE''
Ply/ 96.• 99 4
714 i = _ / / Q / / „ �//�Q i� I \�`� �� -100 OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERSIi
780 - - - - � i, I. �`'I Ai �,mf
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SUFFOLK COUNTY DEPARTMENT OF HEAL'
o ly �� • i ... U'' �I� �'• PERMIT FOR APPROVAL OF CONSTRuC,
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INSURANCE COMPANY OF NEW YORKX978' cI
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TEST HOLE DATA
NIMUM (TEST HOLE DUG BY McDONALD GEOSCIENCE ON OG;
BUSHED
)OPTED
1E LAND
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BROWN LOAMY SAP'
I.II—LIIIII!-I-1111 1
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�=0 I I I PALE BROWN FINE;
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7.1_11-1
Y.S. Lic. No. 49668 —1I J-1I I
UNATHORIZED ALTERATION OR ADDRION
_1 _III— 13'
TO THIS SURVEY IS A VIOLATION OF
_- _ I SECTION 7209 OF THE NEW YORK STATE
EDUCATION LAW.