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ELIZABETH A.NEVILLE ,��� Town Hall, 53095 Main Road
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TOWN CLERK co ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS {, PPV �1 Southold, New York 11971
MARRIAGE OFFICER Fax Fax(631) 765-6145
MARRIAGE OFFICER 4's ,� v � ,1� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER =__ ® gEg �®iii Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER �
OFFICE OF THE TOWN CLERK
SOUTHOLD INASTEEM9CEIRTEECEIFIDSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2634 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : DAREN PFENNIG
Address 1 : PO BOX 244
City St Zip WADING RIVER NY 11792
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 #R10-01-0038
Name Of Owner PFENNIG, DAREN
Mailing Address 1 PO BOX 244
City St Zip WADING RIVER NY 11792
Property Address 1 LAUREL LAKE DRIVE
City St Zip MATTITUCK NY 11952
Tax Map No. section 121 .00 block 4 lot 8.004
Cross Street SOUND AVENUE
Building Permit Number Cross Reference:
Issue Date: 8/08/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE ti A7 ''s. Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR,OF VITAL STATISTICS yo, ,; �� Southold, New York 11971
MARRIAGE OFFICER :� n.,:. ,- ��
v � Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ;4 �: ��®,1� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER .90
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: August 6, 2001
Transmitted herewith is a copy of application No. 2723 for a Cesspool/Septic Tank Construction
Permit submitted by:
Daren Pfenning
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
7/-1 i
Dated
Y y _
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OFFICE OF THE TOWN CLERK .''11��C�Ot`^
TOWN OF SOUTHOLD �� C A 4Q� Application No. �C,
ELIZABETH A.NEVILLE,TOWN CLERK i O
P.O.BOX1179 • Construction
SOUTHOLD,NEW YORK 11971 ; =v • T ;
Alteration
Telephone 0,��0 .0/ $10.00 -Residential
(63•x) 765-1800 : 1 ,;�,r'I, $25.00 -Non-Residential
TOWN OF SOUTHOLD •
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION •
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE
APPLICANT NAME: DA LrFp-1
APPLICANT ADDRESS: b •tgx zy.14
SEPTIC CESSPOOL V
DESCRIPTION OF PROPOSED CO.IVSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR TERATION: .
• OWNER OF PROPERTY: pt12„a4 Nth
OWNER MAILING ADDRESS: 17b 7 2.4-1
v.1 14 1'sci 11-71-1_
OWNER
1`t1z-
OWNER PROPERTY ADDRESS: g,.4 - i`'t� , •
o F (.AtI1444-- U4 r ti�
TELEPHONE NUMBER OF CONTACT PERSON: T2-1-3145(p
TAX MAP NO. : Section I/4 Block 011 Lot
CROSS STREET: /v✓'rro lilt •
BUILDING PERMIT NUMBER CROSS REFERENCE:
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•ignat re o- . pplicant
RECEIVED BY: /NIL- U •
Town Clerk's Office
DATE:
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, cW
O� La 1 X/O/F
> COUAIY'Y OF SUFFOLK
' o Q VACANT SURVEY OF PROPERTY
0 = - SITUATED AT
c N N 88'45'00- E DEED)
MATTITUCK
S 87.33'oo" Et . - TOWN OF SOUTHOLD
(557.33' DEED)
La.,
544.94' SUFFOLK COUNTY, NEW YORK
11 - - -
0 0 R I � FOUND� S.C. TAX No. 1000-121-04-8.4
al
O "
• —...�:..T.i. — A W000 sax 111 N� SCALE 1"=60'
5 d°' SUFFOLK COUNTY p�,PAt2TMGIV7 Or � 1L"!'N.�'QIEPE.a -- -- _—_—_—_—_� NO. $A aa•�. DECEMBER 12, 2000
• DECEMBER 20, 2000 TEST HOLE
pr, PERMIT FGF,!APPROVAL Or Caf�STRUC?IbN FOR ..1, �\ '_ �, JANUARY 6, 2001 ADDED PROPOSED HOUSE
' a.
SINCLS FAMILY RERIDtWCEe. � = >T (^
ONLY , ii"'� z,..- _ : \ O�a� AREA = 202,697.73 sq. ft.
.• "f ;; __ - 10 va 4.653 ac.
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D*TM HoLEATC -2b'� .S. it P. No. h_ 0 i ..O o 3 • —- .a
`� (V APPROVED- 1 -:-.....,..--..,i ' "�"_ CERTIFIED TO:
- ^=� \ �c. DAREN PFENNIG
-- r– Fon MAXIMUM b�;. _ _- .BzOROOM9 - L� _ .. _ � , --
°- EXPIRES THREE YEARS ROM DATE OF APPROVAL ROYAL -,.--,:_ml.„-„....,_2--- .......-:.
- _ ' '.3
,1 TEST HOLE DATA
9 \..........„...„.„..---
J �2 0 (TEST HOLE DUG BY ON DECEMBER 18, 1996)
86i711Im •
tt)o_y 1 , \ � `! IL towSN
2.
' 0TE:_ _ i, .t PALE BROWN FV* SP
.Sig ti
cP
a BUILDING ENVELOPE „.t> i ------ -- ~-- as
03.
tV.
ai. , �r
. I �i'�t --' REIMS OF OLD DITCH BIM CONC.YON.
4.
ca I 0`' 230.31' N 89.41'00" W 110.86'
I Q S 86'56'00" W
.. PREPNffD N A(XXlRMlK�WITH 7HE IN11A1
PMPTE 1:511
STAN(NRDS FUR liRE 531RVEY5 AS ESTABU9 ED
I ora° '` wR a`�L� ,�(ST
I �'/�°��'�R , ,sSO •NOS
i 0,104`rw0` `��fi oy�PN a.�,y ,
otif
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o 4 BICC S 9�F,�+ 10
1 ' . #1
Q� N.Y.S. Lk. No. 49668
ID 8000. .----r DNwD ALTERATION OR ADDITIONADDITION1
WEt NOTES.POEM
SECTION r�OP UffvioLooN OF
NEW YORK STATE
12.6.72 1. REFER TO FILED MAP'FOR TEST HOLE DATA. EDUCATOR LAw. Jo .: eph A Ingegno
" 2. MINIMUM SEPTIC TANK CAPACITIES FOR A 1 TO 4 BEDROOM HOUSE IS 1,000 GALLONS. A.
O S 81.23,10 Vd 3. YINDIUY LEACHING 4sysTEM TGR A-rBEDROOM HOUSE 6300 sq ff SIDEWALL AREADEEP COPIES D5 ITISS SUR/ET V/P NOT O
- f 1 POOL; 1r DEEP, die. T TR COF Land Surveyor
HEREON SHALL RUN
'-.0 PROPOSED E]ipANSION POOL ONLY l PERSON• ,{��`O�'(,�'O, N ADEN Y AND TTe Surveys -Subdivisions - Site Plans - Construction Layout
'6 Ate, , • j PROPOSED WALING POOL LENDING NSTRUIION UF! HEREON.ALM
Gj A6 ! NSW-
TUDOR.roX1105 FTHE OGi PHONE (631)727-2090 Fax (631)727-1727
®PROPOSED 51 TANK
cf
4. THE LOCATION OF WE{LS ANL��'CE��SSPOOLS SHOWN HEREON ARE FROM FIELD
ANTHE D/OR EASEMENTS OFFICES LOCATEDV AT
WING ADDRESS
0 a'RVATIOIN AND/OR DATA�>BFAII�_FROM OTHERS. ANY, NOT SHOWN ARE NOT GUARANTEED. 1380 ROANOKEAVENUE P.O. Box 1931
RIVERHEAD, New York 11901 Fax
New York 11901-0965
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20-862A