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ELIZABETH A.NEVILLE ��� Town Hall, 53095 Main Road
TOWN CLERK ` ® P.O. Box 1179
ga
Southold, New York 11971
REGISTRAR,OF VITAL STATISTICS Fax(631) 765-6145
MARRIAGE OFFICER :®siifi .°1
RECORDS
RECORDS MANAGEMENT OFFICER �® Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
SOUTHOLD WidikiTMICIWARSINSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2710 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : CHRISTOPHER STRASS
Address 1 : PO BOX 821
City St Zip JAMESPORT NY 11947
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 #R10-01-0022
Name Of Owner KRIEB, RONALD
Mailing Address 1
City St Zip 0000
Property Address 1 775 MULFORD COURT
City St Zip ORIENT NY 11957
Tax Map No. section 14.00 block 2 lot 3.026
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 12/17/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE �/.,*,�®_'' (4. Town Hall, 53095 Main Road
TOWN CLERK % ® 'iA�- "# '",` P.O.Box 1179
REGISTRAR OF VITAL STATISTICS I {'} ',' . y 3 Southold, New York 11971
%MARRIAGE OFFICER %jrj 1� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ..���, �'������� Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER = southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: November 28, 2001
Transmitted herewith is a copy of application No. 2799 for a Cesspool/Septic Tank
CONSTRUCTION/ALTERATION Permit submitted by:
Christopher Stress,AIA
I
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 loc ' 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. af.4--19.-"C7.74.4.,..1-.....,
Signature
/2 ,' /3/0-6,
Dated
y•r
° OFFICE OF THE TOWN CLERK ,'�,,, el8 •
TowrtoFsovTHOLD ��.� CQG Application Noc799
ELIZABETH A.NEVILLB,TOWN CLERK '�►
P.O.BOX1179 i� L. Construction �-
S0UTH0LD,NEW YORK 11971 v �T
tt� Alteration
Telephone ‘-----:410/
O,f 0-i • $10.00 -Residential !�
(631) 765-1800 - 101 ‘0
,81' • $25.00 -Non-Residential
TOWN OF SOUTHOL13
SOUTHOLD WASTEWATER DISPOSAL DISTRICT •
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$ /
DATE
APPLICANT NAME: L /-/12- -z--0/4. --7-2. c77Ze-- 4---/-04-
APPLICANT
�APPLICANT ADDRESS: P� is,)\' L/2_,/
,---g--.47)7&,2027— 1/?4.2__________
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
! tg5/27, , 2 / f .
•
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:. •
• OWNER OF PROPERTY: R,. //74 L-/ G` /G-
OWNER MAILING ADDRESS:
u`L role[�
OWNER PROPERTY ADDRESS: 915 J�/-,--- b ci� ,
fZt , I1/
TELEPHONE NUMBER OF CONTACT PERSON: („ , ‘t----75
TAX MAP NO. : Section `1 Block ° � Lot . 24
CROSS STREET: �—�-0� �1� CL /1'2/-11 tv ,
BUILDING PERMIT NUMBER CROSS " i CE: ,
�� • Aillyp •
Signature of Applicant
RECEIVED BY: A4,1.,,,or •
Tow Clerk'sfice
DATE: /i// -40' e:Yr
O
,SUR Y LY OF LOT 22 SEPTIC DETAIL L pROPO
not to scale OwELLl y
MAP OF ORANDVI Elul ESTATES .
FILED JUNE 8, I a82, FILE No. 7083proposed —
max 5% slope grades
SIT'� }�� within 20' of septic •
1 J�iN,ATE: /'�'Ot RIE tT existing grade min 1' inv.=
TOWN:ii /(JT OLO EL= 9 max
inv.= 7 6 cover i8.1 8.3
SUFFOLK
� //��'�//�� min. 1' nv.
../VOL VVUNTY� NY • leaching 7�
1000 gal.
m,n. Pitcft
pools - min pytc tank 1/4: per
4' deep
B' dia. 1/4per ft
300 s.f. s•,9,,b
SURVEYED II - 16 - 2000 , 31deN8ll
min 3' EL= 3 _
AMENDED 12 - 12 - 2000
N-
separation ground water EL= 0 4 -
SUFFOLK COUNTY TAX # 'A'
1000-14-2-3.26 V V •
Test Hole
CERTIFIED TO: '' ' (10-03-00)
@ high tide
ADELE DUSENBURY /SUFFOL4: COUNTY DEPARTMENT OF HE►LTH SERVICES BSIL
ROTH
LOAM
PERMIT FOR APPROVAL OF CONSTRUCTION FOR A z
SINGLE FAMILY RESIDENCE ONLY
PALE
DATESIN iO( lye, ) O! • Obac9, aFINE
FINE
ROWN
TO
COARSE
APPROVED SAND
ck ' FOR MAXIMUM OF kc BEDROOMS
EXPIRES THREE YEARS FROM DATE OF APPROVAL
LOT -------
6
,.
21 e 4'
\'- OWNER
WATER
NE
JOANN SANTORA PALE N
�S0> TAX LOT 1000-14 2 3.25 FTO
DWELLING `SA DE
• •
•
•
EXISTING
WELL 10'
•
•
/� I� �j L / p
N68°45'20"E 10'EASLI NT PERS FILED MAP 165.00'
.6? .7.1
l� proposed pervl p\ ; � +<Q 0 < 47.. .
w�, �� °US drfh e / I , ^�• CJ
I' `46% WQ9 \ /QQQ P
�,pp `� 1(‘‘.c\,
FNr ��SO 00! �, e I 3j m',
fTi Bio r �,a�° ��
m
D Z 9 \� m(,otoo • �03Q, , .csvor"ro) , ).' 11:
X > c19 \ yetbQck - �a
100 ---- S m'
I- -► __- % / s OT
o c � { U �' , L
70 co ``_--- W
hcl •
LO • 23T
/ i :\ // fCl'/--/
D o z N a% \ 22 ' •- •-- -�\ -_/ T R/GH�RD wNER
Z
1 N 6Q- ` S(� , �x L0 /pF G FG
-A A 0 t\ f 'J (,' T o0 4_ ORY
NN > 0 9 '` a / n\ V 4c�NT x'27
,_41Z W )(?s,-. 11
;9 1 il
-
0. O ,, , 1
c., 1 I
' EXCAVATION INSPECTION REQUIRED I,
FOR SANITARY SYSTEM I
BY HE,�LTH DEPARTMENT wc�
e/6, I -
I 1
I 1 c
1 N
240u ,
1
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I, 16Z86' e,7,
IRRIGAT
POND°N ____ •
LOT
24
A/RI/V OwNF 4
T AY R
N
P
X L0-7--
o�/000/4 3 Nc
NOTES: AGANT � �C•.28
� � '
A STAKE FOUND •r
a .I p beooriietl icense[lon or arveyor to seal
survey
y p mop bearing a licensed land Surveyor 5 ela a
0 � ��
PIPE FOUND F,l'v 2,� vlala/,an of Section 7209 d
mfb-rvislan a of Ne
���'. �� New York$tate Etlucatlon LOW'
ELEVATIONS REFERENCE MSL NGVD'2q marke'Onlyd math sa Irons the al th el Of this Survey
kgtl with an I of the lord surveyor
yy �/g �.[Ni �}t� a�r stomped seal shall be considered to be valid true
PARCEL SITUATED ENT RELY t j j+3 H I 1 V [j o I J ��•'t 'LercSwtlans indicated hereon signify that this
S_.I J 1 19 G1 J+i �A.L 1+a<�I7 �L9 C�.s`! '•;.; - rvey coos prepares In acwreance with the
WITH I TH I N FEMA ZONE AE'(e I ci) •
!sting Goole of Proatlas far Land Surveys adopted
\` "* , tM the Nevi York State Association of Professional
Land a person
Said certifications shall p only
\, , to the person for whom the survey 15 prepared
AREA = 42,733 SF OR D.GB ACRES �C :� �� S-- MVP !PAZ �- � ' and on his behalf to the titl0 company 9g e en-
e tai agency and lending,,,=on listed horeon and
ADJACENT AREA COVERAGE = 3,242 SF (5.196) - to the assignees of the lending institution Certifica-
tions not transferable to additional Institutions
' AREA PROPOSED HOUSE 1200 SF (3.3%)' AIN1103 N 1 uI I�' A,, lll; 71 ';'
AREA PERMEABLE DRIVEWAY 2,042 5F (4.5%) 0311130a1 �� f :, � ! �� � � ,'"s
6 EAST MAIN STREET • N.Y.S.LIC.NO. 50202
GRAPHIC SCALE 1"= 40' RIVERHEAD,N.Y. 11901 1,4
369-8288 Fax 369-8287 REF.\\Hp server\d\PROS\20-269.pro ' -
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