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ELIZABETH A.NEVILLE �I�V '4 ; Town Hall, 53095 Main Road
TOWN CLERK ; y ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS • Southold, New York 11971
MARRIAGE OFFICER \C:44:49.1 � � Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER �iaiiaa0"
OFFICE OF THE TOWN CLERK
SOUTHOLD rfiffsfigMesT:UnIMNSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2708 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : STARLOFT ENTERPRISES
Address 1 : 44 SEACLIFF AVENUE
City St Zip GLEN COVE NY 11542
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 #R10-01-0236
Name Of Owner STARLOFT ENTERPRISES
Mailing Address 1 44 SEACLIFF AVENUE
City St Zip GLEN COVE NY 11542
Property Address 1 OAKLAWN AVENUE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 70.00 block 2 lot 21 .000
Cross Street JOCKEY CREEK DRIVE
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 i���_0Dye •
Town Hall, 53095 Main Road
TOWN CLERK % e® - % P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER ®?i , it Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER �__ ®� Jik $ ,,i Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ri'� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD L
Ihirlit N # y 6 '
TO: Southold Town Building Department DFS;
1a2(71jr
FROM: Linda J. Cooper, Southold Town Clerk's OfficeT �sLQC. p,-�T ,
ofsa-)7 oto ,.f''
DATED: December 10, 2001
Transmitted herewith is a copy of application No. 2804 for a Cesspool/Septic Tank Construction
Permit submitted by:
Starloft Enterprises
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: `' ,r�% '�2-,
ee
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Signature V
/2--AX'/
Dated
OFFICE OF THE TOWN CLERIC •'
oS�F
TOWN OF SOUTHOLD �0' f otK�oGy Application No.g(Mq
FT.T7ABETH A NEVII.T.F,TOWN CLERK i
P.O.BOX 1179 : j t ' Construction
SOUTHOLD,NEW YORK 11971 : p T Alteration
. tj7 • � • t7
Telephone �
(631) 765-1800 •, $10.00 -Residential
= 1 �'��
_ ��•�� $25.00 -Non-Residential
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TOWN OF SOUTHOLD
e •
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION RECEIVED
for
DEC 1 0 2001
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL Southold Town Clerk
Permit No.
Fee .$
DATE /.?/ /a/ 2c7-0
APPLICANT NAME: �' O CAI 4 r r
APPLICANT ADDRESS: c -
C roc, z (((,- ° - //cc/
SEPTICSSPOOL —
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION A PJ
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 5-7*. ` ( G 1- ' g-Gc-F C1-0, e
OWNER MAILING ADDRESS: C/ cr^ fQ, C/(f c- C
c7 z_
OWNER PROPERTY ADDRESS: Ey
O'VLeilc9.
TELEPHONE NUMBER OF CONTACT PERSON: 5/(0/(o- ( —041K`
TAX MAP NO. : Section l G Block 0 2 Lot ( r
CROSS STREET: 70C I \ cc C (iZr )."c-
BUILDING
c-BUILDING PERMIT NUMBER CROSS REFERENCE:
1/( '( ._
Si ature o pplicant
RECEIVED BY:
Town Clerk's Office
DATE:
I
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ax
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SURVEY OF PROPERTY
f p8' • 4 o'S`N SITUATED ATL . ,
,9 `�, �. �' 1':: I>> ; z- �) SOUTHOLD
'-,. * 1.s :' TOWN OF SOUTHOLD
p CHs SUFFOLK COUNTY, NEW YORK
`ro; O S.C. TAX No. 1000-70-02-24
SCALE 1"=40'
ND.
6 _ ;n+ ' 7 OCTOBER 27, 2001
10 '
,/0/ Di00 04 g a N�`Z '�
��OJ,D J`ell QJOJ • �7 AREA = 51,697.87 sq. ft.
r' ° r 1.187 ac.
oGc-
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OAP' rpo I// r �x c1
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OF HEAL' SERV' = �\ 4 `�
0 E sU vout COUtkiTY° ?kR t,0 y'CRNI uctio FOR _ '•. "
•g6�' FOR p v�Rf?`1A OF -i'=� =_ •9 .t `� TEST HOLE DATA
6� pRilt C �,� `���®�1.3 $ ; ' �;• �` (TEST HOLE DUG BY McDONALD GEOSCIENCE ON OCTOBER 22, 2001)
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PREPARED I. - , • WITH THE MINIMUM (Vs O0/F t`'
STAN: .•- �� .' AS ESTABLISHED 'Dog dI >"
BY�,, IAL9, ,t.,, D ADOPTED Uc wA �'?�f g Lig1 I 0
- `... STATE LAND ',ie.', /0/ P 1?
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.... N.Y.S. tic No. 49668 NOTES.
UNAUTHORIZED ALTERATION OR ADDITION- " "� ' 1. ELEVATIONS ARE REFERENCED TO AN ASSUMED DATUM
TO THIS SURVEY IS A VIOLATION OF _ �+g EXISTING ELEVATIONS ARE SHOWN THUS:.80.9
SECTION 7209 OF THE NEW YORK STATE �.J
Jos ph A. Ingegno EDUCATION uW ^ . 2. MINIMUM 8 LONG,
TANK CAPACMES FOR A 1 TO 4 BEDROOM HOUSE IS 1,000 GALLONS.
1 TANK; B' LONG, 4'-3• WIDE, 6'-7• DEEP
COPIES OF THIS SURVEY LMP NOT BEARING 3. MINIMUM LEACHING SYSTEM FOR A 1 TO 4 BEDROOM HOUSE IS 300 sq ft SIDEWALL AREA.
Land Surveyor
THE
ADVALID�_TRUHA LHS SEAL DR
EMBOSSED SEAL SHALL NOT BE CONSIDERED O 1 POOL; 12' DEEP, B' clic:
CERTIFICATIONS INDICATED HEREON SHALL RUN PROPOSED EXPANSION POOL
ONLY TO THE PERSON FOR WHOM THE SURVEY y,
IS PREPARED.AND ON HIS BEHALF TO THE I,
Title Surveys - Subdivisions - Site Plans - Construction Layout TITLE COMPANY, GOVERNMENTAL AGENCY AND /PROPOSED LEACHING POOL
LENDING INSRNTION LISTED HEREON.AND
PHONE (631)727-2090 Fax (631)727-1727
TO
CERTIFICATIONS ARE NOT TRANSFERABLE
INST1- VA PROPOSED SEPTIC TANK
OFFICES LOCATED AT THE EXISTENCE OF RIGHT OF WAYS
--
4. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD
MAILING ADDRESS AND/OR EASEMENTS OF RECORD, IF OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS.
1380 ROANOKE AVENUE P O. Box 1931 ANY, NOT SHOWN ARE NOT GUARANTEED.
RIVERHEAD, New York 11901 Riverhead, New York 11901-0965 i
' 21-54E