HomeMy WebLinkAboutDana 11 G
ELIZABETH A. NEVILLE ��� t Town Hall, 53095 Main Road
TOWN CLERK % ® P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER V. 1�, Fax(631) 765-6145
1
RECORDS MANAGEMENT OFFICER 4 ,ss22, *sag"
Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER /,l
OFFICE OF THE TOWN CLERK
SOUTHOLD IMASITUVOCIERITI151131DSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2654 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MICHAEL & PHYLLIS SNOW
Address 1 : C/O C MESIANO INC
City St Zip EAST MORICHES NY 11940
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 #R10-01-0114
Name Of Owner DANA, EDWARD M
Mailing Address 1 924 MARY'S LANE
City St Zip MARTINSBURG WV 25401
Property Address 1 375 BARTLEY ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 144.00 block 3 lot 26.000
Cross Street BAY AVENUE
Building Permit Number Cross Reference:
Issue Date: 9/25/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
„„,,,,,,,,,,,,,,,
a76 SY'
ELIZABETH A.NEVILLE � t� Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS rya Southold, New York 11971
MARRIAGE OFFICER t Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER � �® ��
��®,ii Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER �.”
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD SEP -
6 ,
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office -
DATED: September 6, 2001
Transmitted herewith is a copy of application No. 2743 for a Cesspool/Septic Tank
CONSTRUCTION/ALTERATION Permit submitted by:
Catherine Mesina for Michael & Phyllis Snow
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: Maintain required setbacks from adjacent wells,buildings,property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED.
//etat44.. .
7/".4.e,410dr,
Signature
7/7/0/
Dated
i '
11110
OFFICE OF THE TOWN CLERK 6.111 fg1t/�4
TOWN OF SOUTHOLD 0 U` `��114pja% Application No.,a70
ELIZABETH A.NEVU.LF,TOWN CLERK : 141.
�/ 4
P.O.BOX 1179 •Z iC
� .,�� � Construction
SOUTHOLD,NEW YORK 11971 ; o . T
` % N I1
4
Alteration
Telephone ‘ �,j% �Q�'�' $10.00 ,- Residential
(516) 765-1801 _ Ol °.
$25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
I
ll
APPLICATION
for
, CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1
Fee '$
DATE
APPLICANT NAME: rY) LGIAIL,4 t Q � ,,�0,.,.) /41.4
/ arid
APPLICANT ADDRESS: 'io C C . IY eSicc n-c, I ac . 12 Mill PQrLa L L .
�
E
-
- ( or'-J" . rl ILa4b -
SEPTIC ( CESSPOOL 2—
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
cans-1-rucr aL' XQs' Oz. s$y 5In5Ie -R_inn,ly dweil„N
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: - _ ;_. - f " - _:- --1.. .8-du,avc6 rri. ba,wc`
OWNER MAILING ADDRESS: 92,,c4 m i_,..„,
(n e 2.;t44,tt.4_i 1 w V 4 511b1
OWNER PROPERTY ADDRESS: 37 5 iaA`- i Qj
TELEPHONE NUMBER OF CONTACT PERSON: j03/-871- 1,95/ ,
TAX MAP NO. : Section / '/'j - Block 3 Lot a.. 4
. CROSS STREET: _
BUILDING PERMIT NUMBER CROSS REFERENCE: ,
I
(1(1,71,, ,,: DLe4-c-6-8
Signature of Applicant
RECEIVED BY: Z5
q iT wn ?lerk's Office
DATE:
La 1
t.ilf1
RESIDENCE
SURVEY OF �,
RESIDENCE VACANT I u) R i''-''1=D' LOT 8 Y
MUNICIPAL I Eu SUFI'Ud_i +.r'1!'"!i Y IN
WATER I Q MAP OF PROPERTY OF
SERV, FD ' s
CM `r1 1i Al — PH'� 3: 5 LIDIA BARTLEY
Y
BAR TLE R� '� O ` _ c SITUATE
SCE „h,STr';';,°;T1 ��GN MATTITUCK, TOWN OF SOUTHOLD
( EARTH ROAD SURFACE )
SUFFOLK COUNTY, N. Y.
N 67' 21 ' 40" E 50' TIE= 380.6' FD
1 PIPE
RESIDENCE e.Z.: cm
MUNICIPAL TEST
SURVEYED FOR : MICHAEL J. SNOW
SERV
WATER 1` HOLE SEL/8---..
B� ce PHYLLIS SNOW
6_ p ��`' >- co cwn
0S7Q
CZ
PROPOSED W W
CESSPOOLS
1 a FM# 770
).----7- i-\,, W LOT 9 FILED JULY 27, 1922
EtQ o a RESIDENCE
I I PROPOSED o ZONING R40
Q I I SEPTIC ce ELEVATIONS FROM EAST END TOPO MAPS
ITANK AS PROVIDED BY SUFFOLK COUNTY DPW
O� 10' ,' 1 25' 15% 111
Cp . _ „ill
j TAX MAP NO.
1000-144-03-26
FD PROPOSED 1
IP 3 BEDROOM RESIDENCE Q SURVEYED 04 APRIL, 2001
n SCALE 1"=20'
_ AREA= 9000 SF
m OR
0.206 ACRES
15'
•. -• -"�- FOR S.C.D.H.S.USE ONL Y
RESIDENCE
MUNICIPAL '
W4 TER .• '
SERV. - - -
O
LOT GENERLY,LEVEL CA `0, > '
�A ,%'; L.',a , 1
- 0 CP .:::1 o ti.,
LOT 8 �� ,�-N ''%
- 0 ''l ':;2'‘0::11 'e.'144'04‘. '''1,5 7t-, .
- `'tel r, .-i ,✓,.., L.,
S6721 .4
0 W 50 i`1 .
RESIDENCE a
MUNICIPAL RESIDENCE, r ,
i:-
WATER _- MUNICIPAL P 0 °"-
SERV RESIDENCE WATER -----r---
- MUNICIPAL SERV
' • WATER
- ' • SERV
TEST HOLE DATA '
PERFORMED BY: McDONALD GEOSCIENC£ •
2 APRIL 2001
. a
FINISHED GRADE , ,
, BRONN LOAMY SAND 94'''
d ,
. -I
SURVEYED B Y
GUARANTEES INDICATED HERE ON SHALL RUN STANLEY J. ISAKSEN, JR.
PALE BROW FINE ro Accruu SAND SP ONLY TO 7HE PERSON FOR WHOM THE SURVEY
IS PREPARED, AND ON HIS BEHALF TO THE P.O. BOX 294
',, TITLE COMPANY, GOVERNMENTAL AGENCY, NEW SUFFOLK, NY 1195
PALE BROW RAE SAND SP r' LENDING 1NSATUIION, IF LISTED HEREON, AND
, ,„ TO THE ASSIGNEES OF THE LENDING INS71TUTTON. 6 1 —734-5835
GUARANTEES ARE NOT TRANSFERABLE TO / /
GUARANTEED TO -'r MUER w PALE IoW SAND ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS /� / J
—7 UNAUTHORIZED ALTERA7/ON OR ADDI77ON TO THIS
MICHAEL J. SNOW SURVEY IS A 4OLA7/ON OF SECTION 7209 OF LICE SED LAND S j YOR
PHYLLIS SNOW THE NEW YORK STATE EDUCAAON LAW. NYS LIC.71V0. 492 "3
FIDELTY NATIONAL TITLE INS. CO.
COPIES OF THIS SURVEY MAP NOT BEARING
_ THE LAND SURVEYORS EMBOSSED SEAL SHALL
•
NOT BE CONSIDERED TO BE A VALID TRUE
COPY. J/ ¢a'
i. ,,,, , OIC1000