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ELIZABETH A.NEVILLE Town Hall, 53095 Main Road
TOWN CLERK % ® ' P.O. Box 1179
REGISTRAR,OF VITAL STATISTICS
iv? Southold, New York 11971
MARRIAGE OFFICER s �,1� Fax(631) 765-6145
4.
RECORDS MANAGEMENT OFFICER ----_ f ��� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER �.��
OFFICE OF THE TOWN CLERK
SOUTHOLDITrR LiOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2651 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JOHN BERTANI BUILDER INC
Address 1 : 1380 OAKWOOD DRIVE
City St Zip SAOUTHOLD NY 11971
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 #R10-01-0179
Name Of Owner LAWRENCE, ROBERT
Mailing Address 1 465 EASTWOOD DRIVE
City St Zip CUTCHOGUE NY 11935
Property Address 1 EASTWOOD DRIVE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 110.00 block 3 lot 21 .000
Cross Street SOUTHERN CROSS ROAD
Building Permit Number Cross Reference:
Issue Date: 9/07/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE �� Town Hall, 53095 Main Road
TOWN CLERK - `
R P.O. Box 1179
coa
- Southold, New York 11971
REGISTRAR,OF VITAL STATISTICS • ;�� °Y> ,, _ a
MARRIAGE OFFICER ®.. '{ ��'1� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER � �®�i r ��®��� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER to
o°
OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: August 31, 2001
Transmitted herewith is a copy of application No. 2740 for a Cesspool/Septic Tank
CONSTRUCTION/ALTERATION Permit submitted by:
John Bertani Builder for Kathleen & Robert Lawrence
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.
Signature
7/4/79/
Dated
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD ',. �'co1FF0[I�L►®, a yob
PTT7ABETHA.NEVILLE,TOWNCLERK 1t ®, /� ` Application No.
P.O.BOX 1179 Construction
SOUTHOLD,NEW YORK 11971 v T
Alteration gz
Telephone ?_0,� ®� , $10.00 - Residential
631) 765-1800 --�®l ��'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 up-0- 3 1. 20C )
APPLICANT NAME: John 1 t +tLn I. 6w(�e,�
APPLICANT ADDRESS: Ira O 0 ..�Lvdy 9a., Or.
GOu.`I-f c' tcL- key (IC(l f
SEPTIC l CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
teA {- h o u e._4-. qoy e.
•
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Ko, Robed- ka.G0r c_5)--,
OWNER MAILING ADDRESS: '�f(oS', l Gls.l'fJdod, (Jr
( q 3(
OWNER PROPERTY ADDRESS: Ectilt,000 ar
�-choc�u� $JL-, 1193/
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section if Block 0 ; Lot 2-
CROSS STREET: S u e4v-N CO.c p _
BUILDING PERMIT NUMBER CROSS REFERENCE:
litdc_ • 615/ 64(:<.
�,Q Signature of Applicant
RECEIVED BY: /v
Town CI rk's Office
DATE:
iYY6L:'��e".�°c�ib:'d fre�:.�k"r5 ��e;s. -
L SURVEY OF
LOT 12
1 b[o I t t° 'ti° )0 -0)- 0172 1 �� MAP OF
DATE acv
,r� sV.-�
..___... EASTWOOD ESTATES
I'`1 ,zrQcb, c4" FILE No. 3683 FILED NOVEMBER 16, 1962
r�:502 Y:T��lfi�'6d'�2:5� \
5 ,4� x,� SITUATED A 7'
.., e,Z al, saP.1%,. n Ia.OF��� �
Col I= w P RES 6 �� A ROM DA APPROVAL 1 °� sya �. �,J ��, FLEET'S NECK
u°� ���‘G 4. `�o" Q �� TOWN, OF SOUTHOLD
14-1 am -�'.tu: °� ,o,°'' SUFFOLK COUNTY, NEW YORK
= cam IPF ,... �0`t %.* S.C. TAX No. 1000-110-03-21
C ...1-1— ' c ��� ` S SCALE 1"=40'
c'� ', too ',�� tpyya `� f ��4"4c APRIL 3, 2000
,= if J, +O� x 4 ��G I,�� 1 � JULY 26, 2001 ADDED PROPOSED HOUSE
" . h ��y�iln le.
�P -•
���`a J I �',r! a AREA = 20,250.00 sq. ft.
OC eE f- 1 ,, p I �11� �'' ' ����nsj 0.465 ac.
y
5° .', `\ �
maintain -_ sanitary distance
(, a \ ' Y041 a a c 0 \ o boa p Z an at Ie. a!y end sewage -
9i, v' q` `'° °�'` ��`' o s facilities
g CERTIFIED TO.
ROBERT 3rd\� o �'� �'�^"' 'w��rrt ROBERT LAWRENCE
— -- tit c� ° „,,,,„...--•)41.41...."1"*"..
KATHLEEN B. LAWRENCE
-7..6.,, �y' A� \¢oma , / CO cf,�i� NO. ELEVATIONS ARE REFERENCED TO AN ASSUMED DATUM
• e,.TEST H• \ . oy EXISTING ELEVATIONS ARE SHOWN THUS. foo
/\ . I 2 REFER TO FILED MAP FOR TEST HOLE DATA.
• / `�f� °614).
0, 3 MINIMUM SEPTIC TANK CAPACIUES FOR A 1 TO 4 BEDROOM HOUSE IS 1,000 GALLONS.
_ g, 'O�, / I 1 TANK, 8' LONG, 4'-3". WIDE, 6'-7" DEEP
r C) \FPy h0 \ - °, LAS _ 4. MINIMUM LEACHING SYSTEM FOR A 1 TO 4 BEDROOM HOUSE IS 300 sq ft SIDEWALL AREA
Gm < p \ , /' +�'" E I POOL; 12' DEEP, 8' dia.
(4, v, ,• 94i, Y�, ?p 2—`4 p�P1'' ov.e:PROPOSED EXPANSION POOL
9¢ct"0 Iii , ,Ie
•° \ 1� `<i�1�1 I �SiS PROPOSED LEACHING POOL
o 1?;. P N4G SE o off !!
9
g'(-1,1e,
<<� '� ° n \ -/'yt� yo0,,,,,...''.;,,e
��,Y'�'\p1 ft a 1././A PROPOSED SEPTIC TANK
2 G+ - O ,F, P�'
t,b.�,, �� a ! �� ,+ cs4c CI��a 5. THE LOCATION Of WELLS AND CESSPOOLS SHOWN OBSERVATIONS AND/OR DAY OBTAINED FROM OTHERS. ARE FROM FIELD
tiki
•S\ '- MON c0 S LCA 6. THIS PROPERTY IS IN ZONING R-40
1- °° °�' S�R TEST HOLE DATA
fi s, 1—r •°'� 5'1' `,�
7,+ .,`g S T.t ' (TEST HOLE DUG BY McDONALb GEOSCIENCE ON JULY 6, 200 1) PREPARED IN ACCORDANCE WIT. HE MINIMUM
VA `gy van^ x .° y I �jS� I STANDA _,,,....,^f-,,,,,..„,-2,
. UIN, ESTABLISHED
��i Y. ,..e-..;. 8 >'0 •t BY THE LI f - AND ADOF TED
'�' FOR 1 a-\.-- STATE LAND
y�i U,L.i,j::_.Y \ �o VA
0 TITLE '' 0'�'�"'v`"10
4 ♦ . , �� BROWN LOAMY SAND SM o'' ,,RVA A' °?
4' if1
-4-90,:'°4:
Q16
. ��� . iT, _ I",a1 52
, . BROWN FINE TO MEDIUM SAND SP
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�� 1{l,O$s ��++1�r,;,e `•!,-J I' .-"-' N Y S LIC No. 49668
so• `��1 G INS
���-�,4 BROWN CLAYEY SAND SC UTTHSOSURVEY TIS A OlAOR OOFTION
&��YSECTION 7209 OF THE NEW YORK STATE -
li �Q,�e�,4O'S � I O• COPIES ON tAW Jo A.
S
G°� THIS SURVEY MAP NOT BEARING
THEIIANDFSURVEYOKS INKED SEAL OR-
I - _ EMBOSSED SEAL SHAa NO BE CONSIDERED Land
Surveyor
- - TO BE A VAUO TRUE COPY ay I,1)f
CERTIFICATIONS-INDICATED HEREON SHALL RUN
• PALE BROWN FINE ONLY TO DHE PERSON FOR.WHOM THE'SURVEY
' TO MEDIUM SAND SP IS PREPARED,AND ON HIS'BEHALF TO THE
TIT1,E,COMPANY,GOVERNMENTAL AGENCY AND Title Surveys - Subdivisions - Site Pions Construction Layout
� - LE INS INSTITUTION LISTED ERONG,ANO-
ro THF.AsstG�NtlnEs of n1E LENDuvG INTI
_;=y_ Y, TUTION CERTIFICATIONS ARE•NOT TRANSFERABLE PHONE (631)727-2090 .31)727-1727
'. -Tit 6XISTEHQE OF•RIGHT OF WAYS
t7' AND/OR 6AS'EMENTS f3F 4mcortP, IF OFFICES LOCATED AT NG ADDRESS
ANY, NOT SHOWA ARE NOT GUARANTEED. 1380 ROANOKE AVENUE ••.. Box 1931
, - RIVERHEAD, New York 11901 w York 11901-0965