HomeMy WebLinkAboutSottrios it,/ OFFOUr
ELIZABETH A.NEVILLE �/aOy
A Town Hall, 53095 Main Road
TOWN CLERK H P.O.Box 1179
REGISTRAR OF VITAL STATISTICS oo PP, Southold, New York 11971
MARRIAGE OFFICER sw ��1� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER � �® }ifig. *0" Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER �/' southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2788 R ' Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : RAY DICKOFF
Address 1: PO Box 696
City St Zip AQUEBOGUE NY 11931
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 #R10-01-0044
Name Of Owner KARGAINIS, SOTTRIOS
Mailing Address 1 PO BOX 696
City St Zip AQUEBOGUE NY 11931
Property Address 1 RYDER FARM ROAD
City St Zip ORIENT NY 11957
Tax Map No. section 15.00 block 4 lot 2.000
Cross Street NORTH SEA DRIVE
Building Permit Number Cross Reference:
Issue Date: 4/04/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE ��'a� y Town Hall, 53095 Main Road
TOWN CLERK ti 2 ; P.O. Box 1179
Pr, $ Southold, New York 11971
REGISTRAR OF VITAL STATISTICS v, *. �� Fax(631) 765-6145
MARRIAGE OFFICER :` 4, `. e1
RECORDS MANAGEMENT OFFICER ;_'�l°l �a', Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER r� southoldtown.northfork.net
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department ' `, ,
�1AR 2 8 2002 .i J
FROM: Linda J. Cooper, Southold Town Clerk's Office k"' n_
DATED: March 27, 2002 T f,,, .w=, ' ,0
Transmitted herewith is a copy of application No. 2890 for a Cesspool/Septic Tank Construction
Permit submitted by:
Ray Dickoff
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:
1.00�__ -,v+-.�� ,
Signature
riV4-5/
,t 'Vo.7/ 'A/2--"-
Dated
4a
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OFFICE OF THE TOWN CLERK 11, CO
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TOWN OF SOUTHOLD �' ` `�l GQl , Application No. p�
PT.T7ABETH A.NEVILLE,TOWN CLERK ;�OO G,li p p
P.O.BOX 1179 i g Construction
SOUTHOLD,NEW YORK 11971 : ' ._
ill y� Alteration
Telephone
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Telephone $10.00 -Residential t-''.
(631) 765-1800 %= Ol Dt ,o� $25.00 -Non-Residential
-- -„,,.
TOWN OF SOUTHOLD •
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION •
for RECEIVED
CONSTRUCTION or ALTERATION PERMIT
' MAR 2 7 2002
SEPTIC TANK or CESSPOOL
SoveIeel!Town Clerk
Permit No.
Fee .$
DATE ,3/7/=
APPLICANT NAME: //y ,e/e11/6-
APPLICANT ADDRESS: A $.4- OK Ai;af,I'for _ d,ty 7773/
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
57 it _/-7 / 27 .65,
•
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Sal, '5 A-X/e 4i,V/5
OWNER MAILING ADDRESS: , ///Z1 o/ ' ,toei- e”,
OWNER PROPERTY ADDRESS: Aay.Clfie JC.te°ri y?/7 f "J0,00.7M--A9,1
emic,e 11 // AX
TELEPHONE NUMBER OF CONTACT PERSON: moi- 7aa-- 5'/D
TAX MAP NO. : Section /°Ov Block /S— Lot D / - 601
CROSS STREET: /)/4/1Z /4//?fir AO 9 /0.0/l//i/55i4- ded
BUILDING PERMIT NUMBER CROSS REFERENCE:
4_1(2;r-SO / Signatu f Applicant
RECEIVED BY
Town Clerk's Office
DATE: ala-if 0zi
S
.
• WELL
l om familiar with the STANDARDS FOR APPROVAL
AND CONSTRUCTION OF SUBSURFACE SEWAGE NOTE: LOT NUMBERS REFER TO "MAP OF ORIENT BY DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES THE SEA, SECTION TWO" FILED IN THE SUFFOLK
and will abide by the conditions set forth therein and on the COUNTY CLERK'S OFFICE ON OCT. 26, 1961
permit to construct. AS FILE NO. 3444
The locations of wells and cesspools
shown hereon are from field observations
and or from data obtained from others.
NORTH SEA DR.
LOT S $
o
0
Zi
oU
�� EXCAVATiOM IN$PE REQUIRED
FOR ARY'S VACANT
IN- , METAL �1i HEALTH l�tPw m ENT
TRAILER N. 88`26'00" E .7 .uuG'A/y.�it DEPAR CMF
¢ a.POLE V V 6
EL324
EL 31.4 P p P
,. �,-, Y C
f —In
5� PcaP
4 •
w
Et� -,�
,, 20\ _ 5�3�5 /o / r.11 .111
oP/oP # -Dia ,
li
DWELLING
n/ 70 0/ C 1 h5 e
1 0
/t el 32_ WELL ,so<•
Is. g
-i 3 3'• t iC.P.CIN FRONT
a
R. i ...„ ..,
o p
O
,l
prop ._
EL. 29.1 EL, 26.3 16.1
11 i
Porx S. 88°26'00 ' W. 150.00'
LOT 5s PLUM
VACANT Z ISLAND
n1 LANE
4 •
WELL E GP.
AREA = 20,250 sq. ft. 150,
•
Lor. COI/E/L^GE a 3 2/, cV°
( SURVEY OF PROPER T Y
, , 1"`; '+ AT ORIENT POINT
1=.~ � TOWN OF SOUTHOLD
c -•''. ,' 1 SUPFOLK cOUNte DEPARTMENT MENT OF' HEALTH SERVICES
Luc` f_, SUFFOLK COUNTY, N Y
�.:,� � ,�Y; pg���p�0[�APPROVAL OF CONSTRUCTION FOR A
`"'- L�. C.1 Li 1000 - 15 - 04 - 02
�--� SINGLE FAMILY RESIDENCE ONLYt' LSCALE 1" = 30'
1' ma:-a FEB 5, 2001
DASEr k H.S &E , ioFeb w, 200, (revisio-, )
e
APPROVED / � ~
.
FOR MAXIMUM OF_gr.__BEDROOMS
EXPIRES THREE YEARS FROM DATE OF APPROVAL. ;
ANY ALTERATION OR ADDITION TO SURVEY IS A VIOLATION '.n. `'` *
OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. ' �4" ' �
EXCEPT AS PER SECTION 7209 - SUBDIVISION 2. ALL CERTIFICATIONS .Iii, '<<l
�`�
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF �- �='<�.> � /�
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 'I N $aP/t. NO. 496/8
• WHOSE SIGNATURE APPEARS HEREON. ! ��•.% a'
Asb,'• 496
PECONIC .r7'i l�• '
ADDITIONALLY TO COMPLY WITH SAID LAW THE TERM "ALTERED BY' �� � r
MUST BE USED BY ANY AND ALL SURVEYORS UTILIZING A COPY (6311 765 - : . .,.- x6311 765 - l 797 ;
OF ANOTHER SURVEYOR'S MAP. TERMS SUCH AS 'INSPECTED' AND P. 0. BOX 909 _
'BROUGHT - TO - DATE'ARE NOT IN COMPLIANCE WITH THE"LAW. • 1230 TRAVELER STREET
SOUTHOLD, N.Y. 11971
01 - 105•