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HomeMy WebLinkAboutMatine FOLt �• 00 ELIZABETH A.NEVILLE ���`� ��,; Town Hall, 53095 Main Road TOWN CLERKP.O.Box 1179 REGISTRAR,OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER :®4s > _ � ��� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER ----_ � _ *4>i00° Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER ' ,i' 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. 2719 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : MATINE INC Address 1 : PO BOX 1925 City St Zip SOUTHOLD 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 #R10-99-0223 Name Of Owner MATINE I N C Mailing Address 1 PO BOX 1925 City St Zip SOUTHOLD NY 11971 Property Address 1 545 ALBACORE DRIVE City St Zip SOUTHOLD NY 11971 Tax Map No. section 57.00 block 1 lot 18.000 Cross Street MAIN ROAD Building Permit Number Cross Reference: Issue Date: 1/11/02 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) • r .40 ofF014. 0 l ELIZABETH A.NEVILLE �� � Town Hall, 53095 Main Road TOWN CLERK % o P.O. Box 1179 Southold, New York 11971 REGISTRAR OF VITAL STATISTICS Prt MARRIAGE OFFICER ®t*/ Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER � ®� Ma ,� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER _ //'� southoldtown.northfork.net iii...,, OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town BuildingDepartment © C5 P iU FROM: Linda J. Cooper, Southold Town Clerk's Office , DATED: January 3, 2002 rovi C®G-OF .0 Transmitted herewith is a copy of application No. 2814 for a Cesspool/Septic Tank CONSTRUCTION/ALTERATION Permit submitted by: Matine Inc. 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 RE•UIRED. '4111F Ierhe‘r .‘4i • / Signature / ® y ®— Dated A. OFFICE OF THE TOWN CLERK ,••� ►N�►►►► . CAVULke TOWN OF SOUTHOLD ��• QGy Application No.b01 RTT7ABETH A.NEVILLE,TOWN CLERK P.O.BOX 1179 Construction k( SOUTHOLD,NEW YORK 11971 Alteration t.Telephone OA, At," $10.00 - Residential Oc (631) 765-1800 =�l � �� $25.00 -Non-Residential TOWN OF SOUTHOLD • SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION • for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee *$ DATE PK, 3/ 2-60/ M • APPLICANT NAME: f�1 A7-/iai i /64/C. Mo%(/VCn APPLICANT ADDRESS: / O( &),c /92, 50U7WoL,9 , V. // 97/ SEPTIC / CESSPOOL • DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION /1/[Sly COkS1-4067-/vs' — / r,k /L' • LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: • OWNER OF PROPERTY: Yc 7/L'6/ / ,V_r OWNER MAILING ADDRESS: /o, / O>c /?2.5- S Oa ?ZSSOd /Ioc_1lAY. 1(97/ OWNER PROPERTY ADDRESS: A 4 44 Co t[ 4/t, SOO74'O -, Qi Y /197/ TELEPHONE NUMBER OF CONTACT PERSON: 6.5'3/ 7��_ TAX MAP NO. : Section 7 Block O/ Lot /e'l-l? CROSS STREET: ,/J4 4/ 120,E (5A1 2 $ J BUILDING PERMIT NUMBER CROSS REFERENCE: Signat 're of Applicant RECEIVED BY: Town Clerk's Office DATE: /0/0/ NIL I am familiar with the STANDARDS FOR APPROVAL ANY ALTERATION OR ADDITION TO SURVEY IS A VIOLATION ° OF.SECTI©N 7209 OF THE NEW YORK STATE EDUCATION LAW. AND CONSTRUCT/ON OF SUBSURFACE SEWAGE EXCEPT AS PER SECTION 7209 - SUBDIVISION 2. ALL CERTIFICATIONS DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES H€REON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF and will abide by the 'conditions se/ forth (herein and on the SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR ' permit to construct. WHOSE SIGNATURE APPEARS HEREON. ADDITIONALLY TO COMPLY AND SAID LAW THE TERM 'ALTERED BY' MUST BE USED BY ANY AND ALL SURVEYORS UTILIZING A COPY OF ANOTHER SURVEYOR'S MAP. TERMS SUCH AS INSPECTED'AND 'BROUGHT - TO - PATE'ARE NOT IN COMPLIANCE WITH THE LAW. SCDHS. Ref.# RI 0-99-0223 s:: � CO / �` ) 't. 44 4v SOT _ c: . Qx ,k,- 4C4/l' 41/ ''O, C,q� , N. E3 S vz , °Z0 /1/0i- , 2 6'4- 0,o TOTAL AREA = 2x-000 sq. ft. F ,� '1' or 0,482 acres O I��• O ora tP ' 1h tioT °i � 4. •00, r( "V / 7. s • \ \ 50 ��� /� �cf-C OL \ 6"' 49 •Fr i ,s Gq 1 4,o •\ °\ O C, r�,�J oo �h• VD Q C 's� / �^ 04$ - o, , r i` O' o S • I . rk; AD.- 6,cl, -� / ,` Q 6 5z (6) 456, 4 C)/ , cc s 1 o L° 0 0 ST • '1, 'lift miry ok 41)til: %iv „47% - iltiskr13\.fa , ,, b 0 S ' k sus ; '` ���, �'l ,4' �. SURVEY OF ' 23o. �/ �° LOT 29 & DRAIN • . los �° �'i) "MAP OF SOUTHOLD•SHORES" • Q ti (1, AT FILED AUG. 29, 1963 FELE NO. 3853 �p�, r '` `-74c,... �• A T ARSHAMO AQUE " 4C' 'eo00 , TOWN OF �OUTHOLD Cite? (61:0S#�,�,. 4 SUFFOLK COUNTY- , NY , , R. 1000 - 57 - 01 - 18 & 19 4,sT,�FFr 04, SCALE: 1" = 30' _ , l c n�AY2Z 2001 • :The-10900 of:Well and, cesspools shaven !Weil e n -ike..f om f ;observed. (0 • and'or-horn' el abtQlheF trein others. ' • O - 'CEPTIFIED-TO' . ' .t 4 TMAIE INC. , ' CHICACO TITLE INSURANCE COMPANY . ,SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES - - PERMIT FOR APPROVAL OF CONSTRUCTION FOR A • / 'SINGLE FAMILY RESIDENCE ONLY , • '' •DA'L'E" :5.-. f-0 V' ,. HS . - .NO. e -qt •-02. 3 L FOR MAXIM:''UM OF ROOMS - o �, . nnE>i Op EXPIRES THREE YEARS FROM-DAATE OF APPROVAL r 4 • h - �I�� / Y.S. LIC. NO.°49618 - : EXCAvwl iOh NSPECTION,REQUIRED '- 'r�, r ;1_. • ' FOR SANITARY SYSTEM P ONfE-' , -IT ,,�-::, P.C. a GR ; ;'.; .. ••;;•. . .. 3Y HEALTH DEPARTMENT 6 l 'T $, -; ," 'i4X f631J 765 - /797 Hive _-m,, - G'Sµt':�`- R�``•:t,», a'1- R ', r O, _ A :�+ • ,•,5- ';,�� .-•Y.,, ,.,,}s'---- ' - <' 12` ► t STREET ' _ 't SOU '; .Y. 11971 r, _ v_ . i Kj � • ` ,it ; w1-Fi- 7- - •- , „ _• 01 — :IT$