HomeMy WebLinkAboutAnderson .ELIZABETH A.NEVILLE �� �� fi a t �� Town Hall, 53095 Main Road
TOWN CLERK ' P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER ® + ��} , Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ---,IV/ • eIli 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. 2718 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JOHN HURTADO
Address 1 : 10995 NORTH BAYVIEW ROAD
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 #R10-00-0274
Name Of Owner ANDERSON, DORIS
Mailing Address 1 77 WILLOW AVENUE
City St Zip HUNTINGTON NY 11743
Property Address 1 3400 LIGHTHOUSE ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 50.00 block 2 lot 2.000
Cross Street SOUNDVIEW AVENUE
Building Permit Number Cross Reference:
Issue Date: 1/11/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
2 )
.N„,
ELIZABETH A. NEVILLE � Town Hall, 53095 Main Road
TOWN CLERK : 1,44 � P.O. Box 1179
REGISTRAR OF VITAL STATISTICS • t � Southold, New York 11971
k 16. • 11 Fax (631) 765-6145
MARRIAGE OFFICER 11
RECORDS MANAGEMENT OFFICER ;�®� Ir®lii Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ -IA1,,' southoldtown.northfork.net
rr
OFFICE OF THE TOWN CLERKt�
TOWN OF SOUTHOLD ;tiff
r j f r `����
TO: Southold Town Building Department
CQ
! CIF
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FROM: Linda J. Cooper, Southold Town Clerk's Office LJTI10
DATED: January 3, 2002
Transmitted herewith is a copy of application No. 2813 for a Cesspool/Septic Tank
CONSTRUCTION/ALTERATION Permit submitted by:
John L. Hurtado for Doris Anderson
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
40/7/ 3„,‘
Dated
;Y
Ja—
•
OFFICE OF THE TOWN CLERK ��' a�
'''',"II'•••'��""
TOWN OFSOUTHOLD ,�,.�OF���k • Application No. r
FT i7ABETH A.NEVIT ,TO Q vv
P.O.BOX 1179 . ; Construction
SOUTHOLD,NEW YORK 11971 : p r�irn Alteration
Telephone Q ' $10.00 - Residential
(637:) 765-1800 �, $25.00 -Non-Residential
___Il,..
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE NJl'iv, Z 00
APPLICANT NAME: j.01-i" L , f.f(J/ 7 44)
APPLICANT ADDRESS: /0V7.5- VOA-7A 1377 '(.r,i /WA
50017401-0/ 1/y //97/ .
SEPTIC ✓ CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
AJ ' Co'- CTAuCf.tic.vt LY
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
• OWNER OF PROPERTY: fovtiS /kfrOC.2So,'
OWNER MAILING ADDRESS: 7 7 W ILL w A v(1
OWNER PROPERTY ADDRESS: 3�o kt6-/-(% L/S /'2o,A/J
Jc)(0.4 L� 1/. y //9
TELEPHONE NUMBER OF CONTACT PERSON: 63//16.S--- C, 02a0
TAX MAP NO. : Section 6-0 Block Lot 02
•
CROSS STREET: SOU A/4 jf/041 AU eifC/L/
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant '
RECEIVED BY: c Z/
own C erk's Office
DATE: /72_/0 -2—
` p 700: MHWM I
�� v 7 S��,�fl, �, �y S UR EY OF PROPERTY
100 N . . .I,,,E- ,I'' 3.r® 0_, �n ear
.c. �N A 1 SOUTHOLD
HOLD
L poi TOM DF BLUFFSa.SG t
M��tM //j O. /�`+ + `�,',` TOWN
OF SOUTH—OLD
0 ,U_.F "OLK COUNTY, NEWYORK
moo. r • `01 f\11711 ,"= '
�� 1000-50-02-0,2
-P ti �� �& � a SCALE: 1"-40'
6' O I '� OCT 17, 2000
K •y ,S, F` F.�h NOV. 8, 2000 ( revision )
o wit* o� zas Nov, 27, 2„tav t�ori$, a)
�p�a,,�`,p Ea N Fin. {Grade Dec. 8 2000 (prop.hse)
J �� z ' f^l 1 \ e/ '0 Vac. i 4{S to r"ef7 rof�kraai a( raiA..
• �p ��� '5'L rap DF BLUFF ,%- ,F,�, C� t -�` Feb el y vt"C,carhdk,,f topA )
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<o� �'�C�/ too a E , :,,'_..e. t-1 ., ,� . 'S ass A�(ay 7, 20ô1 l�G s/onl
c ‘, $' " ,:; x5 '`a e t,i4.i 900 gvl. , 3' a a w N I June 12, 200/ (revisions)
..7'..,‘V'44(.. A ::g.
N5 fi'`'r ; ►- �,s .£ t�.�, �—— e/53 1: -.yel:+_ d
erS
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F i� ,,,yah .._. '
San Gravel sand �' '® t0� 7�
f 4,./1.-T,
• ' L y :44' , r n. 4A. 53 . , ,'i,' 'gravel e1 a y:,a 7 ,
h
d _� r 3 •. 'VC ` Seplic System 38 ' _ .
Septic Tank
74. f MkFa. i {.sAb ?�5c'!e:;-„,'"('W Crossectiony.x;. ....).3 1-',..f!.°f.. ie-A.,0
.y{� '/a _ �tlT '�1ift` �'" -1: K. k " . , � a ep ai.'<•'._, 7 {'"?
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_........... ., ._ ..,.•�, �,, �,,, ` 61- '` NO x�'' �', ; }� � d CERTIF TOS
_. a �_ ',
0
{ \ IED
f� ��, ' �,. -t3-...1,' NE CHRISTINE C. HURTADO
- ��k =`, �;. $" z J: & JEAN FIRST AMERICAN TITLE INSURANCE COMPANY
o F#it , ALALOneeMICSMitankesapereleassezemmeseteew
. ' 0*- � ' i KLIN PL. OF NEW YORK �A�IAREQUIREDr ,�7t .t E N.J. ..
ar ' �, . N� , FOR
.,�•_.._ „ ,� w ` . - Y DEPARTMENT
11AIE ?ROM
. -qw
COASTAL gum HAZARD ''" ,
z
COASTAL ER ON HAZARD'AREA MAP %,•, s
�� .,: »: , CLL Review
PHOTO N0. 56-370-8 ' „r -,' ,o - TEST H®L E DATA
G
',Rn4 = B15 `A i Brown sandy loam DL ' dat mutilation dated
04,t14
Y ALTERATION OR ADDITION TO THIS SURV A VIOLATION7,4 , !J ,, — dos
SECTION .209 OF THE NEW YORK STATE EDUCATION .LAW GRA TE 8 1 Brown roomy sand SM
CEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS alir,9 i 2
REON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF ;
ID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVE`'DR er�So AVENUE 1.
iOSE SIGNATURE APPEARS HEREON.
7/\
SOU '
i7 i Brown c7nyey sand with very heavy
I grovel ,n layers SC
JTES i ,'-5� ��OF �ekk
am familiar with the STANDARDS FOR APPROVAL I I ,°`"4 T M „ . t�
�D CONSTRUCTION OF SUBSURFACE SEWAGE �\ r---- — _— 32` _- '` r*,. , : `n `.
ISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCE. �� ,.
f i;�`�1•'sj I
id will abide by the conditions set ror th therein and � CC \-1—
, � ' I11�� �`
-the permit -to construct 0 1� N (DWELLING) I cl✓ater, in brown clayey sand and sandy �� <<T
r,ay a%th heavy gravar rn l• ers SC 8 cL . \\ tia
1
WELL 150 + �� � _NYS `::,,,6,,4119, ._N�e�� bne location of wells and cesspools shown hereon are s0i l �; r
roti field observnt ons and or data obtained from others x ECONICS9 EYHRS, _ D S \ 4• ”
\ \
iFAX (b `�-?RL`7o5-1797
_ 61. (631) 76g-502p0
`� water •n crown Fuge BOX ` 09
Icvntrnn� nrP ref erPnCeCi to N.G.V.D. __ _ - _ _ ,_o i 1 to roar se sand SW _ _ _ _� , —. `.,-r„—r r