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ELIZABETH A. NEVILLE ,��� `0_,A.
# Town Hall, 53095 Main Road
TOWN CLERK o
ti P.O. Box 1179
REGISTRAR OF VITAL STATISTICS � � � Southold, New York 11971
MARRIAGE OFFICER `` "0/� �, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER �_�® Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER '.l � 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. 2975 R Residential X Non-Residential
Fee $ 10.00 Septic x Cesspool
PERMIT ISSUED TO:
Name : SUSAN BECKER
Address 1: PO BOX 289
City St Zip PECONIC NY 11958
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 #R10-00-0007
Name Of Owner BECKER, SUSAN
Mailing Address 1 PO BOX 289
City St Zip PECONIC NY 11958
Property Address 1 480 REYDON DRIVE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 79.00 block 5 lot 16.001
Cross Street NORTH BAYVIEW
Building Permit Number cross Reference:
Issue Date: 2/18/03 Elizabeth A. Neville
Southold Town clerk
(TOWN SEAL)
,,iii...— /]
ELIZABETH A.NEVILLE G�� Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
y Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS V
MARRIAGE OFFICER ``� ��� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER �__�®� �� iii Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ��� southoldtown.northfork.net
, p,, err _� � N
, i.
1 4 , L l!
+, OFFICE OF THE TOWN CLERK
L=l, 2 0 2002 , �•'; TOWN OF SOUTHOLD
TO: ,r Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
CG
DATED: December 18, 2002
Transmitted herewith is a copy of application No. 3096 for a Cesspool/Septic Tank Construction
Permit submitted by:
Susan Becker
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:
- .a.--.17-
O
Signature
Dated
OFFICE OF THE TOWN CLERK ,i''
TOWN OF SOUTHOLD CLERK ��%1%��FFQ `+QG�' Application No.3O c.
ELIZABETH A.NEVILLE,TOWN
P.O.BOX 1179 % 0 Construction
SOUTHOLD,NEW YORK 11971 ;o Alteration
Telephone v," ire: $10.00 -Residential
�'
(63t) 765-1800 = ' 1 * ,,'' $25.00 -Non-Residential
TOWN OF SOUTHOLD •
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
. RECEIVED
APPLICATION
for DEC 1 8 2002
CONSTRUCTION or ALTERATION PERMIT
Southold Town Clerk
SEPTIC TANK or CESSPOOL
Permit No.
Fee '$
DATE ,bP e rnh-e 4' ) ) ZO2 2(X(2._
APPLICANT NAME: 5(T Qin oez),k,o,/
APPLICANT ADDRESS: P 6 . Box Z8T
Pe K) i <} k l i I ig,i-
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
5InjeThY i )y Hth-- f2
•
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 5 0.50,11 6elet( '
OWNER MAILING ADDRESS: (19. . Foy C.
_acme, L g -6--
OWNER PROPERTY ADDRESSzife):
5
l
Soo . ioic( Mui ) . -w
TELEPHONE NUMBER OF CONTACT PERSON: (,�' [` aqz...
TAX MAP NO. : Section Block 5 Lot )(0 , I •
CROSS STREET: (\J \) 'iii
BUILDING PERMIT NUMBER CROSS REFERENCE: .
__ 21/(f1-4Signature oApplicant/
pcoL .
RECEIVED BY: At
MI Town Clerk's Office
DATE: \ 1 11111.8X------- •
TM 1000-079-05-16.1 -
FM # 8395 SURVEY OF _-
FLED SEPT 17, 1987 '„•"(-‘5:1\,1` 0 LOT 1
MON° WArEg., vi. .�, ,:-.
SURVEYED 3 DECEMBER, 1999 r,*i •r s';1 1..•':';-1 1 IN
SCALE 1"=40' ° MAP OF REYDON COURT
•
AREA= 488770 SF RES RFs' C• _- t=' ' 5 5 SITUATE
OR 7i,r, tit� r,++ �'
1.119 ACRES Ste.° <,sr;+r,1(;' S
°- r
0 'DE . u, - ,” r'1G`i-r SOUTHOLD,
a.GUARANTEED TO ' " '"i "! TOWN OF SOUTHOLD
SUSAN DECKER _ . SUFFOLK COUNTY, N. Y
COMMONWEALTH LAND TITLE INS. CO. O
TOWN OF SOUTHOLD I m SURVEYED FOR SUSAN BECKER
ELEVATIONS SHOWN OBTAINED
FROM SCDPW ARIAL TOPO MAP. R,
R= 1 5.00 Sss.00, OPEN SPACE
ZONED AC • L= 33 914.:-...-. 204 S9,
R =30.00' \
L= 30.52' \
Z2\
R= 30.00'
L= 31.42' \
GM \ OO
N
PROPOSED (0O
I 6 \ 1,4,
WELL
O \ /45
JC
I 24 // I ,jS
MON. WATER SVC I t, // I TEST
RES. -�� _ 50' / - HOLE #2
MORE TH4N
150' To PROPOS D I \
CESSPOOLS Q ^ PROPOSED a
509 EXPANSION 4 BEDR(bOM•• • I
-� ,[.,...- WOODFRAME
N
O
O PROPOSED RES.
PROPOSED �� ' TANKC RP'R� L0j\2
CESSPOOLP J�p� srj>
1 X •
L ___ \ R ESI DEN•CE
PROPOSED
, R= 4o 00' DRIVEWAY
L= 02.83 \ --
h \ �' 7 SEPTTANKIC
•
�N
G�gSe N 0 CESSPOOL
0 <9, ry
, N 31' 41' 49" W 900• c
0
'° 15.00' e z� 83F '
���aP\h ROOK i°•4]
yy E
It.-c
m M
Z1
- TEST HOLE #2
FOR S.C.D.H.S. USE ONLY AS PER FM# 8395
FILED SEPT 17, 1987 r- EXISTING GRADE '
' < /k '<\��/i�\ TOP SOIL •
f. — —2'
` 'A Vi 1 . LOAM Guarantees indicated here on shall run
only to the person for whom the survey
Nis prepared, and on his behalf to the
' * . 0. / •, — —3' title rcrn~u;,, Covermental Agency,
–+ orsirr; inst'•,t:cn, if listed hereon, and
-yam to
the csl_,,rees cf the lending institution.
I IN r ,iii Guarantees e Guarantees ure nct transferable to
10 –i —
o SAND AND GRAVEL additional institutions or subsequent owner:
I C
ed c� Unauthorized alteration or addition to thh
survey is a violation of Section 7209 of
t 2 lg. c g I L+ the New York State Education Law.
g -qfi
g C1 "'I S 17- Copies of this survey map not bearing
l O
the land Surveyors embossed seal shall
l pa 4 -'1
not be considered to be a valid true
ek P4 9 1 copy. .
{ O C SURVEYED B Y
C W @oSTANLEY J. ISAKSEN, JR.
-� > c P.O. BOX 294
NES�SUFFOLK NY 1195.
-- • 631i,734-5: . /
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LICEN •9 LAND S L'- EYCV --
- NYS LI? . NO, 49 13
• 99C852 c