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HomeMy WebLinkAboutMartinez • 4. ® ,•� OFF OL (isktELIZABETH A.NEVILLE ;_ d Town Hall, 53095 Main Road TOWN CLERK ® - P.O. Box 1179 REGISTRAR OF VITAL STATISTICS 1,1 Southold, New York 11971 MARRIAGE OFFICER Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER `� "'sQ �� ,I 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. 2984 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : DONALD FELLER Address 1: PO BOX 1692 City St Zip MATTITUCK NY 11952 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 #R10-99-0153 Name Of Owner MARTINEZ-FONTS, AUCIA Mailing Address 1 7231 Sw 100 STREET City St Zip MIAMI FL 0000 Property Address 1 2150 HAYWATERS ROAD city St Zip CUTCHOGUE NY 11935 Tax Map No. section 111.00 block 6 lot 15.000 Cross Street CARRINGTON ROAD Building Permit Number cross Reference: Issue Date: 2/18/03 Elizabeth A. Neville southold Town clerk (TOWN SEAL) , -... , ..:= , •�,,®�®Su��®��o®; 029 S-Y ELIZABETH A.NEVILLE ; 1.\ Town Hall, 53095 Main Road TOWN CLERK % % P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER `� ,fiL � �s Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER ,_"'/®� Zig ��®Bio Telephone (631) 765-1800 FREEDOM OF INFORMATION_OFFICER �������� southoldtown.northfork.net 4 ~� R_ OFFICE OF THE TOWN CLERK �;; i 6E6 2. 3 Zoo? , --,' TOWN OF SOUTHOLD t, e j TO:..,,., Southold To Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: December 23, 2002 Transmitted herewith is a copy of application No.3105 for a Cesspool/Septic Tank Construction Permit submitted by: Donald Feller 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: - ,, /ct(At-7,7--eZ , ,� , . : �. .. ' Signature .7al )2,402— Dated 2,o2Dated OFFICE OF THE TOWN CLERK ,,,, •••••,,,,' TOWN OF SOUTHOLD ;' COF(IL ire FT.T7ABETHA NEVIL E,TOWN CLERK �•`'0� Dy�: Application No.�rj P.O BOX 1179 ; SOUTHOLD,NEW YORK 11971 Construction • „gins Alteration Telephone � � �� $10.00 - Residentia ,� l (63fi) 765-1800 = � ► , �����,,,• $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 2-1 -DI a 2 APPLICANT NAME: DO N Prt,Q & F APPLICANT ADDRESS: ?(j u [61 SEPTIC 4X CESSPOOL ) DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION 't\ N w ,N t • LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: ..,&\A. .( p- i EZ 1., OWNER MAILING ADDRESS: -I 2921 51./V IOD JT OWNER PROPERTY ADDRESS: 7-1 5e.> R is-t? Ftiato c-0-12.44136. U TELEPHONE NUMBER OF CONTACT PERSON: •216 TAX MAP NO. : Section 1 1 Block , Lot `S' CROSS STREET: : P-41JCo ION (249 BUILDING PERMIT NUMBER CROSS REFERENCE: * t-S2(Q / Signature of Applicant RECEIVED BY: I l /(4- o f`4-o n Clerk's Office DATE: /, GUARANTEES INDICATED HERE ON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE 77TLE COMPANY, GOVERNMENTAL AGENCY, SURVEY OF LENDING INSTITUTION, IF LISTED HEREON, AND L 0 369 TO THE ASSIGNEES OF THE LENDING INSTITUTIONGUARANTEES ARE NOT TOA ADDITIONAL /NSTITU ONSrnORSSUBSEEQUENT LE OWNERS IN Ll krhts t._/4/UNAUTHORIZED ALTERATION OR ADDITION TO THIS MAP OF SECTION D ] � 04/4/7), SURVEY IS A NOLATION OF SECTION 7209 OF NASSAU POINT CLUB PROPERajg I •((�,,,tS THE NEW YORK STATE EDUCATION LAW THIS RESIDENCE SERVICED BY f TOFF MUNICIPAL WATER(SCWA) """'��lc((((,,,, c)4. 11, COPIES OF THIS SURVEY MAP NOT BEARING SITUATE �2 <aR so THE LAND SURVEYORS EMBOSSED SEAL SHALL LOT 370 CUTCHOGUE, TOWN OF SOUTHOLD 1' 02 NOT BE CONSIDERED TO BE A VALID TRUE <0, -1,0 COPY. F o o Q° SUFFOLK COUNTY, N.Y. gl ■ 3°t SOT 3g) N 87"59'00"E I 307.00' H SURVEYED FOR: ALICIA MARTINEZ—FONTZ FD Z CM N �D (n • e O ZONED R-40 GUARANTEED TO- , 49 0' pt�V cr: ALICIA MARTINEZ r 165.0' pi i r MORE THAN 150' f 0.5'-1-16.5'= PROPOSED � FIDELITY NATIONAL TITLE INS. CO. c0 O D_ TO WELL OR CESSPOOL Q W DECK N • R (A O z O y 3.5 O p p ' FM# 806 OPROP.1 LPL,- rrj . t®�J DATE FILED MAY 7, 1926 o LOT 357 I3 BDRM W PROPOSED PROPosED p o P RES. N sEPI'C CESSPOOL 1% 10.E--- TANK 1 TEST C)) r'' O ��9� HOLE ' TM# 1000-111-06-015 LOT 358 ` 0 4 ti87.7 X14.5 I 1-5' ` PROP. WATER SVC 0 W 10.0' O SURVEYED: 7 JULY 1999 130'TO WELL p O ,35.TO WELL _ 150'+TO CESSPOOL $150'+TO CESSPOOL SCALE 1"= 50' S 8759'00"W 300.00 \k, 4'` LOT 368 THIS RESIDENCE SERVICED BY ss' FOR SCDHS USE ONLY AREA = 30,404.88 S.F. MUNICIPAL WATER(SCWA). —1 OR r� e 0 698 ACRES II O V O CESSPOOL / I NOTE. RESIDENCES SHOWN HEREON HAVING / MUNICIPAL WATER (SCWA) AS PER DONALD FEILER, ARCHETECT on .44 CARRINGTON ROAD . 8 {-n( .,i NI, ,.3 TEST HOLE BY lit1 Z I( \' 8 - MCDONDALD GEOSCIENCE on 0 >1C9" c'? I4 DONE 9 JULY 99 " o 4 I ORIGINAL GND — 0 .1 i ! E`' -8 ' v� 0 BROWN LOAMY SAND SM .; 0 `u n 3 , � '��' L.., ..p x � i" �- 1 '. Dr. PALE BROWN FINE Cs a tx] TO COARSE SAND SW 1..0 al up" LSI 0 ^'' V\ SURVEYED BY - ;- , i 0 1, �; 1�. STANLEY J. ISAKSEN, JR. P O. BOX 294 ® NEW SUFFOLK. N.Y. 11956 631 -7 4-5835 60 - 0 ! i- ,e___ _ 77' 4r2.-, 11 DEC. 02 SHOW PROP SANITARY LOC AND WATER SVC ICENSED SURV A. 1. m11.OCT 02 REVISE PROP RES NYS Lic No. 49273 99C81'.3