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HomeMy WebLinkAboutMatheson /,lktFFOLat O' G� ELIZABETH A. NEVILLE ® � Town Hall, 53095 Main Road TOWN CLERK % ® - P.O. Box 1179 ti Southold, New York 11971 REGISTRAR,OF VITAL STATISTICS MARRIAGE OFFICER g, ��� Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER �_ 4;41.�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. 3010 R Residential x Non-Residential Fee $ 10.00 Septic x Cesspool PERMIT ISSUED TO: Name : MICHAEL MATHESON Address 1: 6 CHERRY LANE City St Zip MOUNT SINAI NY 11766 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 #R10-03-0035 Name Of Owner MATHESON, CINDY Mailing Address 1 6 CHERRY LANE City St Zip MOUNT SINAI NY 11766 Property Address 1 58756 MAIN ROAD City St Zip SOUTHOLD NY 11971 Tax Map No. section 66.00 block 2 lot 2.005 Cross Street MAIN ROAD Building Permit Number cross Reference: Issue Date: 4/17/03 Elizabeth A. Neville Southold Town clerk (TOWN SEAL) ®swou, ; S610 ELIZABETH A.NEVILLE �i� eto � r ' Town Hall, 53095 Main Road TOWN CLERK % ® `% - P.O. Box 1179 7 REGISTRAR OF VITAL STATISTICS � � � Southold, New York 11971 MARRIAGE OFFICER �, ' .=''' �, Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER L "4% $�®��i� Telephone (631) 765-1800 FREEDOM OF INFORMATIOI\ OFFICER���,s.� southoldtown.northfork.net 5 20(�3 y OFFICE OF THE TOWN CLERK MAR 0 ° TOWN OF SOUTHOLD �3=0� Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: March 5, 2003 Transmitted herewith is a copy of application No. 3133 for a Cesspool/Septic Tank Construction Permit submitted by: Michael Matheson 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: Signature d3 Dated .'7) y r' 4 OFFICE OF TEE TOWN CLERK 8���" FL1/�•����� TOWN OF SOUTHOLD ,';'�c�uFFOLKc�': 3 ELIZABETH A NEVIII.F,TOWN CLERK �� Application No. X33 P.O.BOX 1179 SOUTHOLD,NEW YORK 11971 ‘ _ Construction o • cry y, Alteration Telephone 0 ' _.fol ��Q ��• $10.00 - Residential (63-1:) 765-1800 ... 'ir �o,'� „,,,,,, $25.00 -Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee .$ DATE `a CD APPLICANT NAME: $1•4 ,M, s9 A APPLICANT ADDRESS: (E, � c 1 1--.t•, ' ( • S V ,i v\i, SEPTIC V CESSPOOL DESCRIPTION OF PROPOS D CONSTRUCTION OR ALTERATION M . LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: �kA 1-AI4 S.4 OWNER MAILING ADDRESS: ( 4-k 1' `t, iMC, S\ ii '' OWNER PROPERTY ADDRESS: >4 ' 5.7 -S(.0 1fl j ... Imo( TELEPHONE NUMBER OF CONTACT PERSON: 5Ifo--)6 -91 05 TAX MAP NO. : Section t:4' Block - Lot ›-% • CROSS STREET: i`Alet-ir) lith', BUILDING PERMIT NUMBER CROSS REFERENCE: VUn . ,41 U11/4.....4.--�!� � lA Signature of Applicant RECEIVED BY: I, Town Clerk's Office DATE: rF- ? SUY OFLOT Y2 .\,. v. t 1 MINOR SUE3h IvIS.I Oil • • 1FOR N. GHARLES DELUCA j SITUATE: SOUTHOLD • k e , TOY4I: SOUTHOLD `A' I SUFFOLK GOUNTY, NY Vv i SURVEYED 01-27-03 A;(/// S , / \1 °Dr 0 ♦♦ SUFFOLK COUNTY TAX # I, ' �ry'tidy% t 1000-66-2-2.5 ,`_^ ♦ ♦ N (� ♦ ♦ \ 'V ` ` N� ' \ lCfl�lllllt�llD TO: 'I P`GP ^ 30 VP CINDY MAMMON ON �5 1 • ® DNDYMAC I:;ANKP.S.B. I y `, ♦s — — \ �, CORPORATION _- 0_ METROPOLITAN ABSTRACT ♦pr O -_ ♦�� -- t)) m ♦♦♦� � •. `•• ♦♦�♦ O\\ \ ♦O;• ♦•gyp Op� 2 • w \ -1.„-z.- -1,--- Z �%�4'p ♦.Qi;%`p�‘,?:5; o5Q'3 6 PROP. LOT N. "Z• �� �`�O'[•'`,l `�' .7✓✓ 7 .GARAGE 2 \ I5' p p o Y �i` ♦ --- -- \ O Test Hole • _ ' from Filed Mop ��'< y f'� `, --N PROPOSED u, \ � `♦ y \ `W. �� \ HOUSE W `--, D 1- 1 _ - ♦ . PROPOSED IAIATER 5E:RVICE \ \ � Top son S�C` ` • / \ ` -2 O k.---) I `♦ \ � PROP \ -i'i -lt`� --i ♦ ' 6"I' SEPTIC 6 �G OSE DRIVE/ ♦ rte' . 50nd ` 4.` \ V:: \ �♦ \.,..)0o X` � �` n 5�2°4G'50"E 444 25' -----------------_c------------------- �% p -------------------- ----N72 X49-50_ W --- ---0-- 4 - FCIf�H� of -1^1760` °25 t �) ‘X '''•, DIRT ROAD � LAL1D5_DF_DELULA----------------------------------------- --- x — I I EXISTING MATER SUPPLY IA' ----i— ^-I�N 2-`44 509"1 46T.21 WI 17 --\. • I LOT \ LOT } ...... a D::: ,.r .t - •r^ -' C ^ai " ,�".X VICES 3 \\. 4 . Z NOTES: ' HOUSE UNDER • a0_ \ Dv�ELLING \ CONSTRUCTION . a MONUMENT �,t:;�:'w , °. i > , , ,. . " N---94: ��, p PIPE qJ- /y Pte.: ' , , --4.„ . „nm.tnar°ad alteration or ocia,lar to sw I--— l;,0'3 -,-:,,,,,x-t.,),-,W.„ , , s^s,_ �-O,3, —O '` 4c,, `, '�,�„[' map beerfng a licensed land surveyors seal,s M'"�®y �!f1f, ,���1�)�; ,, ;' ,� q�;�F ,_ x.n g ' .,y »' E3D vlalatlanof.ecticni2C9sub-division 2.cfthe AREA = 80,0©0 5F OR 1.54 ACRES "}^' =''_ "` w'; * q• : -.' New York State Eduwb2 Law' ' :i .4` `,$;- +i j-q.3't'..'0 ijr`'�'� 13:- .: `'-`;+q,�`k� * 'Only wpbs from the Stet l of tn�e survey -1:r �Yi' ,�- �_ ..�-...w•++.+a-_�.. '4 y m'Only wIthcopies s rom th l at the load surveyor, sury y r.> ',� v,.,.",,,,.. _ = - 11.; + i stamped seal shall be cons dared to be valid true ELEVATIONS SHOWN REFERENCE NSVD '2G r >`` _ =p1es r I f�1 �, `•, s 'r I RI i, IRiI n• ''11'''...,',1' -, ; �, e,` '� ) '� II , S , . '', , If SUF I`�,. 't!' N—A I�•I ! -rye y,Y 1 `;-.1, ) AA'�� Pim 'Gert flco[icnz Lndicd°moow�rdonce wrNt the ex- I I '-_S s! i' s<gey was prepare istmg Code of Practice for Land ar../eye axp.ea 6 EAST MAIN STREET �" r�rr+ by the Nen Ycrk State Aszccbtbn ar F''''' ''' N.Y,S.LIC.NO.50202 < r.a v,;; _ -y T"rT E i r' "�•'." !.. - - Lands Surveyors Sold LCrhe survey sear run any GRAPHIC SCALE 1"=50' v tor whom 1 to the is II-ii n"11111111111: , .s. ., '_ ,.� I _ .._.-._..._.._._.......-. _.,._ 'O to the osnigmtd olr the lenatag mstt tion ce tiroo? 16 O /400 NO.501.P. RIVERHEAD N.Y. 1190 - . . ;----.__.____. �-_.�y ��D V'"orae369-8288 Fax 369-8287 °e'er°t'- odd Ytar REF.—\\Hp server\d\PROS\O1-1 Lpr . 2/20!3009 2.2d.91PM \Wp.mver`dWRaS.l4i 1pe %