HomeMy WebLinkAboutHassildine f r
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ELIZABETH A.NEVILLE e * Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
y = Southold, New York 11971
REGISTRAR,OF VITAL STATISTICS v' P
MARRIAGE OFFICER
V46 Fax�����, Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER "'/Q! �a0 iii 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. 3041 R Residential x Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : EDWARD HASSILDINE
Address 1: 555 HORTON AVENUE
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 #R10-02-0194
Name Of Owner HASSILDINE, EDWARD & MELISSA
Mailing Address 1 555 HORTON AVENUE
City St Zip MATTITUCK NY 11952
Property Address 1 855 STANLEY ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 106.00 block 8 lot 12.000
Cross Street BREAKWATER ROAD
Building Permit Number Cross Reference:
Issue Date: 6/11/03 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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1''SUFF®t� 3 0� 1
��I,0�® e,r/ Town Hall, 53095 Main Road
ELIZABETH A.NEVILLE ��i y
TOWN CLERK ' p % P.O.Box 1179
REGISTRAR OF VITAL STATISTICS •W a $ Southold, New York 11971
MARRIAGE OFFICER
O Q Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER �y a®�'��� Telephone (631) 765-1800
-FREINFORMATION OFFICER \-:494_ � 4 6,'� southoldtown.northfork.net
miV 1 6 ad :._ OFFICE OF THE TOWN CLERK
'L -,: TOWN OF SOUTHOLD
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TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office '
DATED: May 15, 2003
Transmitted herewith is a copy of application No. 3165 for a Cesspool/Septic Tank Construction
Permit submitted by:
' Edward Hassildine
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:
17
APPROVE
DISAPPROVE
Comments: �t ".i j: - �� •'�
„2144:„.„ ,,:c
Signature
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Dated �/
f' .rfl
OFFICE OF THE TOWN CLERIC • ",:`�•C•nr•'•�•,, .
TOWN OF SOUTHOLD �•' �ti�1 u�1 • /
ELIZABETH A.NEVIILE,TOWN CLERK •%"k. / = Application No3I��
P.O.BOX 1179
Construction V
SOUTHOLD,NEW YORK 11971 '_ 4
z. O rri �
cry Alteration
•
Telephone y, ���,�, • $10.00 -Residential
(631) 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 April aI` 00v3
APPLICANT NAME: Edward { f55//di r
APPLICANT ADDRESS: 555 /p' -fr
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
•
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION':
OWNER OF PROPERTY: Edikioird C /-/a551Yin f ahs e((:ssA
OWNER MAILING ADDRESS: 555 / 2K1v ) 4V-C
maiLl b, N I/ /1950
OWNER PROPERTY ADDRESS: g55 slari/eXd•
)47,4k, A g95a.
y //
TELEPHONE NUMBER OF CONTACT PERSON: a.C/R •
TAX MAP NO. : Section /QLD . Ir, Block (`)�{, Lot O/a, ODD
CROSS STREET: 3rd Walt 1114.,-g_ty ed
BUILDING PERMIT NUMBER CROSS REFERENCE:
eite%LaAtoga:66;t4,2___77-
Signature of Applicant
RECEIVED BY:
q4:4..
Town Clerk's Office
DATE: d<t,O'
Ilef 3 J
' j . ,
Survey for:
RECEIVED `V°`°nt) EDWARD C. HASSILDINE III
SUFFOLK COUNTY ITY (Vacint)
2002 NOV 2 ! MI I1: 43 EL=581 STANLEY ROAD & MELISSA HASSILDINE
^� EL=564
,I� _ — Lot 10, "Sunset Knolls"
r OF HEALTH f F{ tirF ���( E5 — — ,.....__WATER MAIN
OFFICE WASTEWATER MGM I POLE 6 • �+pp " —EDGE OF PAVEMENT At(iir=11‘111 _ WITH GUY J - SC77 11 OO E 69.79' --- '
EL-58.3
•7 MCLttituC JG
3 EL=ST° Town of
I N87'11'00"W 755.00' Southold
o �k I IIs
,��• I IIS N R=18.50' Suffolk County, New York
I - :CO! L=34.54'
I >- IIo ' rn S.C.T.M.: 1000-106.00-08.00-012.000
I Q0 > I 30 0 30
R�519 SANITARYPROPOSED 1 N-SYSTEM I a IIS
sr
N \\ I FE\\ I a I I ��) 0 SCALE:1"=30'
n
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` a- NOTES:
K w
CV O �0\ '. -/I I 2 (� 1. AREA = 22,828 S.F.
q , \ STI I I a 2. • = MONUMENT FOUND, A = STAKE FOUND.
\ I
0 w ^ \ 4_� I J j (v 3. SUBDIVISION MAP "SUNSET KNOLLS" FILED IN
;N _•
_ I THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON
NU `� --37 '--__ 1I I ( o �/
� JAN. 05, 1968 AS FILE NO. 5023.
3. ELEVATIONS SHOWN HEREON ARE REFERENCED
ciJ 2 --� J
l j 2zo 20,0'- --J
TO N.G.V. DATUM (MSL 1929).
+' a
I p a
ti
PROPOSED HOUSE —I N OCT. 21, 2002 IND PROP WATER SERVICE
'V ci
(4 BEDROOMS) I 0
O I SEPT.OCT. 017,1, 220002 ND02 ENPROP DED PSTRUC ROP TRUC
N 660' H DATE: AUG. 21, 2002 __
ti.,
-di - --- ---------------- --- - ----------- JOB NO:2002-453
— —
� -z-S.
0
3 Q SUFFOLK COUI�'TYDEPAR'I`���EI+3Y OF MAA SERVICES „„_i
CERTIFIED TO:
Z` L EDWARD C. HASSILDINE III &
O Nfi) DD I; PERMIT FOR APPROVAL OF CONSTRUCriON FORA MELISSA HASSILDINE
V 3 W SINGLE FAMILY RESIDENCE ONLY
LI �l0-Ch -fllC/4
DATE3t-12-02 HS : EF,NO.
o t° o 0 0 po _= 1 _ „
fij l() c� APPROVED «/A...4� _-��j/LIL
P FEN Q I
22E >
tij , FOR MAXIMUM OF 1.--- V(M S
23 Z co
Ai
•� cN1 EXPIRES THREE YEARS FROM DATE OF APPROVAL
„p D ,Z G
SHED " Nora EXCAVATION INSPECTION EQU
EL=575 le
FOR SANITARY SYSTEM DAVID H. FOX N.Y.S.L.S. #50234
— -.,--- —�_ LINE OF FILED MAP EL=561
RQ A >r BY HEALTH DEPARTMENT
0B N88°47'00"
"'•8"47'OO"W FEN
FOX LAND SURVEYING
WOOD FENCE 130.29'
20•29f
02'S - __ .. -.. PO BOX 224
•
PLEASE No—-' SPEONK, N.Y. 11972
Lot >
under Sanitary System not to be installed (631) 325-2902
Lot PBb,G N°te[) (Dwelling Well In Excess Of 150') under drivexp/ UNAUTHORIZED ALTERATION OR ADDITION TO THIS syRvEY
v`i"1- • driveway..�f ,
) • • 'E A VIOLA OFSECTION 7209 OF THE NEW YORK STATE
•
\�Wg In — - -- - -��---- _ EDUCATION LAW COPIES OF THIS SURVEY MAP NOT BEARING
Subdivision 1S-V1
HE LAND SURVEYOR'S INKEDT
SEAL OR EMBOSSED SEAL
"Anthony Dris &
y Heten L)ris" SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY
Suffolk County File No. 8995, CERTIFICATION INDICATED HEREON SHALL RUN ONLY TO THE
PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS
BEHALF TOTHE TITLE NLISTED
COMPANY, GOVERNMENTAL, ANDAGENCY
::::
AND LENDING INSTITUTION LISTED GOVERN • AND TO THE
ASSIGNEES OF THE LENDING INSTTUTICN CERTIFICATIONS
ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUT1DNS
OR SUBSEQUENT OWNERS
�I�
DWG: 2002-453