HomeMy WebLinkAboutPaskoff ELIZABETH A. NEVILLE ,/ x^ '� ; Town Hall, 53095 Main Road
TOWN CLERK ; - P.O. Box 1179
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Y Southold, New York 11971
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REGISTRAR,OF VITAL STATISTICS ® �� Fax (631) 765-6145
MARRIAGE OFFICER :� 441 �1
RECORDS MANAGEMENT OFFICER � l ��®,i� Telephone (631) 765 1800
FREEDOM OF INFORMATION OFFICER si 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. 2848 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : AMY MARTIN/FBDA
Address 1 : 413 MAIN STREET
City St Zip GREENPORT NY 11944
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 #R10-02-0002
Name Of Owner PASKOFF, AILEEN
Mailing Address 1 21 WEST STREET
City St Zip NEW YORK NY 10006
Property Address 1 205 NORTH SEA DRIVE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 54.00 block 4 lot 4.000
Cross Street KENNY'S ROAD
Building Permit Number Cross Reference:
Issue Date: 7/23/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE /��.. , 0,; Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �° , i Southold, New York 11971
1� Fax(631) 765-6145
•:g„•r, , • • MARRIAGE OFFICER ®4i i1
RECORDS r,pMANAGEMENT OFFICER ---.794? .air • lig Telephone (631) 765-1800
EEDOM-r3F-•INFQ -lO FICER ���� southoldtown.northfork.net
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JUL - 9 2002 OFFICE OF THE TOWN CLERK
J TOWN OF SOUTHOLD
_v .,"ms's HOLD
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O �� Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
- ' DATED: July 8, 2002
Transmitted herewith is a copy of application No. 2953 for a Cesspool/Septic Tank ALTERATION
-Permit submitted by:
Amy Martin/FBDA
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. Izi. „)...e>, ..zyce,,,,....."
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Signature
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Dated
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OFFICE OF THE TOWN CLERK ,,,��,'se S�,..-
FT.T7ABETTHANEVIILE,TOWNCLERx ,OF SOUTHOLD ���\.,,% OL '%, • Application No.o2 J
P.O.BOX 1179 ���
SOUTHOLD,NEW YORK 11971 z Construction
• to rri Alteration P(...._
Telephone _°,f� ���0' $10.00 - Residential
(631) 765-1800 - 0� $25.00 -Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION RECEIVED
for
CONSTRUCTION or ALTERATION PERMIT - JUL --b 2002
SEPTIC TANK or CESSPOOL
Southold Town Clerk
Permit No.
Fee $
DATE r fa�
APPLICANT NAME: �l _ ` , 4
APPLICANT ADDRESS: 4/� ))44.(,..;_d 3Y
7)ee (ia '
SEPTIC V CESSPOOL
' DESCRIPTION OF PRO/Lt/ Z / &4iJ ED CONSTRUCTION OR AETERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 14/leek /3s/ , A
OWNER MAILING ADDRESS: c0/
GU.t4.f ,J
a4y Nk
OWNER PROPERTY,ADDRESS: ,� X 4...
TELEPHONE NUMBER OF CONTACT PERSON: 477 _4 7s-- -
TAX MAP NO. : Section `6( J Block SY Lot g
CROSS STREET: ' -
BUILDING PERMIT NUMBER CROSS REFERENCE:
19.z/A/c...) ,
-110 ignature of Applicant
RECEIVED BY: , -
Tow e' 'Office
DATE: '7 ..- � -
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PERMIT IFOR APPROVAL OF CONSTRUCTION FOR�� '` N e° i ' \ N / ' , <
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SINGLE FAMILY RFrS1®I�ICONLY /. P'r\ J —_ - �G \\\",� �\\\,`�\ PALE BR06"RJ FINE TO COARSE
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APPROVED N •, • f�, \ ,Fy e, WATER IN PALE BROWN FINE TO COARSE
BEDROOMS
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F®R MAXI�U{�OF &•F.®R�MS C/ S/0, \ O� \� i i ` ST/LG \57,> ;>'
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EXPIRES THREE YEARS FROM DATE OF APPROVAL. v,°���FS °F ��c> 0�� ^� ,/ 10 o'
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�I MON Pr, COMMENTS WATER ENCOUNTERED 4 0'BELOW SURFAC
6 MON SE y `` � rc `yl, ,tSaED,An�+y/
BASED ON SURVEY BY \• , .I, q�ak 06 4, <,1,��(�.8,9'Sill'
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JOHN T METZGER I, iP -6 , TEST I-1 O LE DATA e °
PECONIC SURVEYORS P C NOTE PIPE ' F' �I`' Q IP 'L. ' 2
SOUTHOLD N Y I 1 97. THIS AND SURROUNDING S/_,ST PROPOSED F 'I Y t'Z *
FOR RESIDENCES ARE SUPPLIED 'f'' `ST;,'L'C'., SEPTIC j
ELLIOT 4 AILEEN PASKOFF 8Y PUBLIC WATER / <N `IOL�`7/.`'F, ' SYSTEM 0 UTII POLE SCALE N T � '"k`C =,:
AT 50UTHOLD (S C W A) / FG 0q,,./2,-:, • sQ:� j -,414,111/A.°'\`' ,_,,..3
TOWN OF SOUTHOLD NOTE N / , iy✓ 3 :\ 1634" ON
SUFFOLK,COUNTY N Y O 2 �' y
000- 54 -04-04 EXISTING STRUCTURE y�'P(t- \3 • `�` ` '� ` Z�F N�`N
AREA 34 854 5Q FT 10 TIE LINE
(DESTROYED BY FIRE) O FS •
�• HOLE
TO BE REMOVED F 8 .,/
o� FA I RWE AT h E f�—B RO _
MAY Z 1989 c(-
FE8 13 2001 (SPOT ELEV,) �`�yLq� N NN ' (neP DESIGN ASSOCIATES,INC.
EXISTING LOT COVERAGE 2 809 Sc)FT - 5% f/j
MONUMENT PROPOSED 101 COVERAGE 6 057 SQ Fl = 20% S/° •
6 �� 4 13 MAIN STREET
S o'pS s �O� P.O.BOX 52 I
SITE PLAN 1,` :3°1'
GREENPORT, N.Y. 11944
",S F� MFD 631 -477-9752 (Fax) G3 I -477-0973
SCALE I'=30' °q0
,\4, 05/14/02