HomeMy WebLinkAboutCelic II �®OFFOL,
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ELIZABETH A.NEVILLE / �� Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
REGISTRAR OF VITAL STATISTICS :� � Southold, New York 11971
MARRIAGE OFFICER Fax (631) 765-6145
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RECORDS MANAGEMENT OFFICER -44 4:1''t
��® , Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ,•' southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
SOUTHOLD WUDISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2861 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : ROBERT CELIC, JR
Address 1 : PO BOX 1070
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 #R10-01-0127
Name Of Owner CELIC JR, ROBERT A
Mailing Address 1 PO BOX 1070
City St Zip MATTITUCK NY 11952
Property Address 1 300 NORTH LANE
City St Zip MATTITUCK NY 11952
Tax Map No. section 106.00 block 6 lot 32.000
Cross Street BAY AVENUE
Building Permit Number Cross Reference:
Issue Date: 8/22/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
.. 'il�s FFO it- K01
ELIZABETH A.NEVILLE iso 1• tk; Town Hall, 53095 Main Road
TOWN CLERK i ® a 1 P.O. Box 1179
c $ Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ® 47$
Fax (631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER .��_�®1 �a®�i��, Telephone (631) 765-1800
• FREEDOM OF INFORMATION OFFICER��,,r�'� southoldtown.northfork.net
11 L)
OFFICE OF THE TOWN CLERK
LFin 17 r ri W _-' Ili
I.: ; JUL 2 5 2002 !Li TOWN OF SOUTHOLD
1'0: Sourthf o Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: July 23, 2002
Transmitted herewith is a copy of application No. 2964 for a Cesspool/Septic Tank Construction
Permit submitted by:
Robert A. Celic, Jr.
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: ,00
77‘..c.,44")74.
Signature
®7 3 / ®,Z
Dated
rJ� 10
OFFICE OF THE TOWN CLERK i,,,�•,,,,,,•,��. CSI
FT,T7ABETHTOANNEVITOFSO.F TOWN CLERK
'�.THOLD � S�FFOLKcoG Application Nc lULI
P.O.BOX 1179 1.O
Construction
SOUTHOLD,NEW YORK 11971
v Z
cry Alteration
Telephone 0#t# �0 �•• $10.00 - Residential
(63-1) se
765-1800 --; 1l t, , r• $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION •
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE 2 3 (1)—
APPLICANT NAME: Q6bt.,,--t
APPLICANT ADDRESS: 1- 0 l(
‘f 11q4-2-
SEPTIC2 CESSPOOL X
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: /-)•e /) C,p
OWNER MAILING ADDRESS: f4 i31y /El70
7n�,77-u(/ � lv y ,,9s2
OWNER PROPERTY ADDRESS: 3' 4)g-y6''
Nr ��sz
TELEPHONE NUMBER OF CONTACT PERSON: _if/✓�2Y�
TAX MAP NO. : Section- 10 Block U LP Lot 39,
•
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Js-
'paw
Signature• of Applicant
RECEIVED BY: `k
h4 Town Clerk's Office
DATE: 11.7,'.
-...r -
" N/F IANI•l0 �' SURVEY OF
- ,_-_,- �,�"`' RESIDENCE 4 `j' ` PART OF LOTS I and J '
IN
� �`� �„(lI c{� ,�P00L MAP OF SHORE ACRES
p q w S 89° 44' 00" E
\..____—
\-- )=, 111145. 0' '- SITUATE
n 4-
I E,• 7 t %3, FDREMENANCE OF STOCKADE FENCE \ 125'id ii.
y
_.7 F,' OUND
z— \ ____ ,
' MATTI TUCK TOWN OF SOU THOLD
°' ,- ,� w: PROPOSED
w '� �� TEST O WELL N SUFFOLK COUNTY
v ��� � y; S N. 44 O
� P s
a rc, cn 10 r O 44 40' 0)
I1 \
S LIL 4A
Ev 4 E" L1L 4 OVERHEAD ----a— OVERHEAD SURVEYED FOR • ROBERT A. CELIC JR.
'f--.i w': \ c a� �' o-- WIRES— PROPOSED WIRES __
a 3 BEDROOM
= 59' TO CESSp00 R IDENCE
/
o.! P.43
�= :? T� 80' 7. 0_4„....___O CE�SSP
p c :� RESIDENCE o m �� FM 41
is \ C� co "' �\ '
t c . p 50 N/F BENEDICT FILED JANUARY 3, 1914
- / - "ROP USED RESIDENCE
P„ !`-� - E CESSPOOL ZONING : R40
S ,.3 El' ' 3' PROPOSED
SEPTI
PROPOSED 14 TANK
C ` / ELEVATION SOURCE PROVIDED
W PROPOSED ry
GARAGE SUFFOLK COUNTY EAST END TOPO MAPS
DRIVEWAY N \ N
- - TAX MAP NO.
O O
PRO SED / 46 O 1000-106—06-32
FOR S.C.D.H.S.USE ONLY 23' 50 o E ANS/ON 'NN Cp 150'+ TO WELL
' CD c) 150' TO CESSPOOL °
E� r 4 O 48 SURVEYED 15 MAY, 2001
SCALE 1"=20'
,.;,1-1 C) '=� . OVER o.s' 80' / \ —�_ AREA= 14,932.569 SF
�I== 155.24' �� 24.76'
``J , N 89° 44' 00" W °1P FD OR
._:%__I CU w;J, I,SOUND
` ASPHALT
GMe2, I 0.343 ACRES
t LL. t---r . -. ,
CJ {
(- - ',;. N- 'ti N/F SWEENEY
--� `_ RESIDENCE QLLI
I RESIDENCECt GUARANTEED TO t
TEST HOLE DATA it NiRFORMED BY McOONALD GEOSCIENCE aI v
ROBERT A CELIC JR.
16MAY, 2001 rj
FIN/SHED GRADE A= 45.40' , FIDELTY NATIONAL TITLE INS. CO.
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