HomeMy WebLinkAboutFragola Is,," q FFO(,f�
ELIZABETH A.NEVILLE ���'s �®
_ ®�'� Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
ae
REGISTRAR OF VITAL STATISTICS +,i Southold, New York 11971
MARRIAGE OFFICER Fax��® �e1 Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER � �®� ', Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER ��' southoldtown.northfork.net
OFFICE OF TTH�E�TTTOWNN CLERK
SOUTHOLD V1Ti�►S EIIVXTER I '. 111 SAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2869 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : DONNA & FRED FAGOLA
Address 1 : 138 OREGON AVENUE
City St Zip MEDFORD NY 11763
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 #R10-01-0199
Name Of Owner FRAGOLA, DONNA & FRED
Mailing Address 1 138 OREGON AVENUE
City St Zip MEDFORD NY 11763
Property Address 1 1145 GULL POND LANE
City St Zip GREENPORT NY 11944
Tax Map No. section 35.00 block 4 lot 8.000
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 8/22/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
i
.� ®`:l OFFf= X8(4
ELIZABETH A.NEVILLE �,%1=� Gy�: Town Hall, 53095 Main Road
TOWN CLERK ; ? ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �1 Southold, New York 11971
® �� Fax (631) 765-6145
MARRIAGE OFFICER ,L
RECORDS MANAGEMENT OFFICER \;��_"'* 40®0•i•', Telephone (631) 765-1800
FREEDOM OF INFORMATIO OFFICER ���� southoldtown.northfork.net
P., c.c 0-\1-r.. R
r, ,„ 3......."'" -1 •;
01l r OFFICE OF THE TOWN CLERK
t AUG T,202 '1 TOWN OF SOUTHOLD
,
•
TO. „.1t4 F Soutliold- T wn Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: August 5, 2002
Transmitted herewith is a copy 9f application No. 2972 for a Cesspool/Septic Tank Construction
Permit submitted by:
Fred &Donna Fragola
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
��
ecommendations:
APPROVE
, DISAPPROVE
�
��_ ,ice` / ��== ` .-, 7.00.",
Comments: -
Signature — 4
a V/
Dated '
\„J, ' .
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'
OFFICE OF THE TOWN CLERK �,�,,��"',•••�����
TOWN OF SOUTHOLD Application No.
FT.T7ABETH A.NEWT IP,TOWN CLERK s‘"&4, o� P P
P.O.BOX 1179 � j`
Construction
SOUTHOLD,NEW YORK 11971 ; _ '�
trr3 W, : Alteration
Telephone sVA. ..0I . $10.00 -Residential
••
((631) 765-1800 l �
,' $25.00 -Non-Residential
.----. .s,00
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 1/5/0
APPLICANT NAME: /, a.i/////19- / ; f/2 a/4
APPLICANT ADDRESS: /33 Q/2 eg v /Ale meat' /:5,///*1
SEPTIC CESSPOOL l '
DESCRIPTION OF PROPOSED CONSTRUC=ION OR ALTERA ION
Z 5-�2 / ' ,6. Wei/4
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: t-o//Z 5C1 bra& -35--e,® y. G2(
OWNER MAILING ADDRESS: // �v" ���N 4
!�-���v rDr2
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: �c
TAX MAP NO. : Section 33---- Block q , Iret �p
CROSS STREET: Aigt, /ea ( r25)
BUILDING PERMIT NUMBER CROSS REFERENC •
Signa iiff Applic t
RECEIVED BY: LOP
(� own Clerk's Office
DATE: �C�\ � a�
SURVEY OF
LOT 12
O �'� MAP OF g
25) , �, ELEVATIONSDOM vME REMAIN=TO s�rnQOA,u„ FORDHAMACRES SECTION ONE
(sit* 3. REFER to nun YAP FOR»� HOLE DATA FILE No. 3519 FILED MARCH 7, 1962
s NMIMUY 5' h-. 4' CAPACITIES FORA 1 TO 4 BEDROOM HOUSE e.t.mD GALLONS.i' SITUATED AT
1 TANK: e' OIA_. 4' LIQUID DEPTH
4. IM OM LEMMING SYSTEM FOR A I TO 4 BEDROOM HOUSE IS 300 eq *SOENALL • GREENPORT
A Poria r OOP, r ON REQUIRED
PROPOSED DAWSION Poop ,. ,VATION INSPECTI TOWN OF SOUTHOLD
PROPOSED I,J�.I1°FDo< SANITARY SYSTe
SUFFOLK COUNTY, NEW YORK
�,� j DEPARTMENT S.C. TAX No. 1000-35-04-08
AP �PII01'OSm LS MR SCALE 1'-40'
S. E 2001
5. TME LOCATION OF WELLS AMR CESSPOOLS SHOWN HEREON ARE FROM FIELD N 82.6615'' JUNE 9PR20013 R' NOTES
to, OBSERVATIONS MO/OR DATA OSTAIEED FROM 0111ERS. �'O� 46-10' JULY 7, 2001 SET LATH FOK u•EC. INSPECTION
D. UPLAND AIBJ1 s 10.425,4 R AUGUST 15, 2001 REVISED PROP. HOUSE LOCATION
PROPOSED HOUSE AREA a Zou M}M: OR LON Of Uruao AREA. 4`qN AUGUST 27. 2001 ADDED 50' BUFFER
�. TIRS PRQERIY IS D1 FLOOD ZONE AE(a. e) As SPOON'S ON `� ���Off` SEPTEMBER 25. 2001 ADDED 1.200 gol. SEPTIC TANK
• FLOOD INSURANCE RATE NAP No. 3sT 17® 0
ERNNED
IL ND ADDITIma ONAL FILL TALL RE NEEDED1PSE H.000 Emmons. `rF IP RE
1`t 't.P. AREA = 0.625 7.64 sq. ft.
$ � .emir- `"�"�'z
S .trc �,� e3.0= o
F• _
�� �"• sEr LITH .44..,0
TEST HOLE DATA s Ba-19, �� btrs ' - -- 9
(TEST HALE AS SHOWN ON PREVIOUS SURVEY)) •f `� 1`' �' ,= � '50, µ "N'i0/5721147 \\\\\\\ �7k
554
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1 ' OM w dC as1 alwc • -•/ �,si 0 * �, y • ��T� `� FRED FRAGOLA
..--�.� s al xi, e� _ �e u {p DONNA FRAGOLA
_�� wne r aI9�1 aAner 37EM Ne . \`\ 1 , �' LATH 1! . Health Seivices
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SUFFOLK COUNTY DEP =' ENT OF HEALTH SERVICES
• f " - PREPMED N ,... . TIM DIE WORM
PS
/ i. PERMIT FOR APPROVAL OF CONSTRUCTION FORA ��, + `` , ,,D ADOPTED
EHREMED
4O 2. xss USE r?�, ,•
, • STATE uIo
�� / SINGLE FAMILY RESIDCNCE ONLY '�9D `�.;1.-r
m 0 /�A•`'tip' .�,, I
PROPOSED SEPTIC SYSTEM DETAILHOUSE per ICI SCALE) r 1 — �Ck9 7 I a
I. `' I� ti S 6 44> DATE l GLH. REF• �1� I\ -. -,
Fill 10& F3Nar1°aIDE °m ,/ ��", r I• _ :
P.@m GAME /��.BS V APPROVED Ase -
I C -c�`�-iiJ�\ pia• `t''4�`�1 • -
TaP El.111•�. Ii "' TOP aj.
tea."` ' '��\ F FOR MAXIMUM OF (4 _BEDROOMS
lNN ♦'dA . i _ `�=`i —6�.Y S tic No. 496.86!
�� m FIRM PPE L5gignC LENSING l Ea(PIAES THREE YEARS FROM DATE nF APPROVAL j y`
73• nim FIRM 1/4%7' AIOl1 1/b'/1• ON.Pam, �„y' r P� .'b ��� TIB SURVEY IS A MQA ATE o
1...--63.---...1 °° F / 46.- I- 1 , e s-�-i_ .. ` LA TIS NEW Yana STATE
OR ®` e _�. ,jnge�®
�t COPES OF THIS SURVEY/MP HOT REARM ;` •
— 06IiWIfON L%xi.S OF BOT.Fl. ,� GROUND,.°IIT _THE WO SURVEYOR'S EE Land Surveyor
6.i�00L SYSTEM ELEV. 13 la BE A VAUD TRUE COPD.
CERTIFICATIONS MIMED
SNAIL FILM
SEPTIC TANK (1) 51Q tl O' LEACHING POOLS On CAR12)TIE PERSON FEN MEM THE SURVEY
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WOLF HIE rtb s�.rers — subdna°'rs — — carrtruetlon
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caMIaTE sr 11 ME A UMW COMMUNE SAlE1MIN s 3o0D,r Arm dors a 'ca. Ural.el a. TO 716 ASSTDEFS CF TIE MOMS NSTI- Fax (631)727-1727
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a A,o•IIA.BICE MIURA SEPII6 111•AIM MOUE S ALL E I6MDr®' 1107 SHOWNARE NOT RIYEIDfJID. N96 YOEk 11901 Fax
Nye York 11901-0965
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