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ELIZABETH A.NEVILLE �� 4y1 Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
REGISTRAR OF VITAL STATISTICS 'i Southold, New York 11971
MARRIAGE OFFICER 0Fax(631) 765-6145
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RECORDS MANAGEMENT OFFICER -�®l arig ��®�i��, Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER ���� southoldtown.northfork.net
OFFICTTE OF THE TOWN CLERK
SOUTHOLD WAGS 17EWA SOLUDISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2886 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : GAIL HANLEY
Address 1 : 33 DALY COURT
City St Zip RIVERHEAD NY 11901
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 #R10-02-0103
Name Of Owner HANLEY, GAIL
Mailing Address 1 33 DALY COURT
City St Zip RIVERHEAD NY 11901
Property Address 1 NASSAU POINT ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 118.00 block 3 lot 3.000
Cross Street BRIDGE LANE
Building Permit Number Cross Reference:
Issue Date: 9/24/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE ���h� '� Town Hall, 53095 Main Road
TOWN CLERK . % P.O.Box 1179
REGISTRAR OF VITAL STATISTICS °�
Southold New York 11971
MARRIAGE OFFICER `: /j/ �`��I', Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER �__ ®� ®',� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ���� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
r '' r - - --
TO: Southold Town Building Department ' i)I . i -
i
FROM: Linda J. Cooper, Southold Town Clerk's Office �J U, SFP j
S (;i.
DATED: September 17, 2002 ;k, * y .
` o t f;I,n,1,
Transmitted herewith is a copy of application No. 3012 for a Cesspool/Septic Tank Constructionj
Permit submitted by:
Gail Hanley
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
7 /r>p,_7(. .4. 7e,e,„
Comments: :- . �
'7 Signature
,/, --- 7,/ 2- 2_
Dated
u.
• •
OFFICE OF THE TOWN CLERK
,,`' ��....��.�'
F I7ABETOWANO VJL OWN CLERK ,,�.F SOUTHOLD ' S�FFOtk% Application No 3 0/
P.O.BOX 1179
SOUTHOLD,NEW YORK 11971 = Z Construction v
« Alteration
y
Telephone = 0,� O��•. $10.00 -Residential
(631) 765-1800 == 41 > � '� $25.00 -Non-Residential
TOWN OF SOUTHOLD
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SOUTHOLD WASTEWATER DISPOSAL DISTRICT
•
APPLICATION . : RECEIVED
for2002
• SEP 17
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL •
Southold Town Clerk
•
Permit No.
Fee $
/
� DATE 0 .9//&,/02_,
APPLICANT NAME: CAi ./-/AA)z. 67)/
APPLICANT ADDRESS: 3.3 DA Gc) u t y
;v r-_rant . Y 119o)
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION R ALTERATION
N f-��,� 3 =,-n a00-m s
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: r�Ar) J. /hiiz >
OWNER MAILING ADDRESS: bckLy ova-T'
OWNER PROPERTY ADDRESS: A1/45,1k/ / - Jidh3
TELEPHONE NUMBER OF CONTACT PERSON: 63/ - 020 y 41 4 /4
TAX MAP NO. : Section // 3 Block 3 Lot
CROSS STREET: 3, r o eye LAAiE
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
rm„ft I
IO LOCATION`OF
t SANITARY SYSTEM I
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,— — _ _ ` now or formerly
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Patricia Tennant
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LOCATION OF 1 1-- O 1
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SILTY SAND OSANITARY SYSTEM1.0'
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FINE TO — — _ _
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(SW) (Dwelling With Well) APPROXIMATE�LOCATION
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INOVOLI CO IS1?0trl111 TMENV OF HEASERVICES
lomat F APPROVAL OF CONSTRUCTION FORA s
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(� - APPROVED g:5oa
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EXPIRES THREE YEARS PROM DATE OF APPROVAL '--,g.4,2
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NOTE CHANGE(S) .
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AREA = 49,716 SQ. FT. ff`'"F
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• LOT NUMBERS REFER TO AMENDED MAP 'A' OF NASSAU POINT"
FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON
AUG. 16, 1922 AS MAP NO. 156.
With Pub�1C W°ter) • VERTICAL DATUM = N.G.V. DATUM (M.S.L. 1929)
(Dwe1lin9 • ENTIRE PROPERTY IS IN FIRM ZONE X, SEE FLOOD INSURANCE
RATE MAP 36103C0502 G LAST DATED MAY 4, 1998. _
– • ZONE USE DISTRICT "R=40" o
MINIMUM FRONT YARD = 40'
_ — — ––_ – MINIMUM SIDE YARD = 15'
' MINIMUM TOTAL SIDE YARD = 35'
Abs.op MINIMUM REAR YARD = 50' y e,
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' ✓/01. - -16 05 16.2 e11in9 W.th Pubic Water) SURVEYOR'S CERTIFICATION
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1 PR�� - I \ • WE HEREBY CERTIFY TO GAIL L. HANLEY THAT THIS � W.2
t I.N 3 Q \ SURVEY WAS PREPARED IN ACCORDANCE WITH THE CODE OF E-§
N i' o PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW YORK STATE
4 A, `�S0' I 6 0 1 ASSOCIATION OF PROFESSIONAL LAND SURVEYORS.
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