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ELIZABETH A.NEVILLE 1/0 'y%%
d Town Hall, 53095 Main Road
,
TOWN CLERK o P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ®
Southold, New York 11971
MARRIAGE OFFICER ,1' �1 Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER -'/od 411 $���I,�I Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ southoldtown.northfork.net
OFFICETTAGS OF THETOWNCLERK
SOUTHOLD WWKTEppR DISPVSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2907 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : CLAUDIO VALENTE
Address 1 : 23 REMSENS LANE
City St Zip FLORAL PARK NY 11001
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 #R10-02-0156
Name Of Owner VALENTE, CLAUDIO
Mailing Address 1 23 REMSENS LANE
City St Zip FLORAL PARK NY 11001
Property Address 1 405 HILLCREST
City St Zip SOUTHOLD NY 11971
Tax Map No. section 13.00 block 2 lot 8.004
Cross Street HEATH DRIVE
Building Permit Number Cross Reference:
Issue Date: 10/30/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE ��/j`r y�\ Town Hall, 53095 Main Road
TOWN CLERK ; y - , P.O. Box 1179
REGISTRAR OF VITAL STATISTICS
v, Southold, New York 11971
MARRIAGE OFFICER :�,1,,,/iLLL �����, Fax(631) 765-6145
RECORDS 11IANAG �TT OFFICER "'/Q1 #001 Telephone (631) 765-1800�-- OFTTF\R � ON OFFICER „',..,,r°�� southoldtown.northfork.net
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SES 2.t0 OFFICE OF THE TOWN CLERK
1k,, `1 ___ — TOWN OF SOUTHOLD
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TOWJN%.;.s '
0: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: September 30, 2002
Transmitted herewith is a copy of application No. 3024 for a Cesspool/Septic Tank
CONSTRUCTION/ALTERATION Permit submitted by:
Caludio &Margaret Valente
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
i.
DISAPPROVE
Comments: Maintain required setbacks from adjacent wells,buildings,property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED. ► '4 '` • 41.
2./e 1 e.ed..-t.e, .,_ i//-ed...•-ge< Z 2ty, e
7//#4,..c,9d G�
Signature
Dated 06/02_
...,'- 'a.
l F r
OFFICE OF THE TOWN CLERK ,��l 1 ULK
TOWN OF SOUTHOLD �� /'(CJ 11 CQG Application No. 00-1'(
ELIZABETH A.NEVILLE,TOWN CLERKy:
P O.BOX 1179 Construction
SOUTHOLD,NEW YORK 11971 T
to Alteration
Telephone ,f Q $10.00 - Residential
(516) 765-1801 '4Q, ')
- 0" $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 ' yf 2—
APPLICANT
APPLICANT NAME: ez.40i, /, Y /Vga& qprLf/
APPLICANT ADDRESS: „,,,3 ! se-4,s Gam,
f-ze. /*RIC N //a a l
SEPTIC X CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
! /v c% W / ir/Q, L)/ wcr L //,/
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 0//901 . 1. 0 Zr rn ?92Q,q,457- G
OWNER MAILING ADDRESS: ,,2,3f2g ji-7
_AL4./2gG_ Pi4Q K /Ay. //Dv /
OWNER PROPERTY ADDRESS: 4/O_ ,// 'e --S%
/9 7 /
TELEPHONE NUMBER OF CONTACT PERSON: ‘1/--,2,59--- 732 > .
TAX MAP NO. : Section /3 Block 02 Lot 8. 9
CROSS STREET: HA/T717/
BUILDING PERMIT NUMBER CROSS REFERENCE:
1,1
Signature of Applicant
RECEIVED BY :
Town C erk's Office
DATE: Q` `7-off,
t
SURVEY OF LOT 4:t2 N
'M, OF HILL CREST ESTATES, SECTION I"
1L IN THE SUFFOLK COUNTY CLERK'S OFF I GE A5 MAP No. 121E3 W I E
`SITUATE: ORIENT
roVN: SOUTHOLD
SUFFOLK COUNTY, NY S
SURVEYED 07 - 30 - 02
SUFFOLK COUNTY TAX #
1000 - 13 - 2 - 8.4 VaCt
CERIUM TO:
Claudio Valente m Et:16 2g5151
Margaret E.Valente \IPICIN <,'.5(/.� 3-
Vlv i1 <3,
'reS
el,lD \I Ill 1503°' e,_1,
-sei$ 34,40,tE 1
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;ELl� ia. .Vy: fs.� 9rt() J -,.�, '�� .C,•NS rCT ON FOR A
FINE SAND
LAYERS OF
SEPTIC DETAIL PROPOSED - r IAS-""�,� .5. �-� Fis bvr '° C' , -O. S(p CLAY
not to scale AC. .\."
P graosdesed
FOoka MAX,?M131'!?.OF__._DEDROOMS 13'
EL= 16 existing grade max 2'
man. 2' mc1
min. i' inv - cover inv. 13.9 l
EXPIRES THEE YEARS FROM DATE OF APPROVAIT- al -I- HOLE #4
cover 13.2 13.7
inv.- 900 gal.
13.mietic
1/4- perft1 F I LED MAP
leaching pitch
pools im. per ft
6' deep
min. 3' ,•''``� ‘C. EN(F -0
separation
ground water Q'
se'O ,u S ` 'Unauthorized alteration oraddition to asurvey
'A map bearing a licensed landsurveyor's sealis a
vJ C 1 violation of section 7209 sub-division 2 of the
1fa, q '`
New York State Education Law-
t* �,c�.�(l y� 'Only copies from the original of this survey
ilii]]] marked with anoriginal of the land surveyor s
,: .�� n. stamped seal shall be considered to be validtrue
/ 4--...'' �.. ,t 0 copies'
`/ /, % i. -Certifications indicated hereon signify that this
NOTES: fs,..,ts p • o v;. f survey was prepared In accordance with the e,-
t 0.:. ,�` ItJO Isting Code of Practice for Lana Surveys adoptee
I
�4���u�9 (� '. 9�7 t J,2. It.,r •/1/q - by the New York State Association of Professional
■ MONUMENT S3� Pt��S HII`Jl�;JV �.d,ra +, Si / Land Surveyors Said certifications Association
pn al]ren only
to the person for whom the survey Is prepared
and on his behalf to the title company governmen-
tal agency and lending Institution listed hereon and
A STAKE FOUND CS :7,1 1,18 Z I snv int
to the assignees of the lending institution Certifica-
tions are not tranafaraa,e to additional institutions
AREA = 40,050 SF OR O.G2 ACRES �11�'� .} 1 i JO` ' 'N C. EHLERS LAND S�J `� EYf'S' I!
G3M33.28 6 EAST MAIN STREET N.Y.S.LIC.NO.50202
GRAPHIC, SCALE I"= 40' RIVERHEAD,N.Y. 11901
369-8288 Fax 369-8287 REF.—TIGER\PROS\99-245
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