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HomeMy WebLinkAboutPellegrino ELIZABETH A.NEVILLE O* Oy ; Town Hall, 53095 Main Road TOWN CLERK ` cm. Box 1179 y v, Southold, New York 11971 REGISTRAR OF VITAL STATISTICS �� Fax(631) 765-6145 MARRIAGE OFFICER s'' i1 RECORDS MANAGEMENT OFFICER 51/0l *i,,� Telephone (631) 765-1800 jig FREEDOM OF INFORMATION OFFICER ���� southoldtown.northfork.net OFFICETTOF THETOWNCLERK WAGWA SOUTHOLD S TESppRU DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 2913 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : JOHN PELLEGRINO Address 1 : 1803 WISTERIA COURT City St Zip BELLPORT NY 11713 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 #R10-02-0171 Name Of Owner PELLEGRINO, JOHN Mailing Address 1 1803 WISTERIA COURT City St Zip BELLPORT NY 11713 Property Address 1 LAUREL WAY City St Zip LAUREL NY 11948 Tax Map No. section 125.00 block 4 lot 24.022 Cross Street LAUREL TRAIL Building Permit Number Cross Reference: Issue Date: 10/30/02 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) r ,� "es t., a �il3 ELIZABETH A.NEVILLE ����_® 'y�; Town Hall, 53095 Main Road TOWN CLERK % O - P.O. Box 1179 CA% 2 REGISTRAR,OF VITAL STATISTICS v n� Southold, New York 11971 MARRIAGE OFFICER ;0,fiL �°��1�, Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER =__701 4 11) Telephone (631) 765-1800 41 FREEDOM OF INFORMATION OFFICER ri�� southoldtown.northfork.net TTw r :, ` t I j IJ OFFICE OF THE TOWN CLERK rE LIT�I NT200 '1, TOWN OF SOUTHOLD L._ -43Lf?li TO: ��, ,.�S;outh jd To Building Department To. N� . FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: October 8, 2002 Transmitted herewith is a copy of application No. 3031 for a Cesspool/Septic Tank Construction Permit submitted by: John . Pellegrino 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: , APPROVE1. DISAPPROVE Comments: '�: == .rte i�� Signature P l /c /�. /2— Dated • �. OFFICE OF THE TOWN CLERK •', �Ff __BCK/�� TOWN OF SOUTHOLD /.44° � CD A lection No ��� FI.i7ABETH A.NEVII LE,TOWN CLERK PP iPO.BOX 1179 • j Construction SOUTHOLD,NEW YORK 11971 • Z c Alteration �� Telephone = ,� �� $10.00 - Residential (631) 765-1800 = 01 41 .'��. $25.00 -Non-Residential TOWN OF SOUTHOLD e • SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION • for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee •$ DATE /07:71/) APPLICANT NAME: 14-AI �. �� L L F���6vd APPLICANT ADDRESS: // ,0,3 TE/e/,¢ C , Pog 7- Ad - f( 7/ 3 SEPTIC V CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION NEw RE SI )5A) mg-L C©NsT C -? O / A-r LA v RE L / A) (c$ / 1 zs -- p — LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:. OWNER OF PROPERTY: p -/ti) /4-iv 1 - � L L_ FF 2i„.-a OWNER MAILING ADDRESS: I kD 3 w c S"`li•1=j ( f1- OWNER PROPERTY ADDRESS: 1-A-U kEL 1\--1 TELEPHONE NUMBER OF CONTACT PERSON: (p 3 (- % O3- 7 2,'/b TAX MAP NO. : Section 1 ZS Block D t Lot 2 2 "Z— CROSS STREET: L 2£L j 2 A- I BUILDING PERMIT NUMBER CROSS REFERENCE: Sig re of Ap•Iican RECEIVED BY: Town Clerk's Office DATE: I r 4.I • -1 i F f .,_I t I • OPEN SPACE ;,:_,,- f; _,- - ,f _ , `C fj • PARCEL 'A, R = 2E;5.04' VACANT . L = 28. 03', S 74'46'35' E R - EL, 61.f33' L = S�' 00' ' -.-'(*P, "`.:4 ! T— 32.!' , 07' yS 'gypthe#+' i° ;1"i.i t"� ._!f' J1.' z`L FI S.iStSERVICES N 3$` ,4 • ah�.,:. ‘.-,J;.: -.,,, .`y, , ;�i,�, 0.... �, F ,-,F _ i Vim- 4. I 1 9 �• r-� t i .'d� u / 1 ar API'4:2,2:VIn ..elet/tif 777:3 . .i.z) ' \ -----------.----7, ate.;i„ 'a...LM' 46 .N°: EXPIRES! ELESE:1.nAm RCe;1C'l DATE OAPPROVAL P dio kli 0 nn al 0� / �� PY / FIS , �. - J �� N Z O© CI INT ,` r, T giSf kw 1 KEY MAP: ` ! y , I _ . . ...-;,4-=-7,...-4767,1 A ,�44 �7.VI / c-, Itl.Alle,v ri 14 1 �- p .1 , �- pt 3 / o� s T Y -.2: 11b-,-.A47, 14.;-,7i1a v3 • :-..-•-,t* a *-- ,..t,Nifsiii -_, ,1,143 11 i i �```�, ;t SEAL: - ---� . PROJECT: PELLEGRINO RESIDENCE "'c�?`©o �G 29 LAUREL WAY • u��D I � ;;c�r ��:CNcEr�t,�� /��� LAUREL, N.Y. D UTILITIES ,` o EL 30.7' ; `EL. 292' / ,� • 0 N 74'44'34'1, V 119.00' leo ' c.zy;: ='' �. �.. . TITLE: s s , ii, i • LOCATION PLAN ---------------- �• � x454$• � ` �Sy OF SCALE* DATE: ' LAUREL WAY - 1" = 30'-0" 8/16/02EL. 7' Loc%T I ON PLAN I5,�FI2 UPON (ASPHALT ROAD WO KEVIN V. McCRAY ARCHITECT DRAWING NO. sU�VSy 1EZ,=rgsi3Y 16 TAFT AVENUE P-.coNlc �Ug-VU),PIts C. 'N 4/2C9/0"2 . ISLIP , N.Y. 11751-2131 ��� TEL: 631-277-8545 FAX: 631;859-3627 1