HomeMy WebLinkAboutBooth /����®ktFFO(,�-c
ELIZABETH A. NEVILLE ���� OG'td; Town Hall, 53095 Main Road
TOWN CLERK d P.O. Box 1179
; S
REGISTRAR OF VITAL STATISTICS
� outhold, New York 11971
MARRIAGE OFFICER ��,�. ` �I,, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER �WQl �a�I°i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ��� southoldtown.northfork.net
OFFICETOF TTHgEpTOWN CLERK
SOUTHOLD WAS EWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2925 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : HELEN BOOTH
Address 1 : PO BOX 23
City St Zip . PECONIC NY 11958
. 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 #R10-01-0247
Name Of Owner BOOTH, HELEN
Mailing Address 1 PO BOX 23
City St Zip PECONIC NY 11958
Property Address 1 405 FASBENDER AVENUE
City St Zip PECONIC NY 11958
Tax Map No. section 67.00 block 6 lot 5.000
Cross Street SOUNDVIEW AVENUE
Building Permit Number Cross Reference:
Issue Date: 10/03/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
,/o°,o\,S�FFOL�-co'
ELIZABETH A.NEVILLE ‘ 0?5, 6 .
��'_ Gym Town Hall, 53095 Main Road
TOWN CLERK O r4 1 P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
Ts
MARRIAGE OFFICER N.siyi �.i Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER -_"9Q1 �a�#0 Fax
(631) 765-1800
FREEDOM OF INFOl3.MA_ 'Y' N OFFICER �,°a southoldtown.northfork.net
C Vis---.- k\2J\OFFICE
,;\
`tF..'` � t 6 on OF THE TOWN CLERK
` \CA OC TOWN OF SOUTHOLD
TO: � o 'Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED:
Transmitted herewith is a copy of application No. 3044 for a Cesspool/Septic Tank Construction
Permit submitted by:
Helen E. Booth
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:
APPR V
OVE
DISAPPROVE `
Comments: 7),(,e, -- 1/ 24:y-p-A-21"f-P. . ?-74-e-cA-0- 14....._
Signature
749/ /r7--
Dated
9 / /r7--Dated
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD ��' ,eJgFQ Application No. 3 0 q
ELIZABETH A.NEVILLE,TOWN CLERK i �O t:X;
P.O.BOX 1179 .6GConstruction
SOUTHOLD,NEW YORK 11971 v T
,
Alteration
Telephone • $10.00 -Residential
(631) 765-1800 = '4L ' ,,, $25.00 -Non-Residential
•
TOWN OF SOUTHOLD •
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE a-31-- 2e - Lop 7 _
APPLICANT NAME: /16---Z 'O'c'p7 /,71
APPLICANT ADDRESS: / c$ — Pols 2
,PEcom t G I oki . Y. T/T-6^R
SEPTIC (.7-CESSPOOL V
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
-61-714 .e,atiot
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: •
OWNER OF PROPERTY: 6 oefj7rf
OWNER MAILING ADDRESS: 46S Pd 6 2-.3
jfq s—g
OWNER PROPERTY ADDRESS: Qom— P45 b cl e L AZ
e kr C----
TELEPHONE NUMBER OF CONTACT PERSON: 16s - ci 17
TAX MAP NO. : Section itifia4 Block di:. Lot 0.5—
CROSS STREET: Saa✓vt,c 1lleziAl fj.Q
BUILDING PERMIT NUMBER CROSS REFERENCE:
e _
Signature of Applicant
RECEIVED BY: .VvIU •
own Clerk's Office
DATE: f l) [ (,1 7O
I
-ti:UB No 01-40 TAX I D No 1000-67-06-05 '
]
Al
s , ,
,\ ,
1 .
\
1008 EDGE OF OIRTROAD
- - - -- -
-— — — __t002 FASBENDER AVENUE [50']
—-—-—OVERHEADUELITIES -—- — PO -- -- —
LE---—
AREA OF POo-LE
EXISTING
WELL N 62°45'00"E 102 30' I
U>O 1008 •� A 4 995 350'TO MILL ROAD tt-
G /
'2, Z0 Il g5I
L to
41 D, / PROPOSED 64'X 28'
c1 BLDG ENVELOPE
of 1 of ! 161 /
35'FRONT SETBACK
G9, 7, 1 2 I _ i j - 0 2'FRONT SETBACK[SOUND VIEW AVE]
ma m �1 X98cc
10'SIDEYARD
!G 11 Is, 7 E STING 1ST DWELLING / too
1� I , , Im " gib' 8.. I Pt 4CC E'-IST1N6 LE/CxFr8J(�
r-�-'- o
nLo zee rti' -Pcx'L r4C-COPS Ann-T-1473,. 3 VILt po -o2.1c0(0 LL: Nt1.)GZ Kt>vC2S
I p0: m
�L o m
ACI
j E O °- ,9 Zt=PIPE w1Tt+N=W LE'Cr PVC
n
• ' •YSTEM1
\
—' / I ,'A— I t ' g e3)-TNS7At.L.CAST I RDt� ce,x-P.,
v?
9 -, SEPTIC TANK'Q 76 p 2. `
\ \ 1 1NO3LFS i Z ----co etlerocp= 0)3`.i�S'-CIC TA JK
Ydo\ ,1\ UV KJ m I
POt\
F\
�A S - W OGD
cv
\ /�,� SHED
\
\
1058
1059 S 62045'000W 46 70'
101142 uVC4•
See rno¢e.S 0 2 3 net,- = I17.
SUFFOLK COUNTY DEPARTMENT OF HEALTH SE'VICES
PERMIT FOR APPROVAL OF CONSTRUCTION Fo-A
SINGLE FAMILY RESIDENCE ONLY FIRM MAP No 3610300161 G
FLOOD ZONE X
DATE 4-z-,t-'-'•-• RS.REF.No., lh •.0 -10,
APPROVED C/� ' V - ,
FOR MAXIMUM OF jou 4 EDROOMS
- EXPIRES THREE YEARS FROM DATE OF APPROVAL PRELIMINARY MAP
FOR BLDG PERMIT
ELEVATIONS IN ASSUMED DATUM FILE No 1097 9/26/32
---- --
- - - - -----
r «
Unauthorized alteration addition to this document Is a violation of Section 7209
' of the New York State Education Law SURVEY OF LOTS 6,7,AND 8
Certlfl Ions Indicated hereon shall run omy to ilia person f«wham it is prepared
and on s behetl to the Tttle Company Goemmental Agency and Lending MAP O F BAILEY PARK
Instrtulionssubsequent
toted hereon and to the assignees of the Lending Institution or
subsequent owners
Copies of this document not bearing the professional's inked seal or embossed 1 PECONIC,TOWN OF SOUTHOLD
OF NEW y seal shall not be considered a valid true copy
�� O The offsets I«dimensions i shown hereon from structures tome property lines are
P for a epecffw purpose and use and therefore are not Intended to guide the erection of SUFFOLK COUNTY, NEW YORK
•r fences, nimng walls,pools patios,planting areas,addiction to buildings,of any other
C �
DESTIN G GRAF
R LC
�rTnhe existence right of ways and/«easements of record,rt any,not shown me nteef SURVEY DATE' 8/23/01 L 1 =.3D• .
- -- -- -- ---- -----
--'2,...-
�✓r „I CERTIFIED ONLY TO.
N 4.4.,•
; '`;:),,,, 'r:I Iris% '1.1ri 1''t HELEN BOOTH DESTIN G.GRAF
:.� 0;) _ — — __. _ ____ _. ,
LAND SURVEYOR
J jn
.) u'L f, 73 Woodlawn Road `
V ` I�i„ ,,-, �.�--�_ --- Rocky Point,New York,11778 - -
fi?� ��� '�' ,"S - ---------'---- -- 631-821-3442
— -- --- -- By DESTIN G GRAF N Y S_LIC NO 5006Y-- ----- —�— --