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ELIZABETH A.NEVILLE ,�//_�' may Town Hall, 53095 Main Road
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TOWN CLERK ® P.O. Box 1179
REGISTRAR OF VITAL STATISTICS
Southold, New York 11971
MARRIAGE OFFICER V'S
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Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER = ®1 40„.0 Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER ��' southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
SOUTHOLD
TOWN
SWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2932 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : SANDRA SAVAGE
Address 1 : 1814 MIDDLE COUNTRY ROAD
City St Zip RIDGE NY 11961
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 #R10-02-0133
Name Of Owner SAVAGE, SANDRA
Mailing Address 1 1814 MIDDLE COUNTRY ROAD
City St Zip RIDGE NY 11961
Property Address 1 EAST GILLETTE DRIVE
City St Zip EAST MARION NY 11939
Tax Map No. section 38.00 block 3 lot 16.000
Cross Street CLEAVES POIUNT ROAD
Building Permit Number Cross Reference:
Issue Date: 10/30/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
4, k
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ELIZABETH A.NEVILLE i$1.0. 1‘ Town Hall, 53095 Main Road
TOWN CLERK H P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ® Fax(631) 765-6145
MARRIAGE OFFICER �� ``��1+,
RECORDS MANAGEMENT OFFICER =___®1iNg ��®iii Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ ���� southoldtown.northfork.net
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OFFICE OF THE TOWN CLERK
V:, ' - TOWN OF SOUTHOLD
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TO:- ; r_-Southold,Town,Building Department
FROM; �Y"""`Linda J. Cooper, Southold Town Clerk's Office
DATED: October 28, 2002
Transmitted herewith is a copy of application No. 3052 for a Cesspool/Septic Tank Construction
Permit submitted by:
Sandra Savage for Rodriguez
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
Comments: {
Signature
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Dated
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OFFICE OF THE TOWN CLERK ,,,,;ff/••••••
RTT7ABET TOWN
NOF SOUTHOLD ILLE,TOWNCLERK ‘4.�%c�VFFOtkce. Application No.)3c>>
P.O.BOX 1179 ..
SOUTHOLD,NEW YORK 11971 i.... Constructioirn
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fit• 1S1f Alteration
Telephone .0�� �s r . $10.00 -Residential
(631) 765-1800 = �l 4a 0'
„„.4.0� $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 Ibiza/62-
.
APPLICANT NAME ',rigw2_ �' b „Stn G
, -A-pe....
APPLICANT ADDRESS: OW
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SEPTIC VCESSPOOL ,
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION ?49965e_d' 01 1 `- -- L --fir .v61OD/d 6 Ci
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: e' gi/ _ 1)r e/Lia'/q�
OWNER OF PROPERTY: rgLkP2 46 lGwLGr.v
OWNER MAILING ADDRESS: (l /7 ) 0.--A-L Ili Pis
tC ) ioy it9Lo/
OWNER PROPERTY ADDRESS: 0)- 03ItL. ir
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section 31 Block 3 Lot //O 0. ,.3
CROSS STREET: 0)-4_.(itS ;
BUILDING PERMIT NUMBER CROSS REFERENCE:
04 , .
( � ^ tgnatur of App 'cant 40RECEIVED BY: '
[Town Clerk's Office
7)ATE: ID In 10v
DISTRICT: 1000 SECTION: 38 BLOCK: 3 LOT(S): 16 & 23 1
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S.C.T.M. NO.
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_RECE1�rE0
DWELLING X01..1»» (� �
2002 SEP 13 1110: 51
130VACANT �ICE k�IAST fc1�F9
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U.P. LOT 36 I LOT 43 z
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CORNER N64"51'10"E 169.74' CORNER
CL 7.67 p
mCL 7.48 13- EL 7.4
w EL 7.3 N NYT#11 -
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ILOT 44 WELLINI O•
N -y LOT 35I a O
EL(8.5) EL(8.5) 50.0' D 17.01
I r PROPOSED WATER SER•VI•CE 46.0'
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1 STRY FRM. M1
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DI 6.5 � CO 275" EL(8.5) EL 7.0
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1....1 to EL(8.5)
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CL 7.04 I EL 7.5 07.41
DI 6.6 I o EL 6.7cc
D PIPE S64"51'10"W 172.90' 3
0.8'N
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LOT 34 I LOT 45 F
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VACANT DWELLING
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ELEV. 7.0
EL(8.5) .,- DR BROWN
EL(8.0) EL (7.5) FINISH GRADE SANDY LOAM 2.
Z BROWN
1O'=2.5" Z Z LOAMY
1/4"-FT. 1/8"-FT. io SILTY SAND 3.3'
I" 6" COVER 16'-Y 6' COVER
Q ^ , 6" SLAB BROWN
INVERT-/ ‘I INVERT pOj�IT g�� SILTY SAND 5'
(6.44) (6.24 INVERT 1 INVERT CLEAN°
(5.74) (5.58) BROWN
FOUNDATION TANK 1 , B' 8'0 FINE TO
WALL MIN. POOL COARSE
'-7" 2' WATER EL 0.3' SAND 6.7'
I SUFFOLK COUNTY DEPAR RFI VIRES • WATER
IN
PERM'FOR TO
FOR APPROVAL OF CONSTRUCTION FOR A EL(4.0) BROWN
I
SINGLE FAMILY RESIDENCE ONLY COARSE
/�,` ., SAND
DATE q "
��'Z HS REF.NO. CI' -° -�0 C HIGH SEASONAL GROUNDWATER 1]'
f ,.. I [III_
ATION INSPECTON REQUIREDAPPROVED ,ISrSi-EBY: MCDONALD GEOSCIENCE
M
3-27-01
FOR MAXIMUM OF OOMS Y HEALTH DEPARTMENT
a ''m !U 1E RM1101 g•OPVPL THE WA TER SUPPLY, WELLS AND CESSPOOL
LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS
�-y-- •-- FIRM ZONE AE-9 AND OR DATA OBTAINED FROM OTHERS.
AREA: 21,416.66 SQ.FT. OR 0.49 ACRES ZONED R-40 ELEVATION DATUM: N.G.V.D.
UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCA TION LAW. COP/ES OF THIS SURVEY
MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION
LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE.
THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
c' NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS
I- • AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY
'.,, , , SURVEY OF:LOTS 35 & 44
CERTIFIED TO:
MAP OF: MARION MANOR - HOMEWORKS MODULAR HOMES INC.;
' , . FILED: MARCH 18, 1953 NO.2038 vs •-,. %.1 •• 'a-
-
SITUATED AT: EAST MARION •'~ �a 4_.;'• L`
SOUTHOLD OLD '" - r...
r TOWN OF: _ _ • 1' ., t,, = KENNETH M. WOYCHUK L.S.
SUFFOLK COUNTY, NEW YORK
(L",-:11.17)
'. ""�`'F"�J ' r�_ Land Surveying and Design
^0 P.O. Box 3, Mattituck, New York, 11952
FILE # - SCALE: "- DATE:�fU N 1 2002 `' , ( .;,, `c\G PHONE (631) 298-1588 FAX (831) 298-1588
22 107 1 30 E 7, N.„V, ¢ Lai , ,\'&1227
rT•;y I�h� maintaining the records of Robert J. Hennessy
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