HomeMy WebLinkAboutMason V
ELIZABETH A. NEVILLE ��' • va• Town Hall, 53095 Main Road
TOWN CLERK ® - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS irr',i Southold, New York 11971
MARRIAGE OFFICER Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER `���®1 At ���i�/ Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ��'� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2939 R Residential X Non-Residential
Fee $ 10.00 septic X Cesspool
PERMIT ISSUED TO:
Name : NORTH FORK MANAGEMENT
Address 1: PO BOX 696
City St Zip AQUEBOGUE NY 11931
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 #R10-00-277
Name Of Owner MASON, ED
Mailing Address 1 7 PRISCILLA AVENUE
City St Zip HOLTSVILLE NY 11742
Property Address 1 1045 THREE WATERS LANE
City St Zip ORIENT NY 11957
Tax Map No. section 15.00 block 6 lot 16.000
Cross Street NORTH SEA DRIVE
Building Permit Number Cross Reference:
Issue Date: 12/17/02 Elizabeth A. Neville
Southold Town clerk
(TOWN SEAL)
.� .. -
^- .L ////ilii�_� �9�
�0,o%gOFFO�,��;
ELIZABETH A.NEVILLE �� � OG'y� Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR,OF VITAL STATISTICS
�y, Southold, New York 11971
MARRIAGE OFFICER
Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER y'�Ol *0���'' Telephone (631) 765-1800
FREEDOM OF INFORMATIONIOFFICER ro�� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
\ ! OGT 3 1 2002 '.._�' TOWN OF SOUTHOLD
TO: , ' Soufliold To Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: October 31, 2002
Transmitted herewith is a copy of application No. 3058 for a Cesspool/Septic Tank Construction
Permit submitted by:
N. F. Management
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: y
-. ice? I
•
Signature
11/1/A._
Dated
OFFICE OF THE TOWN CLERK ••,•••..•...,
ELIZAB
TOWN OF
TOWN i‘4‘
� � Application No. 17 J
P.O.BOX 1179 %�
Construction L..
SOUTHOLD,NEW YORK 11971 ; _ • Z ;
Alteration f
00-_„
Y r✓
Telephone ; oy ����•• $10.00 - Residential
(63-1) 765-1800 =�l ,• $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 /GfA/2._
APPLICANT NAME: - /j,1;
APPLICANT ADDRESS: .,ft AtQaf/� J Y �7 3/
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
it)j) SOUJA 1,:9 ,/7' /741i
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 1,0 f/-?5cT,e9
OWNER MAILING ADDRESS: 7 Zc///,, U�
mpkisp/az_ JLo,' //77,2—
OWNER
/77 2OWNER PROPERTY ADDRESS: I®� aChree 1^Id L�
lieA& I)3Y M57
TELEPHONE NUMBER OF CONTACT PERSON: ‘3%-- 7;2-5&967
TAX MAP NO. : Section IJ Block Lot /6
CROSS STREET: %fl'' it10- /$
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signa r of Applicant
RECEIVED BY: (011b1---\
T wn Clerk's Office
DATE: 1013\ ��Z
CERTIFIED TO:
SURVEY OF LOT # 36 N
�� Edmund D. Mason
MAP OF "ORIENT BY THE pkFc,EI\IE� and D. Mason
SECTION #I W e s E � � Q ��( Gommoh Land Title •
nseance Company
FILED NOV. 21, Ic151A5 # 217 p>< 2� �0
ORIENT nL��l� � "3
, � s
SITUATEsR d\
TOWN: SOUTHOLD � c�r ? � �,, � ���
SUFFOLK COUNTY, NY
SURVEYED II-16-00
amended 02-17-2001, OG-07-2001
,,_
SUBJECT TO CONVEld/WTS&RESTRICTIONS LIBER2'`7ooL--/4-9
SUFFOLK COUNTY TAX # �� � o p �--- ---"'
1000-15-6-I6 S C a', DrRvie
opprox existing
well 200±
from proposed septic
Lott ° 35
I
approx I
exlstmg m _
T opprox ^� well m I a L
• Lot #90 existing o•o� . 6s�
septic eeQih c- 0— 6
egL^iSE/9'' I o,0-75
es9 e�O� r 0 �-6"
9pE,cot I c y)�0
Qac fo% / _ v66L
egL.
o% r NOg0E
hooaQ K � � 010
SCOyo /oh d r 0
1 S e//
0
\ e1=21 . S88°5 '40" C 125.00'
0
P
approx P o/ }({7/�Vmay
e
septic Igo,1 ® e) well
(DL__ prod 2_ O
_ �e//
36.33' - .`
- _Ot# 36 Q -
cn �jI'Seof/ Proposed C al o o o
e ` Dwelling W /` �9 o N
'Prop \ �� c
a) `— �i J -- � Well `
=mow �� - •
° � 66d
N , \ / �� OE
L/1 CCS rT� I•' •/ i' HO' -,a 0
to prop dell , 6 Q rn4
Lot #93 rn ® ;i, ' ,Proposed Driveway 1�
vacant -fl � i/ ,_ - '- -- - PlNI \ \
building envelope \
as per pre-existing ® \n\\
O 0 •® non-conforming pre-exing �J
1J
o � vi
® V)
Ste+ eI=2I
w e1=21I N88°57'40"W 125.00'
Fo n –
ee+gi4f 6aL
I `�l jse/h9ll 11 ons"0 U)10
slave/i <2 cs_ �,a�n)
Q,-, S �. •�ER�/ICES m 9
Fco.0 1 SUFFO'V�C' Ir_INTY DEPARTMENT OF t-i.. ,d. Q - o
p o��seE/�h
approx Ah vat a i c 6 S t_
existing
ept 9 \ic t��oP PERIWT�'F"O:?APPROVAL OF CONSTi UC ° E/ ''` A i n o o
C O K Jj � O�L
0` i SINGLE FAMILY RESIDENCE ONLY approx a
' gyp '– OPT' 02� leling
DATE /- 0 O._. HS y' —.� O.
Lot #92 it ,, ''7
APPROVED )/ LA,'
OR MSM OF.BEDROOMS
,/ .
•t IRES t"HREE YEARS FROM DATE OF APPROVAL
OR SANITARY SYSTEM
approx existing - BY �����T�;��PAt`'TA�Ei�4T .. ... . ...`
well .ii...:.�
from proposed septic /`� N
,/ of Ei _
in accordance with ., : t , Revitvw �,�'�. G. EIi fr
A:�prove� Q. �. Vnouthorized alteration or addition to a svr
QIP 7 •
., _, r 4 snap bnarb�g a Ucensed land sth,-diors seal I.
lalotbn of section 120a,sub-division-L,of
' 1 �, ; New York Stale Edxntlon U
(' 1 , YJnItj ropies From the original of Ihls su'
/�/J,%//�/�' rd seal shithall
ll a kpolconsidered
of the lob survey
/ / /V' - / / ' ' ` Li* 1i',1"--1.1f ; slmn(etl I stroll be conzNered to be va d
NOTES: ` n,ig M�_�: � 1 ^r ertlFaae s Indicated hereon mfy enol
rrr.r<.i�,� �Q • ,,,,.rey roan(x nfrared N occoreance wifhathe
■ MONUMENT �(l � � ti / slNg toes o7 Practice far Land e n ey
O �`(`.I by the New York State A,socbllon of Profess)
�ti� ,-� nV I Land S�nve,ors Sold certifications'holt run
PIPE Lo the all far whom the omp f Is orept
�� e0 05 /I his erhon to ehe Nt la sure ed 9o"e
0 •� L D // tai agency old lending institution listed hereon
..�'a.e/S° eo tna ozevg ee.nr u,e Inwwg lreutuunn r eru
AREA = 12,500 5.F. OR 0.201 ACRES an,a m,fernle to adtlitbnl ,tltm
�'l D SU 4 VEY-LP'
TEST HOLE ON FILE �� �'
VARIANCE J'?� N C. �UT !; S �.I N.Y.S.LIC.NO.50202
HELLSTORSEQPTIC -RES MIN. 150'1LES5 REQUIRES A R6 EAST MAIN STREET
WELLS
�* g)yERHEAD,N.Y. 11901
�RAPHIG SCALE 369-8288 Fax 369-8287 REF.\\HP SERVER\D\PROS\20-2
WS ool 9,46,55,1 \ -SERVE.,,bz,\sao-tee
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