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Naoum
�5% ELIZABETH A.NEVILLE y� Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 i REGISTRAR,OF VITAL STATISTICS $ Southold, New York 11971 MARRIAGE OFFICER ?°� • ®�� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER ®1 �►� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT - APPLICATION OPERATION PERMIT CESSPOOL or SEPTIC TANK Residential @ $10-Zor Non-Residential @$25 Application No: Permit No. 6S •7 Owner NameMao C4 -Im C,(,a zz j ULA O Owner Mailing Address df;S=3 S 2,704-A Owner Property Address Z4!5-3 g ?-zz 3?) c �/SUJe-2 l L41 Ga-M��� N'`l Owner Telephone No. [ -7 -6!9.S -0 Z Tax Map No: Section 1-t�O9 p ock� _ Lot _ Cross Street Pi to e Trete Please check each that applies: New Construction ✓ Alteration to Existing System Residential f✓ Non-Residential NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. (Locate building and system; give north arrow and approximate distance in feet from system to building and closest road. New construction may submit copy of survey with SCHD approval.) 3 /zgh-6 , 7 n Signa re of Applicant Date Received by: z 1 I , SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 4500-R Residential X Non-Residential Fee $ 10.00 New X Existing Name Of Owner CHRISTINA NAOUM ------------------------------ Mailing Address 1 45-38 220TH STREET ------------------------------ Mailing Address 2 ------------------------------ City St zip BAYSIDE NY 11361-0000 -------------------- -- ---------- Property Address 1 337 BITTERSWEET LANE ------------------------------ Property Address 2 ------------------------------ City St zip CUTCHOGUE NY 11935-0000 -------------------- -- ---------- Owner Telephone No. 917-693-0320 Tax Map No. section 104.00 block 2 lot 7.004 ------ --- ------ Cross Street PINE TREE ROAD ------------------------------ Issue Date: 4/03/17 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) SURVEY sO uAPROPERTY � 1 CUTCHOGUE G> TOWN OF SOUTHOLD NEW YORK F, SUFFOLK COUNTY, � S.C. TAX No. 1000-104-02-7.4 I =V SCALE 1"=50' JULY 25, 1998 `o' APRIL 14, 2005 ADDED PUBLIC WATER a3 f` 00 `ro. FEBRUARY 6, 2007 REVISED MAP .8r&di! O s "d7 N Os FEBRUARY 12, 2015 ADD NEW HOUSE w, MARCH 9, 2015 REVISE PLAN �0 JUNE 13, 2015 FOUNDATION LOCATION \` ' r FEBRUARY 7, 2017 FINAL SURVEY ZA MARCH 16, 2017 REVISED AS PER SCDOHS < 2Z \ \ AREA = 57,686 sq. ft. LOT 2 1.324 ac. , 2• % ` o • NG � \ tFg� NOTES. 8. ( Q�N�gJC SNP � WELL. GL 1. ELEVATIONS ARE REFERENCED TO NAVD 1988 DATUM ® ["9 g ^�p N EXISTING ELEVATIONS ARE SHOWN THUS: �s 1Y i,D�S_] U� aL 2. THIS PROPERTY IS COMPRISED OF P/O LOTS 51, 52 R 53 HOW0� � "0\ l �. 1oJ MAP OF NASSAU FARMS P_ LOT 1 �2`P_ 43%ON o FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY 1 llJ`'� c3 c;°g' ON MARCH 28. 1835 AS FILE No. 1178 0d 9�\ ° » c O 3. LOT NUMBERS SHOWN THUS: LOT S REFER TO ® !�', r� $ to �� O % Vs SUBDIVISION MAP FOR MABELLE DEMPEWOLF LL ff��� l� CP,C1( } '�o\\ `'� jq- 3 % S LAST DATE REVISED DECEMBER 5, 2005. ® �1f ,{� �I p �clrglg ,\ a o ` C�6 p/0 LOT §37 ` )tift O L- 1 ,._-> O 2 f FOUND x,301 SEPTIC SYSTEM TIE MEASUREMENTS •I 1 �� tJ� \\ ' -----® PIPE ul Q N% HOUSE ❑ HOUSE ❑ O l3� \ - --- wee o CORNER A CORNER[fl CESSPOOL Spit .00H - ro o� SEPTIC TANK COVER 24' 46' c COVERING POOL 38.5' 54.5' LOT 3�tr tq� p/0 LOT(p N LEACHING POOL FOUND p GI COVER 2 54' 66' °`oC ��' PIPE LEACHING POOL ' COVER 3 42.5' 65.5' s `\ J pi' / 01% W o LEACHING POOL COVER �l y� 0 COVER 4 55' 73' TEST HOLE DATA .22 ,Lo \ , 0 o (TEST HOLE DUG BY McDONALD cFOscIENCE ON JULY 2$ 1998) N bra 0 p0 Z \ • O _ R ELEV.zo z D RKBROWN SANDY LOAM OL O 1' Sk BROWN uwrr SAND SM LOT 4 .10 O o05f._IOtc O Y. 0 �PREPARED N ACCORDV6E WRM THE MMU M �••-^Q<` 7N �W PALE BROWN FINE SP YI� 150' N , o I N 1._.1 1p m'..0 WE;6'L �yar iE wo TO MEDIUM SAND r p S I SR' r O G1 'Ss°vw �► O I p/0 LOT© y �d v, I D � ; co �� 1 • i� � PIPE ( �' •! A PRY 1S IP ALONG WIRE FEN�•E OO ' j � f Y., ? GROUND WATER WA,ER IN PALE BROWN FINE To MEDIUM SAND SP � �{1KG I SNC UWP GN�Q ,r 1P Ur yE I FEN COW. 0.3'S 1.3�W 00 I 0.5'S, 1.2'E t �J� ISO. ONC. FOUND N W FENCEt��Gf . .S. Lic. No. 49668 FOUND M FLOORCONC. 1. 2'S,8 43' • UJ I 5 v FOU�JD 2ND 0.5'S CM NCE tui :j UNAUTHORIZED ALTERATION OR ADDITION FENCE FENCE CM 27 qj c.-...� TO THIS SURVEY IS A VIOLATION OF 0.5'S 0.6'S, 0.1'W WELL in- SECTION NLA OF THE NEW YORK STATE c $c , » � Nathan Taft Corwin III J 5'46 00 `,I U-1— LbPIES OF THIS SURVEY MAP NOT BEARING ^ Yr 'V GI' Land Surveyor TME LAND SURVEYOR'S INKED SEAL SI CESSPOOL-10 �CESSP�L CESSP�L EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPi. CESSPOOL »7-1 CERTIFICATIONS INDICATED HEREON SHALL RUN CESSPOOLL' �[ ONLY TO THE PERSON FOR WHOM THE SURVEY pWELLING DWELLING DWELLING : r TITLE C.OIS MPAANY. GOVEED,AND NRNMENTALAGENCY RAND WELL OVER 150' (USES PUBur- ATER) DWELLING p 0 LOT 5� p/0 LOT� Tithe Surreys - Subdivisions - Site Plans - construction Layout / LENDING MWITUTION FISHED HEREON,AND TO THE ASSIGNEES OF THE LENDING INsn- _ pWELLING I p/0 LOT 5 • PHONE (631)727-2090 Fax (631)727-1727 'tea+• CERITFICTIONS ARE NOT TRANSFERABLE �',p Or,kOT® CESSPOOL- OFFICES LOC47ED AT MAILING ADDRESS THE EXISTENCE NT RIGHT OF WAYS WELL 1586 Main Road AND, N EASEMENTS OF RECORD, IF P.O. Box 16 ANY, NOT SHOWN ARE NOT GUARANTEED. Jamespart, New York 11947 Jamesport, New York 11947