HomeMy WebLinkAboutPorcelli SOF 50(/r�,
A.NEVILLE 0`� Qi_ Town Hall,63096 Main Road
TIDWN CL%= `� P.O.Box 1179
REGISTRAR OF VITAL STATISTICS � � Southold,New York 11971
AGE OFFICER Fax(631) 765-6148
RECORDS KANAGEME14T OFFICER Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4381-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner VINCENT PORCELLI
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Mailing Address 1 49 TIPPIN DRIVE
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Mailing Address 2
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City St Zip HUNTINGTON NY 11746-0000
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Property Address 1 1330 WESTVIEW DRIVE
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Property Address 2
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City St Zip MATTITICK NY 11952-0000
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Owner Telephone No. 631-427-3193
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Tax Map No. section 107.00 block 7 lot 14.000
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Cross Street BROWER ROAD
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Issue Date: 10/16/08 Elizabeth A. Neville
------ Southold Town Clerk
(TOWN SEAL)
O �
ELIZABETH A.NEVILLE Town Hall, 53095 Main Road
TOWN CLERK ti Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS O Southold, New York 11971
MARRIAGE OFFICERy • �� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER l �a0 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 /or Non-Residential @ $25 Application No. a
Permit No.
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Owner Name S P Al pe7mtpor- /-z'
Owner Mailing Address A( D 2
1 /
Il -
Owner Property Address /330
Owner Telephone No. I-lo&e C631 ) V 2 Z-.?/2 3 Ce LL -C6 3/ 9/. 167-3
Tax Map No: Section 107 Block 0 :2 Lot T
Cross Street beoco F/L 2
Please check each that applies: New Construction _
Alteration to Existing System
Residential Non-Residential
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. (Locate
building and system; give north arrow and approximate distanc eet from system to building
and closest road. New construction may submit c y of sure with CHD approval.)
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Signature of Applicant ate
Received by:
o WELL
I am familiar with the STANDARDS FOR APPROVAL
AND CONSTRUCTION OF SUBSURFACE SEWAGE SCDHS R/0-08-0060
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES
and wili abide by the conditions set forth therein ant.bn the `
permit to construct. SURVEY OF PROPERTY
The locations of wells and cesspools A T I MA TTJT UCK
shown hereon are ffom field observations
TOWN OF SOUTHOLD
and or from data obtained from others.
JP SUFFOLK COUNTY N. Y.
1000-107-07-14
ATER� ��212008
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pWEi LIN NppN 5.)Q N z JULY 2b, 2008 (revisions)
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NEW SEPTIC SYSTEM (4 BEDROOMS) 0 , sr. ) -= o41
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l- 8'0 x I2' DEEP PRECAST LEACHING �� g2t,a E ® PROF.NewTIcq m n
WITH 3' SAND (SW),COLLAR N o W, D
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364 ',,!gGLE FAMILY RESIDENCE ONLY
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TEST HOLE Y m mss' o 2'S m kw: fi i :. ` EARS FROM DATE OF APPRQ�IA1.
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by McDonald Geoscience A D • Q,(��F �E�tO
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EL EVA TIONS ARE PEFERENCED TO AN A SSUMED RECEIVE �-
LIC. NO. 49618
ANY ALTERATION OR ADDITION TO THIS SURVEY IS A WOLA77ON L JUL 3 1 2008 ECO P.C.
OF SEC77ON 72090F 771E NEW YORK STATE EDUCA77ON LAW. (631) 6 AX (631) 765-1797
EXCEPT AS PER SEC77ON 7209—SUBDINSION 2. ALL CER 77FICA 77ONS B X 909
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SUFF. CO. HEALTI�SER
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR OFFICE OF lNASTEyygrER RA VELER STREET 08_131
AREA-10,050 SQ. FT. _ ■ =MONUMENT WHOSE SIGNATURE APPEARS HEREON. LD, N. Y. 11971