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HomeMy WebLinkAboutRuggieri s � t pF SO!/jy A.NEVUJZ,RMC,CMC �.© ' �p Town Hall,53095 Main Road TIDWN CIE J= P.O.Box 1179 REGISTRAR OF VITAL STATISTICS Southold,New York 11971 MAE,RIAGE OFFICER Fax(631) 765-6145 MANAGEMENT OFFICER ,r Telephone(631) 765-1800 FROSWU 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. 4389-R Residential X Non-Residential Fee $ 10.00 New X Existing Name Of Owner JOSEPH RUGGIERI ------------------------------ Mailing Address 1 45 GARDEN STREET ------------------------------ Mailing Address 2 ------------------------------ City St Zip ROSLYN HGHTS NY 11577-0000 Property Address 1 3690 PECONIC BAY BLVD ------------------------------ Property Address 2 ------------------------------ City St Zip LAUREL NY 11948-0000 Owner Telephone No. 516-625-9373 ------------ Tax Map No. section 128.00 block 6 lot 6.000 Cross Street DELMAR DRIVE ------------------------------ ---------------------------------- Issue Date: 2/23/09 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) T f ELIZABETH A.NEVILLE O�*QF SO 0. Town Hall, 53095 Main Road TOWN CLERK ~ P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold,New York 11971 MARRIAGE OFFICER G Q Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER �� Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER �lij'COU01, 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. _ Permit No.35u Owner Name: Owner Mailing Address: Property Address: n Owner Telephone No. 62, 7 'Tax Map No.: Section: /2 2 Block: Lot: . . Nearest Cross Street: 40&1it�_bA9_;de_, --- -- Please check all that apply: XI 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 distance in feet from system to building and closest road. New construction may submit a copy of s ey with SCHD approval.) _ //-2- 7 - 07 Signa e Applica Date Received by: E117.ASETH A.NEVU" o���F SO(/ry0 Town Hall, 53095 Main Road TO" ~ � P.O.Box 1179 REQ OF VITAL STATISTICS Southold,New York 11871 MARRIAGE OFFICER Fax(631) 765-6148 RECORDS MANAGE'1(ENT OFFICER Telephone(631)765-1800 FREEHOM 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. 3657 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : RUGGIERI, JOHN Address 1: 39 LA BONNE VIE DR, APT E City St Zip PATCHOGUE NY 11772 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 #R10-08-0067 Name Of Owner RUGGIERI, JOSEPH ------------------------------ Mailing Address 1 45 GARDEN STREET ------------------------------ City St Zip ROSLYN HEIGHTS NY 11577 -------------------- -- ---------- Property Address 1 3690 GREAT PECONIC BAY BLVD ------------------------------ ------------------------------ City St Zip LAUREL NY 11948 Tax Map No. section 128.00 block 6 lot 6.000 ------ --- ------ Cross Street DELMAR DRIVE ------------------------------ Building Permit Number Cross Reference: ---------- ------- ---------- Issue Date: 9/09/08 Elizabeth A. Neville ------ Southold Town Clerk (TOWN SEAL) 741-UUTk M&1& l��dIst�i �t.Y. Certification Of Sewage Disposal System By Installer Health Department Reference Number. R/ O - 09 - © 0 6 7 Suffolk Tax Map#:Dist: 1000 Sect(s) \ 2-8 BWS) Lots) Project Name or Address: 3 P Q I a Subdivision Name&Lot# Applicant's Name: Description of System Installed: Septic Tank: Volume(gallons): �C�d SHAPE: Ritectangula []Cylindrical Name of PrecastManufacdmer: A7 5Z s ��rr c� �i�� c C S Other / Z /X F ® ec--(41 1 n c, JO c�c� I Attach or sketch below themes from budding cis to the access covens of disposal system- 17 � ,�q!.. 9 cher I hereby certify that the subsurface sewage disposal system,described herein,has been installed by me in accordance with the approved plans and standards of the Suffolk County Dept of Health Services;and is Installer Signatu= ` � Date: Print Name/Company: Coy, rllk Phone: Consumer Affairs License Number. z Y0 G v/ This certi kation shall not be used in lieu of moons required by personnel of the Department and may be duplicated on cony letterhead,provided a coninias to above information. PLOT PLAN FOR JOSEPH M. RUGGIERI SITUATE LAUREL TOWN OF SOUTHOLD " SUFFOLK COUNTY, NEW YORK oo �`'p S.C. TAX No. 1000- 1 28-06-06 Q) 23.0 SCALE 1 "=30' SEPTEMBER 29, 2008 NNOVEMBER 17, 2008 STAKE FOUNDATION o DECEMBER 23, 2008 FOUNDATION LOCATION �P N AREA = 15,368 sq. ft. 0.352 ac. ti I 124 = 8z NOTES: .0 S Y °� 16 9� a O f?}S \ G �y 1. ELEVATIONS ARE REFERENCED TO AN ASSUMED DATUM EST \ b7 y EXISTING ELEVATIONS ARE SHOWN THUS: 124 T 4 T 23.6' N Q a C",z 12 O r vi "" No p C O Z w 7- 'V " m QO OO N 3 tj _J• W 15A' x.56 Z 20 16.9 { 3.0 0 I O .I 3A p. a 7r� 360, L l r !n r p y G rn O -n nZ :I �o j o j, o ,i C ,ho + O� j PREP WITH THE MINIMUM 3 ST RD SU SAS ESTABLISHED j TRP I C. fjRO AND ADOPTED 1 F YO STATE :AND TEST HOLE DATA 3 (TEST HOLE DUG BY McDONALD GEOSCIENCE) Z o' BROWN SILTY SAND 3 ,� `, �``'' •`?046 ��� ;I N.Y.S. Lic. No. 50467 UNAUTHORIZED ALTERATION OR ADDITION 1 TO THIS SURVEY IS A VIOLATION OF ESECTION DUCATION 2LAWOF THE NEW YORK STATE Nathan Taft Corwin III COPIES OF THIS SURVEY MAP NOT BEARING PALE BROWN FINE SAND THE LAND SURVEYOR'S INKED SEAL Land Surveyor EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. CERTIFICATIONS INDICATED HEREON SHALL RUN j ONLY TO THE PERSON FOR WHOM THE SURVEY I IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND Title Surveys - Subdivisions - Site Plans - Construction Layout I LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTI- 'i TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. PHONE (631)727-2090 Fax (631)727-1727 i 17 THE EXISTENCE OF RIGHT OF WAYS - OFFICES LOCATED AT MAILING ADDRESS i AND/OR EASEMENTS OF RECORD, IF ANY, NOT SHOWN ARE NOT GUARANTEED. 322 Roanoke Avenue P.O. Box 1931 Riverhead, New York 11901 Riverhead, New York 11901-0965 1 1