HomeMy WebLinkAboutGabriel (2) Y
SCIITHCLD VMTEIMTER DI SPOSAL PERM T
CPERATI CN PERM T
SEPTI C TANG or CESSPOCL
Oiler at i on Per ni t No. 4493- R Pesi dent i al X Non-%si dent i al
Fee $ 10. 00 New X Exi st i ng
Name Cf Ower N CF CLAS G4BRI EL
------------------------------
Nbi I i ng Addr ess 1 9 VEDSEVCM OCURT
------------------------------
Nbi I i ng Addr ess 2
------------------------------
0 t y St Zi p NfaN-f4SSET W 11030-0000
-------------------- -- ----------
Pr oper t y Addr ess 1 165 RUTH FU4D
------------------------------
Pr oper t y Addr ess 2
------------------------------
a t y St Zip MTTI TUCK W 11952-0000
-------------------- -- ----------
OAner Tel ephone No. 516-312-6862
------------
Tax Ntp No. sect i on 106. 00 block 7 1 of 23. 000
------ --- ------
Gross St r eet LUTHERS ROOD
------------------------------
------------- --------------------
I
---------------------------------------------------------------
I ssue Date: 7/ 19/ 16 E1 i zabet h A Nevi I I e
-------- Sout hol d Town a erk
(TOIN SEAL)
��SUFFOt,f-�O
y0 G
ELIZABETH A.NEVILLE y� Town Hall, 53095 Main Road
TOWN CLERK tris Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS O Southold, New York 11971
MARRIAGE OFFICER A • ��� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER l �a 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 @$10X or Non-Residential @ $25 Application No. g3
Permit No.
Owner Name HW��AZ7
Owner Mailing Address V1/ 6_1�ww
Owner Property Address
Owner Telephone No. J `
Tax Map No: Section Block Lot
Cross Street WV5to!� PAP
Please check each that applies: New Construction
Alteration to Exis ing System
Residential A 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.)
Signature of Applicant Date
Received by:
' (1)UNAUTHOR17ED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW.(2)DISTANCES SHOWN HEREON FROM PROPERTY LINES TO EXISTING STRUCTURES ARE FOR A SPECIFIC PURPOSE AND ARE NOT TO BE USED TO ESTABLISH PROPERTY LINES OR FOR ERECTION OF FENCES(3)COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY.(4)CERTIFICATION
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 USTED HEREON.AND TO THE ASSIGNEES OF THE LENDING INSTITUTION.CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS (5)THE LOCATION OF WELLS(W).SEPTIC TANKS(ST)&CESSPOOLS(CP)SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTH,'?S.
N 400 Ostrander Avenue,Riverhead,New York 11901
tel.631.'72?.2303 fax.631.121.0144
odmineyovngengineering.com
M4 yowt� {
1
I , , Howard W.Young,Land Surveyor 1'
W E Thomas G.Wolpert,Professlonal Engineer
1 I Douglas E.Adams,Professional Engineer
I i I
, Robert G.Tost,Architect
t >t`13s x�
S _ wATERM AIN SITE DATA
— — — —
RUT>1� fi�O D - - - - . _ AREA = 20,000 sa. FT.
i * VERTICAL DATUM N.R.V.DATUM(1988)
m
* &ROSS FLOOR AREA = 2,143 SO.FT.
e DI ED'61E OR Pqy .
HEALTH DEPARTMENT USE
S �°I I'00"E 104
N87Oil'OO IIYV
118.18'
01
0 1 } - - -7
I
\ I
SANITARY MEASUREMENTSL=344..545''
L �
A B
4
ST IS' 37' • ' to i
30.01
LP 52' 45' 0 n.o'6 Ito n o
;F"e 6 m <9 = mbbry no' Q Q O 5URVEYOR'S CERTIFICATION
N N ❑ v I STORY FRANC ry (() _s Q
1 E 6 V n (5-6 ty HOUSE EBEDROONV L 6 *WE HEREBY CERTIFY TO N 1 C H O LA 5 G 4E 1
C 0 + Q S z _22.4'--- 40.6' � � ) O GEORGE G A B R I E L THAT THIS SURVEY ,.ARiaF3
tftt v,, b 1 V ----- n so.o' L ADOPTED BY THE NEA YORK STATE ACCORDANCE KITH THE CODEE OF f' 744 SU12 t
w I O Z O L PF OFE55IONAL LAND SURVEYORS. t f }
L CON..PATIO L
}
f 0 j}
p Z 6 sr
U.
E &w i to 8 0 1U w QP C J { f r
O 0 1z
� « tu O Q m HOWARD W.YOUN6,N.Y.S.L.S.NO.45MS
N
of N SURVEY FOR
f5Q w o N I GHOLA5 6ABIRI EL 4
(02 z
ZU.< � &EOR6E GABRIEL
a U W _ -a ' at Mattituck, Town of Southold
eL p , Suffolk County, New York
t < FINAL SURVEY
0 Ix0--. County Tax Map o15cFK( 1000 Section 106 Block 07 Lt 23
- - - -
LL
i N 104.00' — — — — — — FIELD SURVEY COMPLETED MAR 30,2016
MAP PREPARED MAR.31,2016
I Lot 2 Record of Revisions
ILot i RECORD OF REVISIONS DATE
p I Subdivision - Subdivision - _gym i`�2016
Anna .�n 5GDN5 NOTA aANE M 2016
s I Map of Sunset Knolls" I Map of Sunset Knolls" A ( SGDNS N�'q
$ I Suffolk County File No. 5023 I Suffolk County File No. 5023
0
I
o I
m
0 ! ! 40 O 20 40 60
eL Scale: IN = 40'
JOB NO.2016-0029
DWS.2016_0024_fs I OF 1
O = MONUMENT SET ■= MONUMENT FOUND Q= STAKE SET A= STAKE FOUND DI = DRAINA6E INLET
I