HomeMy WebLinkAboutBenjamin ELIZABETH A.NEVILLE,MMC Town Hall,53095 Main Road
F'
P.O.Box 1179
TOWN CLERK
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS q Fax(631)765-6145
MARRIAGE OFFICER v Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER K www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Sabrina Born,Southold Town Clerk's Office
DATED: January 25,2019
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4695 for a Cesspool/Septic Tank Construction
Permit submitted by:
David&Erica Beniamin.
Please review the application and location map and advise if this office may issue the permit.
Please complete the form below and return it to me. Thank you.
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: Final approval required fro the Suffolk C ounty Health Depai2tnent
Signature
Dated
ELIZABETH A.NEVILLE t.� Town Hall,63696 Main Roa.
TOWN CLERK �� � � P.O.Box 1179
REGISTRAR OF VITAL STATISTICS !lttyy iy, rn2 - Southold,New York 1197I
MARRIAGE OFFICER 1, -F?' Pax(631)765-6146
RECORDS MANAGEMENT OFFICER 'fir Tele hone(631)766-2800
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r REEDOM OF Ii4FOR1dp.^t ION OFFICER -,Cf south old town.northfork.net
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OFFICE OF THE TOWN CLERK
. TOWN OF SOUTHOLD -
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
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Residential @$10 1 or Non-Residential @$25_ Application No. yl(J95
( Permit No.
Applicant Name '( Y € - 1 ( �,tl n i/{3
Applicant Mailing Address v ,f
Septic Tank. or Cesspool
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Brief Description of Pr.Dposed Construction or Alte tion
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Gf de 'rte 474 y L 11I'G! J�.r
Location of Proposed Construction/Alteration:,
Owner of property: ` j t�L11 f C P, if
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Owner Mailing Address: ( -' I` i a
Owner Properly Address: JU `GAG
Name and phone number of contact person
Tax Map No: Section R Block Lot
Cross Street !t�sr s�--Y`l
NOTE: LOCATION MAP MUST B SUI AUTTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SUIT SNTTH HEALTH DEPARTMENT APPRgVAL
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Signature of App icantDate
P
Received by:
pp 1 r g i..0®s FDECEMBER
ST HOLE DY:
Q j _ ALD GEOSCIENCE
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4, 2017
j- OL D R% HRORN LOAM,
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Hill BROWN sR.Tr SnNn.
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1' ,J 4 16 3p' EN 1'KJ/'+ iC&nTr'OS �� PALE BROWN FINE
c� _ TO COARSE SAND.
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_v •- q4@W IRREGULAR WIRE PENCE -
' �WaTEsDiILLING -
E S 89"31'00" Wy - — - 299.00
P BUC WATER
1000 11. O-kERLY
LAND RJ
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R FOFIi1BitLY .j
7RNN49R'&THOMAS&MIDGE
2745 V_NSV N ROAD,CUTCHOGUE
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BACK OF FRONT OF SANITARY DESIGN:
HOUSE POOL HOUSE (FIVE BEDROOM SYSTEM)
FRONT OF FF 70.3 -1,500 GALLON SEPTIC TANK
FF 67.7 If EL 66.1 -(2) 8'0"DIAMETER X 12'0"DEEP LEACHING POOLS.
HOUSE EL 69.7 ,
SEPTIC 55.7— YE 70,3 i -AREA FOR 50% FUTURE EXPANSION.
4"OSDR 35 PIP8 ._�._
TANK (TYPICAL) NOTES:
3 `�iNV 80.2 ,-_ �, --M 80.4 '�.OagjpSN +OyT 1�.Ot'>y INV 61.1' - -. P11CR 'INV 67.7 -EaSTING SANITARY LOCATION PROVIDED BY OTHERS.
H1+1`+l -S%ISMG SANITARY SYSTEM TO DE PROPERLY ABANDONED ACCORDING TO SCD&5 STANDARDS.
LOCATIWIN. . ALL
SURBG OUNDING DTEUdN SOWITHINN AS �150OOOtLRHAVE9E PUBLIIC WATER.,EXACT LCA71ON TO)�VERIFIER,
- -THERE ARE NO WELLS WITHIN 150.011.OF THE SUBJECT PROPERTY,
m a rnDxaxD ne nox QDR 6x DRAWING INFORMATION: SURVEY of LOT 358,
m rw�s mRvev a a n°u'naa DP _. NE
naDsoo°ufiz"'AS�xreIDiocoFcNeR�"�°BeAwDSnDDsRaDOnWaenecBoE°sTx�azADe cnw TwR�Pe°s%fteuCnrnBPAsA't%eDIDzk4f rwwcC,orO.MaoPraY6ssS
SCALE 1"=30'
la LISA Mc UILICIN AS SHOWN ON MAP OF
DRAWN BY. J.A.M. LAND SURVEYING NASSAU POINT CL
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FILE No.: Q050-18
PROPERTIES, INC.
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R°ffiRQED 3[RDCIDRig BR6 i0R A
Brenn°eDxrose ANn c:As,Ann axa xar DATE:MARCH 5, 2018
IATQN®rD Dn�e txecxcox DP
REVISED: AUGUST 15, 2018 PROPERTY INFORMATION:
�ccew Da°YAR srevcnnt�. 'k �' , � 274 EAST MAIN STREET -SECTION D»
cswxsneAPro mnzcrsD®aon
aux 6NLY ro sffi reRmw PO&.sD ras REVISED: DECEMBER 21, 2018 �`
exssasez xt w� A� `-,- EAST L9LIP, N.Y. 11730 FILED: MAY 7, 1926 - MAP No: 806
x g - '
wem % w �,, AREA: 29,632.34 Sq.Ft. = 0.6803 ACRES .: � TEL 631-277-3605 AT CUTCHOGUE, TOWN OF SOUTHOLD
ZONED "R40" RESIDENCE HQ�� via FAX: 631-277-3906 SUFFOLK COUNTY, NEN YORK
4, `_W>o°"� ELEVATIONS IN NAVD88 DATUM ysb LAHo SCTM: 1000-111.00-06.00-007.000
__ut7z It ZU1162565 YANNSTON ROAD, CUTCHOGUE