HomeMy WebLinkAboutLoGrande ELIZABETH A.NEVILLE s Town Hall,53095 Main Road
TOWN CLERK o P.O.Box 1179
C?j 2: Southold,New York 11971
REGISTRAR OF VITAL STATISTICS sa-
MARRIAGE OFFICER Fax(631)765-6145
RECORDS MANAGEMENT OFFICER , -- Telephone(631)765-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK �q
Residential @$10 for Non-Residential @$25_ Application No. I�
Permit No.
Applicant Name WA
Applicant Mailing Address
Septic Tankor Cesspool
Brief Description of Proposed Construction or Alteration
Location of Proposed Constructlon/Alteration:
Owner of Property:
Owner Mailing Address: —
� VIC
t C
Owner Property Address:
Name and phone number of contact person FIA -2344f
Tax Map No: Section 1,2 Block 4 Lot
Cross Street
NOTE: LOCATION MAP MUST BE;
E SUBIIIITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURN -ALTH " RTI4IENT APPROVAL
./ 7
gnatne of Applicant Date
Received by: �lr+36
SCDHS REF# R10—la-0123 SURVEY OF PROPERTY
RE_ EIVED 8t CUTCHOOVE
pwal-I CI VACIAN UK 2 TOWN OF SOUT OLD
V SUFFOLK COUNTY, N,Y.
PEAL,G wATYR 1 k SUFF.CO.fje rP 1000-137'—U5 1 & 2
! OFFICE Tyr . SCALL 1--40F
NOVEMBER 30, 2017
FLEET WOOD F, .WATM ROADe APRIL 24, 2018
N8fi37` E W svmr Euu SEPTEMBER 24 2018(SCORS COMMENTS)
vn m
SCED " rom MARCH 1Z 2019 (GARAGE LAMUT)
E�s .r „ RINE
4 2019(SCDHS COVMENTS)
70,Q_o' , XNE 10, 2019 (SCOPES COMMENTS)
Pied
t ic, tra e
c
TEST HOLE DATA `S 1* _s{ Department
PC MNOONALO GFOSaDV E � ' F- �- ` c i
0911312 17 ,,.* wl
al °es a.c ilt I€-
7 BROW SILTr SAND SA
as 5.2'
1.A MINIMUM Ni 4 WCNES APPROVED REIMFOIM PRECAST
WATER 1N BRONN SILTY SAND SM _ 'ic+ {. ` '+ CONCRETE BOTTOM AND 4 WCI WALLS
6' r \ '•,T t9 Z
APPRONO
AN 10
PRECASTCTEAE SN DIAMETER BY 4� O�NC
AN.a {� tl S INIX S_ABM TOP INFORIN M CWCeE�0 INCH
WATER da ERONN tTNE SAND
A DROP T'$WSi BE PWWED OR 0141AN1g FIRMLY
Cl,F- a LIM.LIQ ID OEM Wsr BE 3 FEET.
�wAca
TO
t -
NOTE WATER ENCOUNTERED 5.2'BELOW SURFACE
_ a
4 BEDROOM HOUSE TVia- ` .
'.( rzPROPOSED SEPTIC SYSTEM
0GSPTIC TANK -id
I-PRECAST 125
kI
—
> 77-d-6—
LOT
wwmn
LCT
7-8'LEACHING POOLS 2'DEEP
WITH s SAND COLLAR 2'Ara ABO _�
( O•
GROUND WATER = -
s ra
E*smo SEP=sYsTEA To BE REMOVED. r.IMP-ERE -- -_�_�'_.._ --------------
� - °�
No wrELLs PHTHIN TSD'of PROPOSED SEPTIC SYS7E14 N8°t3.6 LOT M
0wa.Llw_7 Lnas
• MaaAxNr
—Nt— PROrOSM GONTOIR € _�- s - t .€ ? I COMM- a - `s� T - s" .€
ORA
ELEVATIONS ARE REFERENCED TO NAVD eb ' - - ` PER-'-`-OR - OF -ON_ E
L , R r .k ?. - E..ems ,€r r
° calf E ,!, -f'�._F d
FLOOD ZONE
NE FROM FIRM 36103CgI04H
MEFFEGTIVE DATE- SE?TIDAUM 25 1009 - c•s ), Al
j I
LOT NARDERS REFER TO *W OF RAVATONE REALITY CARP.• '� :. � € �1 c,
FILED IN THE SUFFOLK COUNTY C.I.EF.K'S OFFICE av >f r { + {
ON DEC. 22, KM AS FILE NO. 574 -
# t ,• S. LtG N?. 19615
ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF s - L AVX1 klU 0:4s P C£OAW SURVEYORS P.C. -
5EGTION 91090E THE NEW YORK STATE EDUCATION LAW. EXCEPT AS - ,t �3- -��PW i (631) 765-5020 FAX(631) 765-1797
PER SECTION 9209-SU9DIVISION 2 ALL CERTIFICATIONS PERSONARE ' ' - _ - - ` gT '
OR c PEED FOR
WKE51SED SeALL OFFTEFE5 SURVEYOR.SAID 1?30 TRAVELER STREET
SIGNATURE APPEARS EEXEOAL AREA = 20,881 SO. FT.
SOUTHOLD N.Y. 11971 17-100