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Home My WebLink AboutPad Family, LLC Michael J. Domino, President ��1►OF S0!/Tyo Town Hall Annex John M. Bredemeyer III,Vice-President ,`O l0 54375 Route 25 P.O.Box 11 Glenn Goldsmith l Southold,New York 11971 A.Nicholas Krupski G � O Telephone (631) 765-1892 Greg Williamsyc4U O a Fax(631) 765-6641 � NTY,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: 111,21 19 v Ch. 275 ✓ Ch. 111 INSPECTION SCHEDOLE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction '/2 constructed Project complete, compliance inspection. fku-&a,tssioN INSPECTED BY: COMMENTS: _ e G ef,A;ol Aos-) .1 f r a ;c Wo' n �.—_J 4o Aar) god c ih� in c�NA oK $oc �] " w;dP jgaA� ID beach CERTIFICATE OF COMPLIANCE: HiQ I SCDHS AP 1 11111 v %W -- -- TOWN OF SO UTHOLD g j• SEPTIC I.E., CENTER 2I' B.4, TANK 7.9 I.E. POOLS -I 6.0' SUFFOLK COUNTY, N. , 1'min. n ./ GROUND WATER -- ------------- IDOO-99-01 12 ,�,o�' ----------------------------------------------- SCALE.• 1'=40' �O �'�� SECTION SEPTIC SYSTEM 2009 t� APRIL 7, JULY 22, 2009 (DECK REMOVED) �1 YAUAAM �� o + of/ AUGUST 20, 2009 (B.O.H) �°// PROPOSED SEPTIC SYSTEM O 41 �'/ p (1] 1,200 GALLON PRECAST CYLINDRICAL SEP77C TANK AUGUST 27, 2009 (LOT COVERAGE) 80 x 4' LIQUID DEPTH �� OCT. 29, 2010 (CONTOURS ADDED) 6 g FT. DlA.x 2 FT. DEEP PRECAST CONCRETE LEACHING POOLS .�' JULY 7, 2011 (ADDITIONS) BOO+ / // C 1 BACKFILL IMTH 3' SAND (SW) COLLAR, 2' ABOVE GROUND WATER J or JUNE 08, 2017 (REVISIONS) �, qGUT 17, 2017 (C TOUR,�E�SONS AREA TO 77E INE = 16,540 SQ.FT. / / G \ ��j AREA TO COASTAL EROSION HAZARD �/ LINE = 5150SQ.FT. `' a, HSE: & DECK = 1494SQ.FT. NOTE: �,�• / 1494/5150 = 29x r '� r/ *� /2 ✓{+® SUBSURFACE SEWAGE DISPOSAL / �, of / �, �` ,� D, 4 k G� ✓� ((%% K�� SYSTEM DESIGN BY.' o o� �� off' / // / `'a/ 0 c ,yt% JOSEPH FISCHETTI, PE oo / / / 9 U-/ HO T ROAD ° J SOUTHOLD, N.Y. 11971 p / / I �� ,/ 4` rev +� vot � - (631) 765-2954 / / ; // / 9 � ?, C, �y `� •�„ 133 CERTIFIED TO: JAMES MESKOURIS CHRIS MESKOURI S ti / LAWRENCE J. SILBERMAN, ESQ. �9 ��`�// // �ti°5 / `e / TEST HOLE DATA LAWYERS TI TLE INSURANCE CORPORATION �t`,p ��,�/ °, , StP��a /9 / ��l �. ,/ McDONALD GEOSCIENCE - �O/ 1 , IGOP , / �/ •�5 �y 0 / R=25.00' / 4/13/09 x L=35.77' EL. 6' D/ CPp`�. t, � � // MIXED SAND AND LOAM 2' PALE BROWN FINE TO COARSE SAND WITH \ O. , 5�� 30X GRAVEL k�p �/ 26 � WA 3.6' 5A o FLOOD ZONE FROM FIRM 36103CO143H o��i E�s�o / � / s j o��6 t September 25, 2009 :S t�-y-. Ei WATER IN PALE BROWN FINE TO COARSE SAND a� � �/ 1� c+f R� _�-/-• F WITH JOX GRAVEL COASTAL EROSION HAZARD LINE FROM / OAF'1ti11 S COASTAL EROSION MAP PHOTO 59-533-83. LOT NUMBERS REFER TO BLOCK 2 'MAP OF CAPTAIN P 9 _J�, �e°� OO 6� ,�i, to' KIDD ESTATES" FILED IN THE SUFFOLK COUNTY V r CLAY �P� �� NEyy r CLERK'S OFFICE ON JANUARY 19, 1949 AS FILE N0. 1672 � �i ✓J�$��G� F�' (`� ' �+ O ��5� -o ,OO 9�� nErz�r � I am familiar with the STANDARDS FOR APPROVAL `d` GQ. tiGO \G q .� AND CONSTRUCAON OF SUBSURFACE SEWAGE 4�`A J�� J ! DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES �' S 6 Y and will abide by the conditions set forth therein and on the / ��• �P Q 0 istee N0. 4961 permit to construct. V'��G J Z ti IG Elevations referenced to N.G.V.D. S� QJ �- G� P.C. The location of wells and cesspools shown hereon are _ AX (631) 765-1797 from field observations and or from data obtained from others. ��. Southold T011111 (6 01 ANY ALTERATION OR ADD177ON TO THIS SURVEY IS A VIOLATION � = REBAR Q P.O. F THE NEW YORK STATE EDUCATIar LAWaF sEcnaN 72M a 1230 TRAVELER STREET C� EXCEPT AS PER SECTION 7208-SUBD/V►SfON All azRnONLY IF ® = PROPOSED ELEVA770N O" —��_ HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY fF SOU7HOLD, N.Y. 11971 - SAID MAP OR COMES BEAR THE IMPRESSED SEAL OF THE SURWOOR wHOSE SGNATURE APPEARS HEREON. �—= PROPOSED CONTOUR AREA=16,540 SCS. Fr. TO TIE LINE Michael J. Domino, President �Qr buut Town Hall Annex h�� Ol0 54375 Route 25 John M.Bredemeyer III,Vice-President P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A. Nicholas Krupski G Telephone(631) 765-1892 Greg Williams 'ply ,�aFax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Chapter 275-8 A. "Presubmission conference. Applicants are encouraged to schedule a voluntary presubmission site visit to discuss the proposed operations with the Board., Discussions in the,fieid are purely advisory and nonbinding, but this meeting is intended to facilitate communication between the applicant and the Board. There will be a $50. for this - conference, which maybe applied to an application fee for a wetlands permit made within six months of the site visit and which application involves structures that were the subject of the site Visit." I HAVE READ THE FOREGOING AND AM AWARE OF ITS CONTENT: \ a e ,J7 Z'�v lel &,e �ka -cel e�f e e oi- ex A .. 44 /P"f Z�h'Ae A e A e-7 � car. l� /Gtr- ort 74 v^ / tXA -Kt 1 l Lam,vs*.•�c—, D E C E V E am '28 206 f Southold Town Qard of Trustees i Board of Trustees App? cation AFFIDAVIT BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED'HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND,THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREE&TO•HOLD-.THE TOWN OF SOUTHOLD AND-THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID,PERMIT(S),IF GRANTED. ]N COMPLETING THI_S APPLICATION,I-HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES-IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. Ii FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM. OF THE PERMIT. - r r Signature of Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS 4 4 h DAY OF J u Lq 20 19 t Pu is N ()I ARy PUQWC 5'1 ATE of N0( , *'AL"9 IN e I A N 6006-1 SR r,� �• hind 3r,a �2� Board of Trustees App: -,ation AUTHORIZATION (Where the applicant is not the owner) I/We, J's- . .� �s%�v s J�v��) /'gym 'L z< " owners of the property-identified as SCTM# 1000- CI — �/ /�/ in the town-of York;he're' by authorizes �`i r' ,'s/� . ✓'l.�GaJ - to°ad'asmy:agent and Handle all necessary work involved'with the applicationpr"ocess for"permit(s)from,the-Southofd To'wn' Board of Trusteeslor this property. ° =f, Property Owner's Signature Property Owner's Signature SWORN TO BEFORE ME THIS 6 f DAY OF �u cy ,20�_ Notary Public N67AIZy puGuir- S4AtC Or N Gw yoRK 4uAc�c�� ltr ��ki�Ns fpwlb� Na• 0IANG00671 G4 Exp 10CS op MAY 41 9024 Board of Trustees App'7 ' :ati.on AFFIDAVIT BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERmrr(syAND-THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL-WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS'AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRAN'T'ED. IN COMPLETINGTHIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,-TO ENTER ONTO MY PROPERTY TO INSPECT THE.PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Signature of Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS 41h DAY OF _ 2019 N 01 ARy PUQwC 6't ATC OF e t A 0 160067 Sq Boar<` if Trustees Application AUTHORIZATION (Where the applicant is not the owner) owners of the property identified as SCTM# 1000- �1 — �/ / in the town of I®PTZ/cl 4w York,hereby authorizes - - or tr to act as my agent and handle all necessary work involved with the application process for permit(s)from the Southold Town Board of Trustees for this property. Property Owner's Signature Property Owner's Signature SWORN TO BEFORE ME THIS ` }ti DAY OF J 20_9_____ ,no Public °d(,%r•'�'� cQ..a: & A b%N07A' %l pu151.1c: STA-TC of N VW JoRK , NO. 01AN100GI R t xp iR£5 op HA%4 aJ 902-4