HomeMy WebLinkAboutBoyle, Thomas ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hail, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF $OUTHOLD
TO:
FROM:
DATED:
Southold Town Building Department
Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. 3509 for a Cesspool/Septic Tank Construction
Permit submitted by:
Dorothy G. Tyte
Please review the application and location map and advise if the project has received Suffolk County
Health Department approval and if this office may issue the permit.
Please complete the form below and return it to me.
Linda J. Cooper
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE ~
DISAPPROVE
Comments: ~
Dated
ELT?~BETI/A. l~v~J,~, '"'
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICEB
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
.~Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.ne~
Residential ~ $10 // or Non-Residential ~ $25 __
Application No.,~ 50~
Permit No.
Applicant Mailing Address
Septic Tank ~or Cesspool
Brief Description of Proposed Cons~'uetion or Alteration
Location of Proposed Construction/Alteration:
Ow~eroCP~opony: /7~o~,~ .,O. /3°¥
Owner Mailing Address:
Owner Property Address:
Name and phone number of contact person ~)oC~+l~% L~'7~e t4 5 7 ~& t S
Tax Map No: Section /0~ Block .-~/// Lot ~' - ~
Cross s~eet 6/¢ ~ ~ c,_~ ~ ~
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRVCTION m~Qvnu~s SVRV~Y~aTa m~T~P~ APraOVAL
Signature o f Appl c~ant - ~ Date
Received I~y: ~ ~
E U VF:'r' OP P OPF:: T'T'
51TUATE.. 50UTHOLD
TOINN: 5,::~THOLD
SOl=FOLK C_.,OUNT~, NY
SURVE'FED 02-22-200.5
SUFFOLK COUNTY TAX ~
IOOO-.54-5-~'
no~ [o,~
bndis~.ur-bed 5oil. 4000
TEST HOLE
McDONALD
EL= 7.2'
PALE I~F~OI, NN DINE
TO COAF~SF SAND
WITH D-IO~5 ®F~AVEL
HATER IN PALE
~O~N FINE TO
~OA~SE SAND
'"'J,-IOg~6RAV~L
DZSTRIBUT;0N POOL
SEA H~NG PO ~-8 DZA X ~' DDEP
4-8 O~A X 2' 8~EP
EL-9.9 ,, /...5.~ SLOPE t~;. T~,,,-n :GRADE EL-10.d
8' AB0~E POOL BOTTOM
GROUNDNATER EL=~.5
~ SEPTIC TANK
1200 GALLON
FF EL=~.5.
INV=9.2
SEPTIC E,~OSS SECTION
NOTES:
· I'4ONUI~ENT FOUND
O PIPE FOUND
ELEVATIONS ~EFERENC, E 5,UFFOLK: COUNT'F' ToPe MAPS
PARCEL LIES ENTIRELT IN FEI'IA FLOOD ZONE AE (EL II)
ANNOTATED FROI"I DIRI,4 PiAP No..~,,f210.~_,OI54 ~ HAT 4, IqqS~
t~UILDIN~ AREA BASED ON TO~N Of= ~OUTHOLD LAH REeARDIN~
NON-CONFO~MIN~.~ LOTS (ZONE
AREA = 2q,q¢4 r:,f or o.6q ocre5
~F~APHIC, ~:~.,ALE I"= .~O'
//
INSPECTION REQUIRED
FOR SYSTEM
BY HEALTH RTMENT
SUFFOLK COUNTY DEPARTIvlL~NT OF HEALTH SERVICES
PERMIT FOR APPROVAL OF CONSTRUCTION FOR A
~-I~TGLE FAMILY P-.ESI~I~NCE
DATE '7 [~'/~'¢
N
e
®
, 0'~ F,, -';~J~TIFICATION
Us~ FORM WWM-073.
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