HomeMy WebLinkAboutMoustakis, John
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ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEM~FFICER
FREEDOM OF INFO~TIONOFFICER
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\"" -~. r ", OFFICE (,)F THE TOWN CLERK
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T~~:8'6frfhOld Town Building Department
FROM: Linda], Cooper, Southold Town Clerk's Office
Town Hall, 53095 Main Road
P,O, Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
Boutholdtown,northfork,net
DATED:
May 10, 2006
Transmitted herewith is a copy of application No, 3592 for a Cesspool/Septic Tank Construction
Permit submitted by:
John Moustakis
Please review the application and location map and advise ifthe project has received Suffolk County
Health Department approval and ifthis office may issue the permit.
Please complete the form below and return it to me,
Linda], Cooper
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I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
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DISAPPROVE
Comments:
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Signature
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Dated I '
, .
EUZABETH A. NEVILLE ....,
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 63096 Main Road
.~ P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6146
Telephone (631) 765-1800
southoldtown.norlhfor k. net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential@$IO_ or Non-Residential@$25_
Application No. 3S-qL.
Permit No.
Applicant Name TI'. r~lO,~"S;LA~1 ),
ApplicantMailingAddress-1fS-~ Gl'ArC'EL L I?}/ "
Q#FC-~J f?tJ Itr
Septic Tank_or Cesspool y:-
Brief Description of Proposed!5mstruction or Alteration
Location of Proposed Construction! Alteration:
..-,....
Owner of Property:_~ , ~ { ,! t:> f.J-i\ I ,fy( Oli. <;; "cAQJ
OwnerMailingAddress:-l:f~' ~"tJ /'" Gar II Al -
OwnerPropertyAddress:-!f.,- S;; LIIAI t;.fiJ '~G"tl/doR..r.
. ~
Name and phone number of contact person
Tax Map No: Section 33
Cross Street ; '( J /I' b /J~/PC
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURvEY WITH HEALT~ DEPARTMENT APPROVAL
~ AI~h .
~~e of Applicant ~ Date
Block
i
Lot
5'/
Received by: {fP
N 25' 79' 50" W
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(()
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0) 13.1'
ElcistirM} septic tank AND OR cess~ls
location to be ver1f~ by UeenHd
Installer. Install4lr must baclcfill with cleo"
sand and obondoned in ac:eordonce with
Suffolk County Health Deportment
regulotionll.
INSTALLER TO VERIFY 3' IolININUM
Cl...EARANCE BETWEEN ~OONEO POOLS
AND NEW PROPOSED S#,NITARY
STRUCTURES.
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Existing
Cesspools
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Soilbori"9t hole -<~
" performed /15/2005 ):..
by McDonald eoscie~,~
Southold NY. ,-
~ PROP. 2 STORY
(J) '" FRAME
!!. ADDITION
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N " 12.0' b
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Ex(;A'I1A - -- l?j
rFW INSPEC nON REQUIRED-I
if'o ..- ETAf.?YSYSrl::M
_~A WI-{ uEPAR H<1ENT
~ 2r 30" 30)/ E:
75.06'
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TEST HOLE DATA
D<>r-kbro.,., 0
50.,.,<:1 \0"'" L
:BrownsK'ty S
..MId M
a,.own fln~ 10 S
..P<fIu,,';c"'l<l P
,.
Bro."sRty S
50...0 M
Brow,., fin.. to
cO<l.rs..;;o.n<:l S
with 207. \J
....o.v..\
Brown sUy
5",,.,<1
Brown fin.. to
coo.l'"......<>,.,d S
wi'th<?07. \J
g,-covel
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o
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t:i
t:J
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______ 3 5 5.57.__________
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w..SOwcI:~
s-g. 0I",_1llIonaI
loo.UrtacelYltflm
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NO SURFACE WATERS OR WETLANDS
WITHIN 300' OF APPLICANT'S PLOT.
TRAfF1CBEARlNG
SLAB & COVER AT ALL
STRUCTURES
,
"
l' Min. to 2' Max
O<J1U:TlIT
INVERT EL 22'
#
Septic Tonk in accordance of SCHD
Standards for Precast Structures
4" SDR-3S 1/8"/1'
OUTLET TEE'S TO LEACHING POOLS
AlL PIPE OUTLET INVERTS EQUAL
For (Expansion Pool)
SEPTIC TANK(1.500 GALLON)
5 or 6 Bedrooms
Leaching Pool in accordance of SCHD
Standards for precast structures
Sanitorv Oetoil Residel'ltinl SeD tic Svstem NTS
3'Mln.
Property Data obtained from survey prepared by LOCATION: 45 Sunset Lane
Anthony At[ruzzo, LS, 1700 Hortons Lane, Southold. HAMLET OF GREENPORT
NY 11971 qated 03/23/2002. TOWN OF SOUTHOLD
MAP OF: - Describe COUNTY OF SUFFOLK
. , i/" STATE OF NEW YORK
SeTM# 1000-033-04-054
f!
45 SUNSET LANE
GREENPORT. NY
Site Pian and sanitan' details
ERIC J. PELLETIER, ARCHITECT, PC
Uarmcrs/PlANNEllS
Ul-UlMlDDLE COtlN'n.YItOAD stIllE 3
SEIJ)BN, NEWYOn U7N ("1) 451-7",
NEW'YOU: FLORIDA.
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