HomeMy WebLinkAboutRyzuk, Thomas
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ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 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 SOUTH OLD
J\.\L \ 3 'C~;01 .
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T~: \'-..-:J3:'\lV,th61d,;J1W-111uilding Department
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FREJM:" Linda J. Cooper, Southold Town Clerk's Office
DATED:
July 12, 2007
Transmitted herewith is a copy of application No. 3727 for a Cesspool/Septic Tank Construction
Permit submitted by:
A,' Goldin!! for Thomas Rvzuk
Please review the application and location map and advise if the project has received Suffolk County
Health Department approval and ifthis office may issue the permit.
Please complete the fonn below and return it to me.
Linda J. Cooper
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I have reviewed the application and location map ofthe project cited above and make the following
recommendations:
APPROVE
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Comments:
DISAPPROVE
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Signature
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Dated / /
.
,
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
SepticTa~ or Cesspool 0
Permit No.
}'EfResidential @ $10 or 0 Non-Residential@$25
. Application No. ~1iT: 1_
Applicant Name: !/61..)/1B5?Jc!.1l ~CD/D6.
Applicant Mailing Address: ? () , tt:nK G'8
I1/Jrnn 1".1<1 1...')'1- JI9~.
Brief description of Prop sed Construction or Alteration: JtJr:i 11) eX 6ry.
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fJ/fJ..; IL/ 'f?5nlp13"LJ(l~
Location of Proposed Construction! Alteration:
Owner of Property: "'7fIO"-l/l~ 5. RYZU;.u
Owner Mailing Address: ,2Q OlfI.Tit+O(JA<r::;-r tt1ffY kT..SlfJIl1/f1) JJY. j/76~.
Property Address: 7qO J)oR77I ~ef} :1)RIIJG
ScviHOlp, j ),y. l/q?1
Name and Telephone No. of Contact Person:
Tax Map No.: /OQC)Section: f5f Block: () S
Nearest Cross Street: KF-,[)L) Y ~c:; ''Rnf1'D.
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL.
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Si ture of Applicant 6
Lot:
1'1
Received bY:{JYj
1-tJ. -01
Date .
C:CiU r:\'~} 1J=:PA~rn.:,;<t~~;;:'~i:: H~' S.ERVICES
P"'"MI1' FOri i\PPliOVAL 01' CONSiIll.iCTiON FOR A
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SUBSURFACE SEWAGE DISPOSAL.
SYSTEM DESIGN
BY' JOSEPH FISCHETTI, P.E.
HOBAR T ROAD
SOUTHOLD, N. Y. 1/971
1631 J 765 . 2954
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C:-ERENCEO TO N.G.V.D.
'S A VIOLA TION
'CA T/ON LA W.
ILL CE:RT/FICA T/ONS
/E:RE:OF ONL Y IF
OF THE: SURVeYOR
SURVEY OF PROPER'j
AT SOUTHOLD
TOWN OF SOUTHOLl
SUFFOLK COUNTY, N
1000-64-05-14
SCALE: 1"=50
NOV 16, 1999
MA Y 24, 2006
SEPT. 28, 20061TEST HOLE' TOPO.
NOV. J, 2006 IRE:VISION}
Nov. i::.', 2006 18 "~I 1-1)
FLN. FLR ELlI
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PROPOSED GRADE
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TA-'.jj( 6.3 L f
~WATiii EL. l.8' __._-L.-_
PROPOSE:D SEWAGt: DISPOSAL. .(.'{
B POOLS WITH J' CL:.ilN ..AND COU
/500 GAL. PRECAST COIV..'riE,E sa
TANK, BOTTOM OF LE:ACH,,""; POOL<
BE: 2' ABOVE: GROiJNO If A TE/".
SEPTIC SYSTEM CROSSECTlO
17,971
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Test Boring '7
fitACOONALO GtOSCIENCi:<>
9/15/06
I . e14.
PALE BROWN FINE TO COARSE SAND SW
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WA TER IN PALE BROWN FWE TO COARSE SAND SW
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WA Tefl' IN PALE BROWN FINE TO MEDIUM SAND SP
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hREA - 38.561 sq. it.
EXISTING DWELLING NOT S,
ELEVA TlONS 8. CONTOUR L
FLOOD ZONE AE lei. IN
FLOOD ZONE FROM FIRM 3
I om familiar with the STANDARDS FOR APPROVAL
AND CONSTRUCTION OF SUBSURFACE SEWAGE
DISPOSAL SYSTEMS FOR SINGLE F AMIL Y RESIDENCES
and will abide by the conditions set forth therein and
on the permit to construct.
ANY ALTERATION. OR AODlTION T
OF SECTION 7209 OF' THE. NEW 1
EXCEPT AS PER SECTION 7209 -
HEREON ARE VALiD FOR THIS. MA
SAID MAP OR COPIES BEAR THE. I
WHOSE SIGNA TURD APPEARS HER
The location of wells and cesspools shown hereon ore
from field observations ond or data obtained from others.
Elevations ore referenced to on assumed datum.
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