HomeMy WebLinkAboutNeafsey, Tom
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Town Hall, 53095 Main Road
P.O. Box 1179
Southold. New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANA~EMENT OFFICER
FREE.DOMOFINFQRMATION OFFICER
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
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TO:
Southold Town Building Department
FROM:
Linda J, Cooper, Southold Town Clerk's Oflice
DATED:
October 3, 2007
Transmitted herewith is a copy of application No. 3750 for a Cesspool/Septic Tank Construction
Permit submitted by:
Tom Ludlow for Tom Neafsev
Please review the application and location map and advise if the project has received Suffolk County
Health Department approval and if this oflice may issue the permit.
Please complete the form below and return it to me.
Linda J. 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 /
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ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
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.,Town Hall, 53095 Main R<
P,O.Box1l79
South'Old, New York 119',
Fax (631) 765,6145
Telephone (631) 765-180
sou tholdtown ,northfor k, n
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. '37:;D
Permit No.
App licant Name ---ro H \.... vi) l.- (J\-o-J
Applicant Mailing Address 10'5 OU=
V'r\ AiTTT \J<-~ I t'0 ~ '
Septic Ta~ or Cesspool_
Brief Description of Proposed Construction or Alteration k.J~ $y :s f ~
) <..x.>u G <;,;-p'\', L lyQN~ '3> d- 8'~ 6 \ l-~iJ1 ~L'S
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Location of Proposed Construction/Alteration:
Owner of Property: TC>M ~'-C:Y-\I="S~
Owner Mailing Address:~ 4- eu i:l ~5 f") (C.
'"'5A'(\Jll..L..C. ~'i, '''~d-
Owner Property Address:' d.f>jJ S\.JIv<)ff PAIt-\'
So limo LD
Name and phone munber of contact person ----rc\ ~
Tax Map No: 1060 Section 34 Block
Cross Street \-\ 0R:r D~ s \.-00 ",IE'
NOTE: LOCATION MAP MUST BE SUBl\fiTTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WIT ALTH DEP9~ APPROVAL
..=: -, ,,~'(J-d.- '0 7
. ~I) ~ ' Si ature of Applicant Date
Received by: ~ A
LvolQ.J d...q~5080
Lot J 8
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SURVEY OF PROPERTY.
AT SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y:
1000-54-01-18
SCALE: 1-=30'
MARCH 16. 2005
Dec. 26, 2006 (proposedhse.J
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I om fomilior with the STANDARDS FOR APPROVAL
AND CONSTRUCnO/'i OF SU6S(JRF'ACE SEWAGE
DISPOSAL SYSTEMS FOR SINGLE FAMIL Y RESIDENCES
and will abide by the conditions set forth therein and on the
permit to construct.
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The location of wells and cesspools shown hereon are
from field observations and or from data obtained from others.
EXISilNG HOUSE AND SEPnC SYSTEM TO BE REMOVED.
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D TE
A ".OVED
FOil MAXIMU
PIRES THREE Y
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I rt~G'. .~ ~!/ V-"~\U': '{if>.
pIG .,i'O ~O ~ .n.l y>U :
566 \CrlT' #11' .
lair ~IC\..\..\~G
~ ~O'f<"" .
o BEDIIOOMS
S FROM DATE OF APPROVAL
PROPOSED ELEVA nON
--@J- = PROPOSED CONTOUR LINE
COASTAL EROSION HAZARD LINE FROM COASTAL EROSION
AREA MAP Pholo 56-570~83
FIRST FLOOR ELEVA TION 19.5'
BASEMENT FLOOR ELEVAnON 11.6'
ELEVA nONS REFtRENCED TO N.G. V.D.
ANY AL TERA TlON OR ADDITION TO THIS SURVEY IS A VIOLA TlON
OF SECTION 72090F THE NEW YORK STATE EDUCATION LAW.
EXCEPT AS PER SECTION 7209-SUBDIVlSlON 2. ALL CERTlFlCA TlONS
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONL Y IF
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR
IWOSE SIGNA TURE APPEARS' HEREON.
TEST HOLE DA TA
AlcOONALD GEOSOENCE
a. ..2,12/6/06
E.L/.7
_., ~4__""_.__"~
VATION INSPECTiON R€QUIREO
FOR SANIT"RY SYSTEM
BY HEALTH DEl"At./T~"'HT
- 2.5'
JL
WA7U\' IN DARK BRO'MI LOAM Ol.
DARK BROI/roI LOAM OL
- 2.D'
-
WA TER IN BROWN $ANDY etA r a..
AREA=10.506 SQ. FT.
- 6'
.=MONUlJEN T
e=PIPE
WA TrR IN PALE BRO'MI FINE ro
IIt1J/UM SAN/) 51'
;4'
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NOTE'
SUBSURFACE SEWAGE DISPOSAL
SYSTEM DESIGN
BY' JOSEPH FISCHETTI, PE
HOBAR T ROAD
SOUTHOLD, N. Y. 11971
(63/) 765 - 2954
.5 LlC. NO. 49618
.C.
(631) 765-17g7
E
(631
P.O. B
1230 TRAVELER STREET
SOUTHOLO, N. Y. 11971
06-152
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