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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
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TO:,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
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Southold TOV1l1Jilding Department
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FRONL.-
Carol Hydell, Southold Town Clerk's Office
DATED:
February 12, 2008
RE:
Cesspool Construction Application
Transmitted herewith is a copy of application No. 3781 for a Cesspool/Septic Tank Construction
Permit submitted by:
Robert's Custom Homes
Please review the application and location map and advise if this office may issue the pennit.
Please complete the form below and relul11 it to me. Thank you.
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I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
~
DISAPPROVE
Comments:
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Signature ,
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Dated I '
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 53095 Maln 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 SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$lO--"Or Non-Residential @$25_
Application No. ::;JB I
Permit No.
Received by:
Applicant Name 'RDbe~ ~j-3.+O~ l~Il-LeS
Applicant Mailing Address -PO 60)( 3 1 d--
lA. h-cl_.t(~('1 J?/\/(l ~
Septic Tank Vor Cesspool_ '
Brief Description of Proposed Construction or Alte~ion
lJ(llJ..) C-/YT).c;+vu-<,ficfY'-..-' 8uw/((? arh(~t ('11.1)///16
Location of Proposed Construction/Alteration:
OwnerofProperty:--kn b ~..~ r -uJ-f-r,m H-ofYJCS
Owner Mailing Address: Po tuX:> '7 &-
Lcb-cL ~ I!.I\IV'- ^-JY //19()--
Owner Property Address:~ 0; l LD /..U IR-rrll- U
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Name and phone number of contact person ~&,") \ 52J / J1
Tax Map No: Section 02 & Block ~
Cross Street LU; \ (flU) T ljV I {.(; ~ S-I-
NOTE: LOCATION MAP MUST 'E SOOMI TED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY ~ALTH DEPARTMENT APPROVAL
~'--ro--!t- d/t~!op
/ Signature of Applicant Date
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Lot 10
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. '. "'ea\~" ser,jl
SURVEY OF ~M'F'"
AT ORIENT
TQWN OF{SOUTHOLD
SUFFOLK COUNTY, N. 1':
10001.26-02-10
SCALE: 1.-30'
JUNE 21, 2005
bE C. 1, 2005 (f>eop "'SE )
JUNE 27, 2006(CERTlFICA TlONJ
AUG. (5, 2D061CERTlFICA TfCNJ
NOV.7, 2006 (CERTlFlCA nONJ
MCU' 'li.. 'l._~ ((c:VlJI"" $eptoc. )
OCT. IO,cQ07 Is.plle syst.mJ
Cf.RTfE(ED TO'
CHR(STlNE M.;ENANEY
DARLENE ARMENTI
. or'.' (P.~ nj,fl~11-;;lt)'\1
)~IJ1$~" '''j ~
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( am fomlllar wl/h (he STANDARDS FOR APPROVAL
AND CONSTRUCTION OF SUBSURFACE SEWAGE
DISPOSAL SYSTEMS FOR-SINGLE FAM(L Y RESIDENCES
and w({( abide by (he .;ond/fions set lor(h Iherein and on (he
permit 10 .;ons(ru.;l.
c l,
The locations 6f wells and c~spoDls
shown hereon are from field observations
and or from dala oblained'lrom olhers.
KING S'fREET
SUFFOLK COUN
4.73'
TEST HOLE
9/30/05
BY McDONALD GEOSCENCE
DARK BROWN si. TY LOAM OL
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BROWN SIt.. T ilL
APPROVED
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"~TER fII BROWN SLT IC.
-. -- 6'
EXPIRES,
5.4100 sw
irA TER IN PALE BRO,", FIE TO
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NOTE< Q
SUBSURFACE SEWAGE DISPOSAL ~
SYSTEM DESIGN Cl
BY' JOSEPH FISCHETTI, P.E. '1.
HOBART ROAD
SOUTHOLD, N. Y. 1/97(
(6J() 765 - 2954
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LOT NUMBERS REFER TO "MAP OF W(LLOW TERRACE
SECT(ON ONE" FfLED (N THE SUFFOLK COUNTY CLERK'S
OFFfCE ON NOVEMBER 28,. 1969 AS FILE NO. 5407.
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well 6.
MO/.foID W," T</l
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CROSS SECTION-SEPTIC SYSTEM
AREA=23,739 SQ, FT.
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'ECONfC SURVEYORS, .LANO
(631) 765-5020 FAX (6
P. O. BOX 909
1230 TRA VELER STRE '. -""';'fiQi/D.
SOUTHOLD, N. Y. 1197 "':i!,>;L\~!f!5. ~~.~'
1.1'.....,,)(
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ANY AL TERA nON OR ADDJnON TO THIS SURVE:Y IS A VIOLA nON
OF SECnO,,! 72090F THE NEW YORK STATE EDUCAnON LAW.
EXCEPT AS PER SECnON 7209-SUBD""S10N 2. ALL CERnRCA nONS
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONL Y IF
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVE:YOR
'MIOSE SIGNA TURE 'APPEARS HEREON.
OCT 1 8 2D07
SUff~ Co. Oept. of Health SelVir-"A
ce of WaStewater MnIm ."'"