HomeMy WebLinkAboutBergen, Joseph & Virginie
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OEFICER
FREEDOM OF INFORMATIONOFFICER
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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OF.FICE OF THE TOWN CLERK
\ TOWN OF SOUTHOLD
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TO:
Southold Town Building Department
FROM:
Carol Hydell, Southold Town Clerk's Office
DATED:
February 19, 2008
RE:
Cesspool Construction Application
Transmitted herewith is a copy of application No. 3784 for a Cesspool/Septic Tank Construction
Pennit submitted by:
Amv Martin for Joseph & Virginia Ben~en
Please review the application and location map and advise if this office may issue the pennit.
Please complete the fonn below and return 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
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Dated
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 53095 Main Ro9'
.....
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
sou tholdtown.northfor k. net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTH OLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $ 10 I or Non-Residential @ $25 _
Application No. "3J..E 4
Permit No.
Applicant Name A/hl {Y)fJ;('T /J ~s A 1-t:i7T
Applicant Mailing Address ~@ 5 _ f5A 'I ;<:J (/t:
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Septic TankLor Cesspool_
Brief Description of Pro posed Construction or Alteration Nt w
4'fi.icl.ene kU
Location of Proposed ConstrnctionlAiteratio.l1j. . .
Owner of Property: VO~~7h 'l< V/~6tA.l(~ {) ~n
Owner Mailing Address: 2_3 I/~ __
f!..tJdv,I!.e.-- 0n-fte.u ,Ivy
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Owner Property Address: /o,)S Reydor/ });e.t cJ-V
..JJ LoT -II 0 L.1J '
Name and phone number of contact person Al'nj /l)i'tte-I/:J
Tax Map No: /00 t) Section J- 0 Block /
Cross Street Ofl~ (&JMlt.;/./ w.Yh )
NOTE: LOCATION MAP MUST BE SUBl\UrfED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURvEY H ALm DEPARTMENT APPROVAL
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Received by:
OAK DRIVE
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BASE ON SURVEY OF
LOTS 5 I THRU 54 INCLUSIVE
IN MAP OF REYDON SHORES. INC.
SITUATE
SOUTH OLD, TOWN OF SOUTHOLD
SUFFOLK COUNTY. N.Y.
FOR JOSEPH BERGEN
DATE FILED JULY I. /93 I
TM# 1000-080-01-29
5 I T E
PLAN
SCALE: 1"=30'-0"
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SURVEYED I 2 MARCH 200G
AREA = 29.208 S.F.
OR 0.G70 ACRES
SURVEY BY STANLEY J. ISAKSEN. JR.
ISO
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FINISHED
GRADE El. DATUM- 0.0'
FITCH 1/4' I fT-:---
INV.EL INV.EL
-1.92' -2.17'
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GRADE
PITCH 1/5" / fT.-
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INV.EL. INV.EL.
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SCDH5 APPROVE
PRECAST 8'0
LEACHING POOL
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(BOT.EL.@TE5THOLE)
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NO WATER ENCOUNTERED
PROPOSED SEPTIC SYSTEM DETAIL
TEST HOLE
DATA
N.T.5.
PALE BROWN
SANDY SILT ML
I- - - 3.0'
BROWN FINE TO
COARSE SAND SW
/7.0'
NO WATER ENCOUNTERED
DATE, NOV./5. 2007
IT IS A VIOLATION OF THE
LAW FOR ANY PERSON,
UNLESS ACTING UNDER THE
DIRECTION OF A LICENSED
ARCHITECT, TO ALTER ANY
ITEfJl ON THIS DRAWING IN
A~IY WAY. ANY A. .THORIZED
ALTERATION MUST BE
NOTED,SEAlED,AND
DESCRIBED IN ACCORDANCE
WfTHTHELAW.
IU.S.
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C UNTY D~P~RTMENT OF HEAI.TH SERVICES
SUFFOI.K 0 ~ ,
PERMIT FOR APPROVAl. 01' CONSTRUCTION FOR A
SINGLE FAMII.Y RESIDENCE ONLY
DATE~ ,\~\j\, H.S. REF .NO. \;l.. '\'\) -\:)\:, - \JJ--:JJ
APPROVEo~r^ - ~^~~
FOR MAXIMUM OF '0<, l3:0ROOMS
EXPIRES THREE YEARS FRO'M DA"'E OF APPROVAL
BERGEN
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o 1/28/2008
F AI RWEA TH ER-BROWN
DESIGN ASSOCIATES,INC.
205 BAY AVENUE
GREEN PORT, N.Y. 1 1944
(;31-477-9752 (Fax) (;31-477-0973