HomeMy WebLinkAboutFallon, JohnELIZABETH A. NEVTI.LE, RMC, CMC
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
~':: '): '5 ~i>~:~ ~ TOWN OF SOUTHOLD
TO: , ~S,b~atl~6~:Town Building Department
FROM: /- Carol Hydell, Southold Town Clerk's Office
DATED: December 3, 2008
Transmitted herewith is a copy of application No. 3842 for a Cesspool/Septic Tank Construction
Permit submitted by:
Frederick Weber for John Fallon
Please review the application and location map and advise if the project has received Suffolk County
Health Department approval and if this office may issue the permit.
Please complete the form below and return it to me.
1 have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE Y
DISAPPROVE
Comments:
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRLa. GE 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 SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential ~ $10 .~ or Non-Residential ~ $25 __ Application
Permit No.
Applicant Name ~k~E) ~g-~t (A~ ~~,,
Applicant Mailing Address
Septic Tank ~ or Cesspool
Brief Description of Proposed Construction or Alteration
Location of Proposed
Owner of Property:
Owner Mailing Address:
Omer Prope~ Ad&ess:
Name and phone number of contact person
Tax Map No: IP~0~ Section ~3
Cross Street ~gr-'~lvt.~fq~ W'vqLto
Block (oLot I
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
~ignature of Applicant Date
Received by:
.....-. S 78 43' 07"
O-PARC£L ~,
/-07
~ 51TE
PLAN
TEST HOLE DATA
crEST HOLE [:XJG BY HcDONALO GEOSCIENCE, 1/11/O/,)
LiNE 07"
GRADE)
GROUND
LOT ~ I I/2'~' mATER LINE
(BURY A UINIUUN OF
~l'-&' EELOm GRADE)
VACA
FLOOD ZONE: AE (EL 8). X* AND X
ALL CON3TRUCTION IN ZONE X* OR ZONE X.
8 ~ NEt!J CONTOUR
CONCRETE
CHIUNEY DEPTH
LOT
4'~ APPROVED
PIPE. I/'4' PER FT.
FF HOU3E
TRAFFIC
LOCKING CA3T
+1~ 5' IRON COVER 3LAB
GR--~EL BEARING
~ TO GRADE -~ GRADE EL +14.5'
~ ~'e APPROVED CONCRETE
CH ~ I PIPE. I/8" PER FT. COVER
EL +I2.qS' ~L +~=.r J I~=) I I /
L.r I I...rL,ou,~ J
~EPTIC ~
TANK
flSO0 GA L.)
EL +15.25
FLOU. I---/
BAFFLE
PROPO.SED ,
SANITARY SYSTEM
8'-O" (MIN.
_~_L +1 s'
HEET ALL 5.C. DEPT. OF HEALTH SERVICE5 REGULATIONS.
66,3.59,
VACANT
PE~OPERT¥ O~INEI~: :
JOHN t SUSAN FALLON :
SITUATE; BATVIEIU (5OUTHOLD) ' f',.h
TOIUN OF .~OUTHOLD
SUFFOLK COUNTY, NEIII YORK r ~.;
SURVEY. INFORFIATION:
JOSEPH A. INGEGNO, LAND SURVEYOR
RIVERHEAD, N.Y'.
SURVEYED: JULY' 2005
+C'.O' = ELEVATIONS REFERENCED TO N.G.V.D. of 1fl2fl
o 'T
, L~19~