HomeMy WebLinkAboutBarry, Joyce and RobertELIZABETH A. NEV~J,E, 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
TO:
FROM:
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
JAN ff.2 2009
BLD~. DEPT.
tOWN OF SOUTHOLD
DATED: January 22, 2009
Transmitted herewith is a copy of application No. 3851
Permit submitted by:
for a Cesspool/Septic Tank ALTERATION
Jo¥ce & Robert Barry
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.
I have reviewed the application and location map of the project cited above and make the following
recommendations: ~
APPROVE
DISAPPROVE
Comments:
Maintain required setbacks from adjacent wells, buildings, property lines and water
Bodies. EXC~AVATION INSPECTION REQUIRED.
Signature
Dated /
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 SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential ~ $10 / or Non-Residential ~ $25 __
Applicant Name ~O~C-~
Applicant Mailing Address [~ ~._~
Septic Tank or Cesspool__ 0 - -
Brief Descripti. on of Prl~posed Conskruction or Alteration
Location of Proposed Construction/Alteration:
Owner of Property: ~OO__~ 3C, ~
Owner Mailing Address: ,~5/~
Application No. ~ q~ ~
Permit No.
Owner Property Address: ,,~/"P'I'
Name and phone number of contact person '~-'0~/~9_, [~Y~y. ~),~[
TaxMapNo: Section lob BlockO[ Lot (5~. j
Cross Street Se ~[c~O_[_ ~Cy~._~
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
Signa~f ~p~ic~mi 0 /Datot '
Received by:
NOTES:
]. ELEVATIONS ARE REFERENCED TO AN ASSUMED DATUM
EK~ST~NG ELEVATIONS ARE SHOWH TNU$:~O-O
2. REFER TO FILED MAP FOR TEST HOLE DATA,
3. MINIMUM SEPTIC TANK CAPACITIES FOR 4 BEDROOM HOUSE l$ 1,000 GALLONS.
1 TANK; 8' LONG, 4'-5" WIDE, 6'-7" DEEP
4. MINIMUM LEACHING SYSTEM FOR 4 BEDROOM HOUSE IS 500 sq fi SIDEWALL AREA.
1 POOL; 12' DEEP, 8' dia.
PROPOS£D EXPANSION POOL
QPROPOSED LEACHING POOL
~2-~PROPOSED SEPTIC TANK
S. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD
OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS.
6. EXISTING SEPTIC SYSTEM STRUCTURES SHALL BE PUMPED CLEAN AND
REMOVED IN ACCORDANCE WITH S.C.D.H.S. STANDARDS.
LOT~
PREPARED IN ACCORDANCE WITH TI
STANDARDS FOR TITLE SURVEYS AS
BY THE I-I.A.L.$. AND APPROVED A
FOR SUCH USE BY THE NEW YORK
TITLE ASSOCIATION