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HomeMy WebLinkAboutFNV LLCELIZABETH A. NEVILLE, 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: DATED: Southold Town Building Department Linda J. Cooper, Southold Town Clerk's Office OFFICE OF THE TOWN CLERK Tow or so T.o .. April 7, 2009 ~=q - 8 2009 BLDG. DEPI. TOWN O[ SOUTI'IOLD Cesspool Construction Application Transmitted herewith is a copy of application No. 3865 for a Cesspool/Septic Tank Construction Permit submitted by: FNV~ LLC (bv Gerard Stankewicz) Please review the application and location map and advise if this office may issue the permit. Please complete the form below and return it to me. Thank you. I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE ~ DISAPPROVE Comments: Signature ELIZABETH A. NEVILLE TOWN CLERK REGISTBJdt 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 Applicant Name or Non-Residential ~ $25 ~ Application No. 3 ~- ~'' Permit No. Applicant Mailing Address Septic Tank or Cesspool Brief Descup~on of Proposed , ~cation of Proposed Constmctio~teration: Owner of Property: Owner Mailing Address: [z-NY )LLC Owner Property Address: Block / Lot Name and phone number of contact person Tax Map No: Section ~ / Cross Street t~f~ ZCZ/eL, NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL Signature of Appl[can't I d d D~tet Received by: K ~ _~ (~ TEST HOLE ~OT TO SCALE APPROVAL STAMPS 10 --mc-c-c-- OCT 2 · CO. HEALTH SERVtCEI i~.iFc~F~ OF WASTEWATER MG~ Plans am prepared by Condo. Enginee~g, p.c' It is a v[d,a~ of the New yod[ dale d such ~a~'ms, and a sped~ descfip~ of the al~a~* Engineering, P.C. 1755 ~ R~ed ~a~a~ kb~.Ynf~ 1,1952 FEATHER HILL COMMONS 53345 MAIN ROAD ,~SOUTHOLD, NEW YORK 11971 COUNTY OF SUFFOLK STEVE LEVY SUFFOLK COUNTY EXECUTIVE DEPARTMENT OF HEALTH SERVICES HUMAYUN J. CHAUDHRY, D.O., M.S. COMMISSIONER PERMIT CONDITIONS H th S ces ef rence # - O ? - 0 0 ~e a~h~ pl~ when duly si~ by a ~en~ve of ~e d~t, ~ conj~c~on ~ ~e ~ndigom, ~nsfimtes a p~it ~ ~m~ct a wa~ s~ply ~or a ~age ~o~ or ~ll~on s~t~ for &e p~pe~ ~ d~ict~. ~e ~plic~t ~ould ~e note of ~y ~n~gom of ~pmv~, w~ch ~y ~' ~cat~ on ~e pl~ or ~clos~ h~. Co~on mint confo~ ~ ~ph~le s~ inclu~g "Standa~s for Approval of Plans and Cons~c~an for S~age Dispos~ Syste~ for ~er ~an S~gle Family R~idenc~.' ~ssiom, in~mist~cies or l~k of d~l on ~e pl~ do not ~1~ &e ~lic~t ~m ~e ~spomibility of ~ng ~e ~m~odon done ~ ~nfo~ce ~& ~plic~le s~s. Issu~ce of ~s p~aiiit ~1 ~ no way relieve ~e desi~ pmf~sion~ of ~omibi~ for ~e M~,ocy of · e ~mplete desi~. The permit (plan) expires three (3) years after the approval date. Any modification which may affect the proposed sewage disposal or water supply systems requires submission of a revised plan and additional fees (if applicable) for reapproval prior to conslxuction. No inspections will b~ perfo.ma_~ ~!.ky the dopa!Llment on expired p~mits. Permits may be renewed, extended, transferred, or revised in accordance with the procedures described in Instructions to Renew, Extend, or Transfer an Existing Permit for Other than Single Family Residences (Form WWM-081). It is the applicant's responsibility to call thc deparmaent bt advance to arrange inspections of the sewage disposal and/or water supply facilities prior to backfilling. These include inspections of the sewage collection and disposal systems, water supply system components and piping, and final grading as shown on the approved plans. In certain cases, inspections of the soil excavation may be requil~ to determine the acceptability of the soils for sewage disposal systems. The department mnst be notified at least 48 hoars in advance to schedule an inspection by calling 852-S7S4; and excavation inspections 'must also be confirmed by calling 852-$700 prior to 9:30 a.m., the morning of the inspection- Article FI/of the 'Suffolk County Code, "Septie Industry Businesses," requires that all installers of septic systems within Suffolk County shall possess a valid license from the Suffolk County O~ce of Consumer Affairs, This O.O~ce can refuse to perform inspections or grant final approval for the construction of projects that are installed by an unlicensed individual. It is, therefore, in your best interest to utilize a cesspool contractor with a valid license to avoid substantial delays in your project. Final approval issued by the Department is necessary prior to the occupancy of new buildings, additions to existing buildings, or for the use of sewage.disposal or water supply systems. SEE PAGE 2 WWM-016 (Rev. 10/02/06) Page 1 of 2 CONDITIONS FOR OBTAINING FINAL APPROVAL OF CONSTRUCTED PROJECT As a condition of this pcxmlt to construct, the following items must be completed as a minimum, prior to building occupancy and use of the sewage disposal system or water supply facilities. For further information concerning this, refer to Instructions For Obtaining Final Health Department Approval Of Constructed Projects For Other Than Single Family Residences (Form WWM-19). [] Excavation Inspection by the Office of Wastewater Management prior to installation of any leaching pools to dete. ffine acceptability of soils. {Call 852-5754 to schedule an inspection and confirm by calling 8$2-$700 prior to 9:30 a.m., the morning of the inspection.) ~atisfactory inspection by Office of Wastewator Management of the sewage disposal system / sewage treatment system. (Call 852-5754 to schedule an inspection.) ~"~0'4-.-~s 4, ~, 1, ~ ¢ ? ) [] Satisfactory inspection of the water supply system by: [] Offico of Wastewater Management (Call 852-5754 to schedule an inspection.) [] Office of Water Resources, Water Quality Unit (Call 852-5810 for inspection.) [] Satisfactory inspection bythe Office of Pollution Control (Call 854-2502 for inspection.) [] Storage tanks [] Other: [] Application for a Food Permit to the Food Control Unit (Call 852-5873 for instructions.) [~our (4) prints of an As-Built plan [] "Tap letter" from water district [~Certificafion from the licensed sewage disposal system installer (to [] "S-9 form" from Suffolk County Department of Public Works (SCDPW) [] Sewer dis~et approval of sewer line installation (for other than SCDPW districts) cWell drillers certificate [] Water analysis ertificafion of Sewage Disposal System Abandonment (form WWM-080) ( o ~ f,~ ,~,~ [~Design Professionals Certification of Constructed Works (form WWM-073, enclosed) for: [] Sewer lines and sewage collection system [] Retaining walls (approved as part of the sewage disposal system) [] Sewage pump station/valve chamber [] Sub-~u, face sewage disi~osal system [] Sewage treatment plant [] Water supply system ~Abandonment of Preexisting sewage disposal system a,'~.dzr WWM-016 (Rev. 10/02/06) r Page 2 of 2 N 29'38'30" W 65.08' , N CHAIN 110.2' S 28'28'40" E N/O/F LAND OF SO~HC BECKWITH AVENUE