HomeMy WebLinkAboutSwing, RobertELIZABETH A. NEVILLE, RMC, CMC
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hail, 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
TO:
FROM:
DATED:
RE:
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
April 14, 2009
Cesspool Construction Application
DLOG. DEPT.
TOWN OF SOUTHOLO
Transmitted herewith is a copy of application No.
Permit submitted by:
Robert Swing
3867 for a Cesspool/Septic Tank Construction
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
Signature
Dated
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
.~Residential ~ $10 or [] Non-Residential ~ $25
Application No. ~7 ~ 7
Applicant Name: .~.~'. ~ ~-q~, '~1~1~'~'
Applicant Mailing Address: '~,~ ~l/~-
Brief description of Propsed C0nstmc~i'onIor'~ltemti~:
Septic Tanl~r Cesspool []
Permit No.
Owncr ofProperty: .M,,n~-~d~. ~~-'~
Owner Mailing Address: z~])/~ ~cJ~.-t ~.t~t~-4 ~
Property Address: '~f~'~ '~J~c/~--~t~li~- q~?. /
Nme ~d Telephone No. of Contact Pemon: I~~
T~ Map No.:, ~ ~ S~fion: ~ ~ Bi~k: ~ Lot:
Newest Cross S~t: ~
NOTE: LOCATION MAP ~ST BE S~T~D ~H ~PLICATION.
CONSTRUCTION ~QU~S SURLY ~H ~ALTH DEP~E~ ~PROVAL.
Receiv~ by: S~
N
SUFFOLK COUNTY DEPARTMENT OF H~ALTH ~¥1CP.8
APPROVED~--
....... ~um urn.. BEDROOMS
EXPIRES TEREE YEARS FROM DATE OF APPRDV. AL
,THE CONTRACTOR IS TO I,~7~tFY ALL MEASUREMENTS
IN THE FIELD AND ANY DISCREPANCIES ARE TO BE
BROUgh, IT TO THE ArrEN~ON O~ 7H£ ENgINEeR
F,?IOR TO CONSTRUCTION. /
~ EXCAVATION INSPECTION RECHJIRED
FOR SANITARY SYSTEM
LOt CO~,~E e¥ ~r,
LOT AREA IO0$$,~O~;FT. NOTE: ALL SURROUNDING Off,LUNGS i~THIN.
AREA OF' UPLANDS 7503 150' HAVLm PUBLIC WA~R
EXISTII~ COVER, aG['
$vl 4
EXISTIN~ DII~EI. UN6 - 1060.5 SOFT ,, 14J~
CONC~I'~ ,ALRS & ~ ~
Cx/sr~ CO~A~ , I7. e~
~0~ CO~R~
WALK 1809 gO. FT. 24J~ ~ ~l
Abandonment of existing sanitary system must be in "[I
comformance with departmertt, requimment Subnfit
completed form WWM- t~ ~ as proof.
N85'40'$0' , ~.
8W &2' ·
I am familiar with the STANDARDS FOR APPROVAL
AND CONSTRUCT?ON OF SUBSURFACE SEWAGE
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES
and will ob/de by the conditions set forth therein and on the
permit to construct.
The location of we/Is and cesspools shown hereon ore
from field observoUons and or from data obtained from others.
Elevations referenced to N.G.V.D.
ANY AL TE'MA~ON OR ADDITION ~D THIS SURVEY IS A IffOLABON
OF SECnON 7209 OF' THE NEW YORK STATE £DUCAnON LAW.
£XCEP 7 .~ PER SECTION 7209- SUBO/ V~ S/ON 2. ALL C£R nF/CA170NS
HEREON At~ VALIO FOR THIS MAP ANO COPIES THEREOF ONLY IF
SAID MAP OR COP/ES B£AR.'TH£ IMPRESSED SEAL OF THE SURVEYO~
GRADING t 1.4N
4° ,~'~Ot~
' .,~ [ r~.~~ [.4~, 't'I~,GsH $. Il ~ALLTO~TA~L
LEACHING POOL S t '~ I ~
SURVEY OF PROPERTY
A T ARSHAMOMOOUE zo~.~, ,
TOWN OF SOUTHOLD, '~*
SUFFOLK COUNTY,
I000-6,?,-0~-R4
ECAI.~ I~20'
JANUARY 29, 2008
FEB. 4, SO09 (REVISIONS)
MARCH 6~ ~009 (Revisions)
180.
\,
~. LIC. NO
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