HomeMy WebLinkAboutSafer, SylviaELIZABETH A. NEVIT,LF,: RMC, CMC
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF IlgFORMATION 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
TO:
FROM:
DATED: April 5, 2010
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No.
Permit submitted by:
Thomas Samuels for Sylvia Safer
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
BLDG.
__ TOWN OF $OUTHOLD
3940 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.
Carol Hydell
I have reviewed the application and location map of the project cited above and make the following
recommendations: ~
APPROVE
DISAPPROVE
Comments: Final approval required from the Suffolk County Health Department
Date7 ~/~/~O
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTHAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF IBIFO~OFFICER
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
Town Hail, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
£
Residential~ $10 ~'or
Applicant Name__
Non-Residential ~ $25 __
Application No. !
Permit No.
Applicant Mailing Address ~-'~ I~_d,/~,,_ ~
S~fic T~ ~ or Cesspool'
Brief Description ofPropos~ Cons~ction or Mteration d~ h~c ~ f ~& 0~
~c~on of Proposed Com~ctio~terafon:
Owner of Property:
Owner Mailing Address:
Owner Property Address:
Name and phone number of contact person
Tax Map No: ~ Section C~ g
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HE~TH DEPARTMENT APPROVAL
Signatu~o~f Applicant · D/ate '
·, Received by:
mS. NG ~,T" D^TA
/-' ~ LINE FI ISVATION I~ FT'. -- SCTM# 1000-98-05-13
/ ........ ~" '~"'"'"'~'"' "~ ~ / ~'==1 I ..,-.~ ~= ,l~_esP~ PROPERTY: S6001NDIANNECKLANE
/ ~,.~r~ &.ll~ rl,r;,yP~llr~l~l ic~ FI, / l~ ll.,v ~ ~ ADRESS Peconlc, NY.
/ '~ , ~ r HIN. 2' HAX. , f- I' HIN. 2' I,'~X. / FOf~ II=~.I~ATION ~ OWNER: SYLV~ SAFER
I/4"A=T ~ /~,.__ I I J~ / % SITE' 146.495 SF = 3.363 ACRES
· · J , ~ /fiT. I I J TOP OF P~OL 14.(~1 FT. / 7nm'ut.. n ~n
' E~L=PTIC' ...... LEAC, HII,~ ~ =~ .................... ~ ~ I lC,
/~ TAFB( R JJ---- , I / ..... ~ SURVEYOR: Nathan Taft Corwin Ill
[IE+IS.b4'/I ~LIE +1~.4,4' [I~'c'~a- t~:rI' OF POOL ~,.bq P*T :~T~lg::t'~ \ 1856 Main Road
1~-o+14.q4 i ! ~1::. +1~-.,~o -' ~ r ' ~ ,'7 J' " License# 50467
--~.-'~-_,,-I-- I---~;-=~,, -I- I~--'"'~ ~'~ ' ~' / , (=)e'r:,l^x e'~l~ LE,~_ml~ \ o,~, :u..17.~09
..... ' ................ ,~..-~m~ a'~::l'&l~l~.J'[l~ /] P. rr~ LC~^TIO~ ~ (I)e' LOCATION MAP
,,.T.S., I /I
~ ~ IL~ ~o~ ~ i------I I X ~ ~ I I ' -J I~// I '~ \~'
"~ ~ J~, ~ I I..,-'-, ',, ,,~.. / I % ..,~:~,.~ ~ I ~\\~~
['-"' \ I I .----- - I
,,.itl
~ ~ J~ ~ F~ ~I~ATION ~ ~F~.I~ m~' ~ I ~ / BY~RKMc~
~- J L~ X ~ ~ / / J /TFgT H~I~ GEOSCIENCE
~ TO~ 16' - - I NO SC~ N~ YORK 11971
~ r 1~'_. ~ ~ -~ ~ ~~ '0 ~ ~ / TEST HOLE DATA ,,.t..) EL~ 161
~ . T ~ ~t I I ~ ' '
~ I I~ / ~' ~--- ~ '~ J.''/ -- / ~, ~ARKBROW~O~OL
~ ~IDE~E ,
o- I~' ~ ~ ~ ~ ~ I ~ .~;B ~ ....... I
~= Iu, ~ ~ ~ ~/ L~ /.~-~13 -- I WA~RINPA~BRO~
~ I. ) % / I ~ ~ ~:[ / 17~, IFIHEsANDsP
~"l I~ / / 16i-~ ~ ~C~o . t4.4~BELOWRURFACEWA~R~UN~RED
~1 17~ ~ ~'~ s~s= ~ SJ
Y~I J/ ~$~~1~, ~X I I ~ /.. / .....
~"1 I-I~e~ict~(sv) ~ .}~lg~ t/Il/JO ~.~10-~-~7~
F~I DI~x~'HI~I~ ~ , ~,~UMOF ~ BEDR~MS
~ O~ comfom~ce xvith de~et~t r~ U~'J~ / I d ~]" ~l I
~..co ' I~ ..... i ................. I ~/