HomeMy WebLinkAboutSchultheis, Gerard HELIZABETH A. NEVILLE, RMC, CMC
TOWN CLERK
REGISTP~AR 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
Fox (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
Linda J. Cooper, Southold Town Clerk's Office
May 4, 2010
Cesspool Construction Application
Transmitted herewith is a copy of application No. 3946 for a Cesspool/Septic Tank Construction
Permit submitted by:
Gerard H. Sehultheis
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 Y
DISAPPROVE
Comments:
Signature
Dated ~'-~
REGISTtLM~ OF VITAL STATISTICS
MARRIAGE OFFIOER
RECORDS MANAOEMEN~p OFFIOER
FRERDOM OF INFORMATION OFFIOER
RECEIVED
MAY 4 2010
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
.~Town Hall, §3095 Main
P.O. Box 1179
Southold, NewYork 119~
Fax (631) ~65-6145
Telephone (681) 765-180~
southoldtown.nor~hfork.n
$outhold Town Clerk
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10 /or
Non-Residential ~ $25 __ Application No.
Permit No./~x-"~-002/
Applicant Mailing Address ~0
Septic T~. or Cesspool
BfiefDescdption ofPropos~ Cons~ction or Alteration ~e~ ~ 0 ~ ~ -
Location of Proposed Construction/Alteration:
Owner of Property: Go.t- &f~ ~
Owner Mailing Address: P:O 8o~
Owner Property Address: d 5 140
Name and phone number o f contact person (~'x'~Vr*~ S oko I'~eo
T= Map No: 8=tion Il 0 Block. ~ Mt b~
CONSTRU~ION ~Q~S 8~Y ~H ~T~ DEP~T~ ~PROV~
, 8i~ of~phc~t Da~
R~iv~ ~ ~
· 45 Holden Avenue, Cutchogue, NY - Google Maps
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O.3, D'4R~ BROF~ LO/LId OL
TEST HOLE DA TA
BY McDONALD, OEO$ClENCE
TO'tN OF SOUTHOLD
SUFFOLK COUNTY, N. K
~ MAR~ 24, 2010
I om familiar with the STANDARDS FOR APPROVAL
AND CONSTRUClTON OF SUBSURFACE SEWAGE
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES
and will abide by the conditions set forth therein and on the
permit to construct.
The location of wells and cesspools shown hereon ore
from field observations and or from data obtained from others.
ANY ALTERATION OR ADDITION TO ~I-IIS SURVEy IS A ~IOLATION
OF ~EClTON 7209 OF THE NEW YO~K STATE EDUCA~70N lAW.
EXCEPT AS PER SEC~70N 7209-SUBOI~fS~ON 2. ~ CER17~TCA17ONS
HEREON ARE VAUD FOR THIS MAP AND COP/Es THEREOF ONLY IF
SAID MAP OR COPIES BEAR THE IMPRESSED 5~.AL OF THE SURVEYOR
WHOSE SIONA TUR£ APPEA~$ HEREON.
AREA= 14,842 SO. FEET
ROOF RUNOFF- HOUSE, 2,27~ ~q. fl. ~ i ,, 0.17 = 38~.,2 cu. fl.
DRIVEWAy - 1125 sg. ff. ~ I'~ 0.17.= 19l cu. ff.
57X/~E.E = 14 ~F ~u. fl.
PROVIDE 2' DFs. I' 8'e"8' dp. I- 8'*" 6' dp.
P~OPOSED LOT ~RAGE: 2.272 SQ. ~./ 16~
E~VA~ONS ARE R~RENCED TO AN ASSUMED DA~M
P.O. BOX 909
1230 TRAVELER STREET
SOUTHOLD, N.Y. 11971
49618
10-115