HomeMy WebLinkAboutGatehouse, Susan & RobertELIZABETH 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
southoldt own.northfork.net
TO:
FROM:
DATED:
RE:
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
September 7, 2010
Cesspool Construction Application
8EP 8 2010
BLDG. BEPT.
TOWN OF SOIITH0[D
Transmitted herewith is a copy of application No. 3977
Permit submitted by:
Tom Samuels for Susan & Robert Gatehouse
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 retum 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
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 __
Application No. ~7~
Permit No.
Applicant Name
Applicant Mailing Address
Septic Tank ~'~ Cesspool
p~ Brief Descriptioll of Proposed Construction o.r Alteration
Location of Proposed Construction/Alteration:
0wrier of Property: cJ'O/~,-~?~ ~ ~,Z~---7
Owner Mailing Address: x.~ ./'-./'-./'-./'-./'~ ~
0wner Property Address: ~--~ ~70 /~-'-~-~X.d/~..~
Nme ~d phone n~ber of contact person ~~~ t~ Map No: j~ Section ~ B~ck
NOTE: LOCATION M~ ~ST BE SUBMI~ED ~TH APPLICATION. NEW
CONSTRUCTION ~Q~S SURLY WITH HE~TH DEP~TMENT APPROV~
Si~df Applic~t b l '{ ~ate
Received by:
/-- ~ LINE I~1 EVA'I'ION I~,.~ PT. NO SCALE SCTM # t000-12~06-tt
PROPERTY: 2870 PECONIC BAY BLVD.
/ ~.?~.~=~ uNE ~,~,ON ~,, ~. BY ~RK .c~ONALE OEOSClE.CE ADDRESS LAURE', .V
I t"flN. 2' ~ ,/- I' MIN. 2' I~ua<X. SOUTHOLD, NEW YORK 11971 OWNER: SUSAN & ROBERT GATEHOIL/~.~.~F ~
TEST HOLE DATA 2191 10 ELEV. + 14.1
/
IE.+I~.I4' /I T~ I~- IL. +11...~4' /IPOOl'' ~I~:3T Of= t°OOE 5..~=1 PT. ~ FT, I BROWN SILTY SAND SM
PALE BROWN FINE TO
JAMESPORT, NY 1~947
5 Fl'. I COARSE SAND SW
-
- License # 50467
~)'"~'-0""1 I' ~-~' I ~'~' HIN -- 13.8FT. I PALEBROW. FINESAND SP Dated 11/23<9
WATER IN PALE
SEPTIC PROFILE RESIDENCE 17Fr.I BROWN FINE SAND
13.8 FT BELOW SURFACE - WATER ENCOUNTERED
(N.T.S.)
~.~UFFOLK~3ERMIT FOR A~~R0¥:~ L ~ CoNSTRUCTiON FOR A
~AY ~LVD
iooo ,~,N.. eeP'nc. TN, K [eT) \
J74C ~ LOCATION F'C3~ (I)g~' £ 5t~EAT
UPA t75 ~ ~L~. J'~I~B'rEJ..INE
~ 14..5
TO BE
~EXiSTING HOUS£\
~' .~ 421.95'
EXISTINg, BANIT,~I'
J~IA~ Lille TO ~
R]~II~=C, TE~ TO
ITE/P LAN
E: 1" = 40'-0"
SCDHS SUBMISSION
SIT