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HomeMy WebLinkAboutZervoudis, StevenELIZABETH 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 9/14/2010TO: FROM: DATED: RE: Carol Hydell, Southold Town Clerk's Office September 14, 2010 Cesspool Construction Application OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Southold Town Building Depamnent //j~/[_~.~iiT~:~,,,o'-~[ Transmitted herewith is a copy of application no. 3979 Permit submitted by: Frank Notaro for Steven Zervoudin for a Cesspool/Septic Tank Construction Please review the application and location map and advise if this office may issue the pemiit. Please complete the form below and remm 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: f APPROVE DISAPPROVE Comments: Final approval required from the Suffolk County Health Department Signature Dated SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK ~"ResidentialApplication No. ~ $10 or [] Non-Residential ~ $25 Septic Tank~'Orpermit No.Cessp°°l~ t~ []7 Applicant Name: I.-4~-. ~~-~ Applicant MailingAddress: ~. ~ ~ [ Briefdescri tion of Pro sed ~:~A~on P P : Location of Proposed Construction/Alteration: OwnerofPrope~: _ 3 . ~ 0 ._ Owner Mailing Address: _ ~ ~ Prope~y Address: [~O ~1~ S~m~ ~,~ T~¢Oho,~ So. oCCom¢~ V¢~o,: $~ I - ~ ~ ' Tax Map No.: [~ Section: ~ ~ Block: ~ Lot: ~ Newest Cross Street: ~ NOTE: LOCATION MAP MUST BE SUBMITTE9 W1TH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL. a~ ~~ Date Sig Received by: SCDHS Ret,# R10-10-0028 N SURVEY OF PROPERTY AT EAST MARION couNr I~-BB-OS-OB R=25.00~ SCALE: 1 ~40' ~=~ ~0' mAeCH ZO O MARCH ~, ~0~0 (CERT~FfCA TIONS) ~ ' CERT~IED TO' A~IL Z$, ZOlO (pr~os.d ~o~ ~o~ ~u ~W ~VE~I~ A~ 28, g~O (A~T~S) LOT 6 (~uNG) sEpTIC 150'+ LOT NUMBERS REFER TO 'HIGHPOINT AT EAST MARION, SEC710N ONE" FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE ON JANUARY 11, 1984 AS FILE NO. 7680. ROOF RUNOFF HOUSE 5033 SO. FT. 8~t~1 x 0.17' ~6 VF E.Z - ;2~.$ PROVIDE $ D~gs ~ ~ 8' D~p HOU~ TO USE GUTTERS ~ LEADERS C~CTED TO DRY~LLS \ \ \ \ \ \ \ ELEVATIONS REFERENCED TO AN ASSUMED DATUM I om fomilior with the STANDARDS FOR APPROVAL AND CONSTRUC?70N OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES ond will obide by the conditions set forth therein ond on the permit to construct. The Iocotion of wells ~nd cesspools shown hereon ore from field observotions ond or from d~to obtdned from others. ANY ALTERATION OR ADDI~70N TO THIS SURPEY IS A ~IOLArlON OF SECTION 720~0F THE NEW YORK STATE EDUCATION LAI~. EXCEPT AS P~R SECTION 7209-SUBDI~4SlON Z. ALL OERT~TCATIONS HEREON ARE VAED FOR TMfS MAP AND ~ THEREOF ONLY IF :m:~OVAL 258,66' HF~NU, FLR., EL. 0 E7.57,5'" 0 x L.O~T~jg~ G) PROPOSED SEPTIC SYSTE~ 9 BEDROOMS I' 2250 gd (10 dia..~4.5 elf. Deplh SEP~T~C_.TANK ~- 8' dio'x /4' Deep Leqching / LOT COVERAGE HOUSE DECK 115 s ~., POOL 7020 sq. ft. 7020/40484= 17.3~