HomeMy WebLinkAboutHorvath, 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
southoldtown.northfork.net
TO:
FROM:
DATED:
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
July 18,2011
Transmitted herewith is a copy of application No. 4026
Permit submitted by:
for a Cesspool/Septic Tank ConstructiOn
Charles Thomas for Horvath
Please review the application and location map and advise if the project has received Suffolk County
Health Department approval and if this office may issue the permit.
Please complete the form below and return it to me.
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE ~
DISAPPROVE
Comments: ~
SDiagti~eT~~/'
ELIZABETH A. NEVILLE
TOWN CLEP. K
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
southaldtown.north fork.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. 14 0
Permit No.
Location of Proposed Construction/Alteration:
Owner °f Pr°perty: ~ -~Z"~f~ a~. ~~
Owner Mailing Address: II ~
I
N~e~dphonen~berofcontactperson ~ ~~ q
T~ Map No: Section ~] Block ~ ~t ~
NOTE: LOCATION ~ MUST BE SUB~TTED ~TH ~PLICATION. NEW
co s uc Io
Si~amre of App~c~t ~ate
R~eived by:
Applicant Name C~
Applicant Mailing Address ?
S~tic T~ ( or Cesspool
Brief Description of Proposed Co~tmctio~ or Alteration
N
comforma~cc
system
-cs proof.
SUFFOLK COUNTY DEPARTMENT OF HEALTH sERvICES
pERMIT FOR APPROVAL OF CONSTRUCTION FOR A
S[NGLf:L G~.~4~;/( ~E~V~L-.NCE ONLY
A.PR~~~ ROOMS ~
FOR M~IMU~ OF ~ ~ BEO
EXPIRES THREE YEARE FROM DATE OF APPROVAL
ELEVATIONS REFERENCED TO N.A.V.D. '88
SURVEY OF PROPERTY
A T BA YVIEW
TOWN OF SOUTHOLD
SUFFOLK COUNTY,N.Y.
1000-01-03-05
SCALE: 1'=30'
MARCH 25, 2010
DECEMBER 21, 2010 (PROPOSED SEPTIC sYSTEM & ELEVATIONS)
JANUARY 13, 2011 (PROPOSED ADDITIONS)
MARCH ?~ gOII (ctddltlons~
PROPOSED SEPnC SrSTEU
(SIX BEDROOMS)
f~I, 5OOGALLONSEPTICTANK
8' DEEP x 8' DIAMETER LEACHING POOLS
EXISTING SEPTIC SYSTEM TO BE REMOVED OR FILLED
IN ACCORDANCE WITH S.C.D.H.S. SPECIFICATIONS.
TEST HOLE DA TA
McDONALD GEOS¢IENCE
~2/~/~o
m fo ilior with the STANDARDS FOR APPROVAL CERTIFIED TO:
' ORVA TH 8UFF. CO. HEALTH SERVICE~
I o t~;TRUCTION OF SUBSURFACE SEWAGE ~ ROBERT G. H
AND CON ..... .A'~. · · ~*'"' '-~'q~/'~ TH OFFICEOFWASTEWAT£RM~,i,
ESIDLNULb ~vtv ,, .....
DISPOSAL SYSTEMS FOR SINGLE FAMILY R ; - .~ ~0¥- ,~',,-,-,,~^,.~, 'n'nr ti, lc/to.aN COMPANY
· · ' ' t forth therein and Ol3 [ne u~,r~- ,~ ........ .._CE
,and will abide by the conditions se ~J'
~r~,it ~o ~o,,~uc~. ~ ~ ~~Er HO~E
~'~-~ 72~ ~E NEW Y~K STA~ ~UCAE~ LA~ __.._ AO~A=~ I~~."~/BOX 909
~p~ ~ ~c~ 72o~-~o~ 2. ~ ~c~.~ ~ ~v~"~~n m~ ~ ~EETI
.......... P~ ~ ~ ............. ER S
SAID MAP ~ C~IES BEAR ~E IMF~3~u oc~ ~ ,,,
~0~ ~GNA~RE 4pPEARS H~E~. ~ =MONUMENT ' ''