HomeMy WebLinkAboutKruse, RhondaELIZABETH A. NEVILLE, MMC
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS OF 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
September 14, 2011
SEP 1 4 2011
BLDG. DEPT.
TOWN OF SOUTHOLI)
RE:
Cesspool Construction Application
Transmitted herewith is a copy of application No. 4041
Permit submitted by:
Heath C. Richards for Rhoda Kruse
for a Cesspool/Septic Tank Construction
Please review the application and location map and advise if this office may issue the permit.
Please 6omplete 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
DISAPPROVE
Comments: Final approval required from the Suffolk County Health Department,,
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTR~t~ OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICEY{
.,Town HM1,.53095 Main
P.O. Box 1179
Seuthold, Ne~ York 11971
Fax (631) 765-6145
Telephone (631) 766-1800
sou thcldtown.northfork.ne(
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTItOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential Q) $10 / or
Applicant Name /~e~ ¢£
Non4{csidential ~ $25
<
Application No /~C C)/ /
Permit No
Applicant Mailing Address
Septic Ta~ ) o~ Cesspool
Brief Description of Proposed
~cation of Ih'opos~ Consm~ctio~Alteration:
Owner of Prope~y:_ ~A
Owner Mailh,g Address:
Owner Urope,ly Address:
'Name aad phone number of contact person
'F~ Map No: Section /o7 Block
Cross Street _
NOTE: LOCATION ~' MUST BE SUB~TTED W~H ~PLICATION. NEW
CONSTRUCTION REQUIRES S~VEY ~TIt H~TH DEP~TMENT ~PROVAL
Silage of Applicm~t Date
Received 1{y: (~
SURVEY OF LOT # 3
SITUATE
MA TTITUCK
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
MAP OF MINOR SUBDIVISION
CONSISTING OF 4 LOTS
PREPARED BY OTTOVAN TUYL
LAND SURVEYORS, GREENPORT N. Y.
APPROVED: FEBRUARY 14, 1986
BY THE TOWN OF SOUTHOLD
PLANNING BOARD
SCTM # 1000 - 107 - 1 - 10.2
AREA = 106,102 sq ft
2.45 acre
IWater Line(s) MUST Be Inspected B~t?~'b°'
Suffolk County Dept. Of Healt~LS=e4~.ices-
Call 852-5700, 48 Hours ? ~,~lvanc~L--~____
To Schedule Inspection(s)- [
/
nq
Dark brown loam
Brown silty sand
25'
17'
ot=
Very pale brown
fine sand
SUFFOLK COUNTY HEALTH DEPARTMENT ENDORSEMENTS
SUFFOLK COUNTY DEPARTMENT OF HEALTH SER~J~'CE$
PERMIT FOR APPROVAL OF CONSTRUCTION FOR A
SINGLE FAMILY RESIDENCE ONLY
DATE_~H.S. REF. NO. ~',,10-/o
FOR M~IMUM OF ~ ~ BEDROOMS
~PJRES THREE YBARS FROM DATE OF APPEAL
~.~_ ~ :N72O2~.50,'E_~ -- -- ~223.00'-
NOTES:
* BUILDER TO PROVIDE:
* 1 - 1500 GALLON SEPTIC TANK
*1-8'DIAMETER X 16' DEEP
LEACH POOL
* ELEVATIONS IN ASSUMED DATUM
* TEST BORING AS PER Mc DONALD
GEOSCIENCE DUG 11/04/10
0 100'
OL
SM
SP
~ ~ set RIGHT OF
-- ~ ~ ~ -~ ' /
. ....
vaca.t -- 12r ' -~u~F~-~-:~-
~ ravelled d~ test /
REVISED: NOVEMBER 8, 2010 ( HEALTH DEPARTMENT INFO
REDATED: OCTOBER 8,2010
SURVEYED: SEPTEMBER 1 , 2009