HomeMy WebLinkAboutZoitas, GusELIZABETH 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, NewYork 11971
Fax (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
September 15, 2011
Cesspool Construction Application
8EP 1 5 2011
BLDG DEPI
TOWN OF ,SOHTHO! g
Transmitted herewith is a copy of application No. 4042
Permit submitted by:
for a Cesspool/Septic Tank Construction
Patricia Moore for Gus Zoitas
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 applica~tion map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: ~
Signature
Dated t
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
sout holdtown.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¢~) ¢~'/
Permit No.
Applicant Name f~tc.~
Applicant Mailing Address
Septic T~ or Cesspool
Brief Description of Proposed Cons~ction or Alteration
Location of Proposed Construction/Alteration:
OwnerofProperty: E:~-L,',5 ~/'-/'-,"~
Owner Mailing Addr :
I, ~1lO~
Owner Property Address: "~J~/P '-~z_ ~C~'//~&.z../~ //P,~-~b/,~- /~.
Name and phone number of contact person /a~t'-
Tax Map No: Zo c~o Section c~O Block o~ Lot
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVE~ffI~LTH DEPARTMENT APPROVAL
Si'grta~o f Applicant Date
Received by:
Town of Southold
P.O Box 1179
Southold, NY 11971
Date: 09/15/11
* * * RECEIPT * * *
Receipt:
114399
Transaction(s):
1 1
Septic Permit - Construct - Resid.
Reference
4042
Subtotal
$10.00
Check#:9138
Total Paid:
$10.00
Name:
Moore, Patricia
51020 Main Road
Southold, NY 11971
Clerk ID: LINDAC internal ID: 4042
RAIN RUNOFF CONTAINMENT
HOUSE - 2811 sq. ff.
2811 , I ~ 0,17 ,, 478 cu. fl.
4T8/42.2 ' ILS VF.
PROVIDE 2 DFIs 8'¢~6' Deep
or EQUAL
LON(~ ISLAND sOUND
SURVEY OF PROPERTY
AT EAST MARION
TO ~N OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
1000-30-02-78
SCALE: 1'---40'
MARCH 17, 2011
MAY 4, 2011 (B.O. HJ
JUNE 28, 2011 (revision
LOT NUMBERS REFER TO "MAP OF PEBBLE BEACH
FARMS" FILED IN THE SUFFOLK COUNTY CLERK'S
OFFICE ON JUNE 11, 1975 AS FILE NO. 6266
ELEVATIONS REFERENCED TO N.G.V.D.
." \\
Tesl Boring
by McDonald Geo$cience
IO/IIBO EL
O~ ~o~ L~ OL
P~/e Brown EEl ML
EL
LOT 126 '~
HSE
PROPOSED SEPTIC SYSTEM I -] J
(5 BEDROOM.q)
l- 1500 GAL. CYLINDRICAL COL tL~~ Z' ~_l $' I
POOL ~ITH Y SA~
COLLAR. DIG DO~N TO ~ ~ I
\ ap //
h TRENCH
DRAIN
SAND (SPI & BACKFILL
FILTH SAND (SFI~
954. 47'
I =MONUMENT
· =REBAR PUBuc WA ~R)
am familior wifh the STANDARDS FOR APPROVAL
AND CONSTRUCTION OF SUBSURFACE SEWAGE
DISPOSAL SYSTEMS FOR SINGLE F/Edit Y RESIDENCES
and will abide b,v the conditions set forth therein ond on the
to constYuct.
/ (OI'IELLING I~TH /
/
(YACAN0
The' Iocotion of we/Is and cesspools shown hereon ore
from field observotions ond or fram data obtained from others.
ANY ALTERA?JON OR ADDI~
OF SEC~' 7209~
'XC~T
HERE~
SAID MAP ~ ~l~ ~EAR ~E IMPR~ ~ ~ ~E ~R~
~o~ ~,~,,~,,~ ~. TO TIE LINE
×,~ECOmC ~,~YORS. P.a
(631) 765-5020 FAX (631) 765-1797
P.O. BOX 909 ~'
1230 TRAVELER STREET
, SOUTHOLD, N,Y, 11971 ii--ilO