HomeMy WebLinkAboutSakarellos, ElizabethELIZABETH 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
TO:
FROM:
DATED:
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
June 7, 2012
JUN - 8 2012
BLDG. DEPT.
TOWN OF SOUTHOLD
RE:
Cesspool Construction Application
Transmitted herewith is a copy of application No.
Permit submitted by:
Elizabeth Sakarelios
4090 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.
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE ~
DISAPPROVE
Comments: Final approval required fi.om the Suffolk County Health Department
Dated
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMEN'P OFFICEB
FREEDOM OF INFORMATION OFFICER
.~Town Hall, 68095 Main R°a,
P.O. Box 1179
8outhold, New York 11971
Fax (681) 765-6145
Telephone (681) 7615-1800
sout~holdtown,northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
Residential ~ $10__
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Non-Residential ~ $25 _
Applicant Name
Applicant MaiLing Address
Septic Tank t//or Cesspool
Brief Description of Proposed Constmction or Alteration
Location of Proposed Construction/Alteration:
Owner of Propex~y:
Owner Mailing Addr~s: '~. O. i~ t-~-O~
Application No.
Permit No.
Owner Property Address: 15~ ~e ~+~OO~ ~e
Nme ~d phone nmber of ~n~t person (.~%~ ~-- ~g 2~
T~ Map No: S~fion ~ Block ~ ~t ~
CONSTRUCTION ~Q~S S~ ~H ~~EP~T~ mPROV
Si~a~ ~f ~phc~t Da~
iT 74
~1 PUBLIC WATER)
"MAP OF EASTERN SHORES,
rilE SUFFOLK COUNTY CLERK'S
~985 AS FILE NO. 4426.
TANDARDS FOR APPROVAL
~UBSURFACE SEWAGE
SINGLE FAMILY RESIDENCES
nditions set forth therein and on the
SURVEY OF PROPERTY
A T GREENPORT
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
1000-33-02-03
SCALE: 1'--30'
AUGUST 11, 2011
I TEST HOLE DA TA
BY McDONALD GEOSClENCE
MA Y 4, 2004
I~TH 10-20~ GRAVEL
~7"-- ~ (631) 765-5020 FAX (631) 765-1797
· =MONUMENT P' 0. BOX 909
12~0 ~A~LER STREET
· =PIPE SOU~OLO, N.~ 11971 11--185
RAIN RUNOFF CAL CULA TIONS
N
HOUSE z PA TIO- E?I9 sq'fl'081
DRIVEIFA Y (PER~/IOiJ, S] -
~0 ~ 0.7 ~ OJ7 ~ ~7 ~ft.
559/4E.E ~ 13~ ~
PROV~ 3 DWi 8~ ~ 5' Deep
o
PROPOSED SEPTIC SYSTEM
(FIVE BEDROOMS) ~ ~ m
[1] 1,500 GALLON SEPTIC TANK
[2] LEACHING POOLS 8' DeeP x 8' DIAMETER~
LOT 75
67'
(DWELLING 1
AREA=18,520
ELEVA DONS REFERENCED TO AN ASSUMED DA TUM.
The Iocotion of wells ond cesspools shown hereon ore
from field observotions ond or from doto obtoined from others.
ANY ALTERADON OR ADD/DON TO THIS SURVEY IS A !40LA770N
OF SECDON 7209 OF THE NEW YORK STATE EDUCA17ON LAW.
EXCEPT AS PER SEC11ON 7209-SUBDI~ISlON 2. ALL CER17FICADONS
HEREON ARE VAUD FOR THIS MAP AND COPIES THEREOF ONLY IF
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR
FvHOSE SIGNATURE APPEARS HEREON.
LOT NUMBERS REFER
SECTION TWO" FILED I,
OFFICE ON AUGUST 1~
I om fomilior with th~
AND CONSTRUCTION
DISPOSAL SYSTEMS F(
ond will obide by the
permit to construct.