HomeMy WebLinkAboutJohnnidois, NickELIZABETH 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.nor th fork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO:
FROM:
DATED:
RE:
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
July 6, 2012
Cesspool Construction Application
Transmitted herewith is a copy of application No. 4094
Permit submitted by:
Stacey Bishop for Nick Johnidois
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 thc application and location map of thc project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments:
Final approval required from the Suffolk County Health Department
JUL - 9 20t2
BLDG DEPT.
TOWN OF SOUIHOLD
Signature
Dated --
TOWN CLEHK
REi~I6TRAR OF VITAL ~TATI~TIC~
M-AKRIAGE OFFICER
I~,ECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
.~Town Hall, 53095 Main
P.O, Box 1179
Southold, New York 1197
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.nortlffork,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 __
Applicant Natne,~d<:~y 7-~'tx/4l~ (.-¢.~.-t~ r..~.~j~.~
Applicant Mailing Address
Application No. q 0(~ _1~~
Permit No. ~ -
Septic Tank or Cesspool
Brief Description of Proposed Construction or Alteration
Location of Proposed Construction/Alteration:
Owner of Property:.
Owner Mailing Addr~s:.
Owner Property Address:
Received by:
Name and phone number of contact person .('w~act_~ ~, fda? ~o~4-~t. Xr-'- 5,/j ~ 2._
Tax Map No: S~ction [(~o Block /~ Lot
Cross Street 4~.t.~ tr-~ ~
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION, NEW
CONSTRUCTION REQUIRES SURVEY WITH ItEALTH DEPARTMENT APPROVAL
S.C.T.M. NO.
DISTRICT: I000 SEC~ION: 106 BLOCK: 5
LOT(S): 3',3
SUFFOLK COUNTY DEPARTMENT OF HEALTH SER~
PERMIT FOR APPROVAL OF CONSTRUCTION FOI~
SINGLE FAMILY RESID£NCE ONLY
HAY 2 Z 2012 ,...
W/PUBLIC WATER ~
FOR MAX~.~ R~ BED,CO,S
EXPIRES THR~ YEARS 'F DATE OF APPR'
MAP OF CAPTAIN KIDD ESTATES
OWELLINGS
W/PUBLIC WATER
150'
S87°1 I'O0"E
EL 52.4
mX
EL(53.O)
26.0'
EL(52.0)
48.0'
PROPOSED
2 STY FRM.
DWELLING
MIN
EL 51.2
$4.0'
~ ~ COVEREi PORCH
5'
N87° 11 '00"W
CL 50.9
EXISTING WATER MAIN
2ND TLR. CANTILEVER
GARAGE
14.0'
I,,,
.0
la:
.~-
i
100.00'
X
CHAINLINK FENCE 0.9'S
EL(53.0)
, 51.3
).00'
26.0'
EL(52.0)
EL 52.5
POST
DWELl
W/PUSLI(
0
EL 51.3
POST
9
291.50'
CL 50.24 CL 50.22
RUTH (5o') ROAD
22'± ASPHALT PAVEMENT - TOWN MAINTAINED
DWELLINGS
~ W/PUBLIC WATER
NYT~3 150'
VACANT
100'
THE WA TER SUPPLY.
LOCATIONS SHOWN ARE
UPDATE/CHANGE HOUSE 04-10-12 ANO OR DATA O~TAINED
AREA: 12,500 S.F OR 0.29 ACRES ELEVATION DATUM:
UNAUTHORIZED ALTERATION OR ADD/T/ON TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STALE EDUCATION
MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES
ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF' TO THE TITLE COMPANY, GOVERNMENTAL AC,~NC