HomeMy WebLinkAbout82 19th Street CorpELIZABETH 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
TO:
FROM:
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
AUG 1 4 2012
BI I)G DEPT.
]O?~N OF SOiJIHO[ D
DATED: August 13, 2012
RE:
Cesspool Construction Application
Transmitted herewith is a copy of application No.
Permit submitted by:
82 19th Street~ GRP
4100 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 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
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 766-6146
Telephone (631) 766-1800
southoldtown.nor~hfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Applicant Name f~
Applicant Mailing Address
Residential ~ $10 V/or Non-Residential ~ $25 __
Septic Tank or Cesspool
BriefDescripUon' of Proposed Construction or Alteration
Application No. 1.({0 0
Permit No.
Location of Proposed Construction~Alteratic~'r/2
OwnerofProperty: ~.. {c~ rtl ~l~ r~
Owner Mailing Address:
Owner Property Address:
Name and phone number of contact person
Tax Map No: Section , '~
CrossS eet
NOTE: LOCATION MAP MUST BE SUBMITTED W~T~ APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTM'~C~RTMENT APi~ROy~kL
bY~: ~/~J~'~"~ Si~ature of Applicant Date
Received
BlockLot
LOT AREA = 19,869 SQ. FT. TEST HOLE BY McDONAlD G£OSClFNCE
FFL ELE'V -- 4-2.5 5-14-2012
NOW OR FORMERLY
GAR EL.EV = 40.5
ZEBROSKI
DARK BROWN LOAM OL
~_~~ N 25'05'50"£ 75.00' 0.5' --
¢3Ls) ('30.0) BROWN & PALE BROWN
~/ CLAYEY SAND SC
PALE BROWN FINE SAND
Z ~o 28' -- SP
o
0
o ~ < 0
° FxcaYa ion Inspection
c By Health Depart
'-~ 0
o
PROP
E~ 707.02?
Location of water mains 5-'YSTEM
& adjoiners water supply
by others and ore not DWELLING / PUBI. JC WATER
9uaranteed' 6-28-2012 REVISED SANITARY
~wum~ma~.~mc~mu~a~a[~o~ JOB No. 12--95 FILE No. 951
MAPPED FOR
~ ~ ~ ~1~ ,or ~ m ~ ~smtrneas TOWN OF SOUTHOLD, SUFFOLK COUNTY, N,Y.
ca~se~su~y~er~z~su~we~s~e~ms[~ SCALE 1" = 40' DATE 5-9-2012
FILED MAP No. DATE
CERTIFIED ONLY TO: TAX MAP No.(REF ONLY) ~000-78-7-38 DISK 2012
HAROLD F. TRANCHON JR. P.C.
LAND SURVEYOR
P.O. BOX 616
~/~ /: ~ ~ 1866 WADING R IVER-MANORNEw YORK, 11792RD' WADING RIVER,
LIC No. 048992 631--929--4695
HAROLD F. TRANCHON JR. PENN LIC, No 2115-E