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Cody, Arthur
~Og11FF0(,r~, ELIZABETH A. NEVILLE, MMC Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 N Z Southold, New York 11971 REGISTRAR OF VITAL STATISTICS p • .1C Fax (631) 765-6145 MARRIAGE OFFICER Telephone (631) 765-1800 RECORDS MANAGEMENT OFFICER Oj ~a FREEDOM OF INFORMATION OFFICER www.southoldtownny.gov OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department OCT 2 3 2013 ~D FROM: Carol Hydell, Southold Town Clerk's Office GUI-G. HPT. DATED: October 23, 2013 or: r; o:G:.i !o 0 RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4170 for a Cesspool/Septic Tank Construction Permit submitted by: Mark Schwartz for Arthur Cody 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 r Signature Dated gUFFO~,~cOG ELIZABETH A. NEVILLE TOWN CLERK co y~ Town Hall, 53095 Main Road 1179 REGISTRAR OF VITAL STATISTICS ca P.O. Box Southold, New York k 11971 MARRIAGE OFFICER O RECORDS MANAGEMENT OFFICER yi7 • O`~ Fax ne (6 765-65-1 FREEDOM OF INFORMATION OFFICER Telephone 00 southoldtown.no .northforfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @ $10 1,/ or Non-Residential @ $25 Application No. "L t l Permit No. Applicant Name ~ ~ T Applicant Mailing Address_ :_~~~X~ 9 l?~ PL~ Septic Tank or Cesspool Brief Description of Proposed Construction or Alteration~fr _t/ u ~ li71/ f Location of Proposed Construction/Alteration: Owner of Property: CaJd Owner Mailing Address: -441 CCA_J~ 2,1= f C /yj Owner Property Address: ti Name and phone number of contact person Tax Map No: Section. 1/6 Block p Lot 0 ~ Cross Street NOTE: LOCATION MAP MUST BE SUBMITTED WIT APPLICATION. NEW CONSTRUCTION REQUIRES SURVE H HE P MENT APPROVAL Signature of Applic Date Received by: ~0 t ooy 13 ANI am D CONSTRUCTION OF SUBSURFACE SEWAGEVAL DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES and wAl abide by the conditions set forth therein and on the N perm;( to construct. EPARTMENToFtlF~+ITHs~`^cES SURVEY OF PROPERTY $UFFOC'OU DPROVALOF CxN15iRFORA PERW FOR AP P$1DENCE AND e3 AT . CUTCHOG UE • LE FAMILY o. G S>» ^ TOWN OF SO UTHOLD AREA OF UPLANDS = 9287 sq.tl. ~0 _ ODo y SUFFOLK COUNTY, MY EXISTING LOT COVERAGE = O% O PROPOSED UPLAND AREA.COVERAG 1000-116-04-02 (by imprvious surfaces) = 8% DATE SCALE.- l s=300 APPR BEDROOMS N y OV. 18, 25, BOH) PPROV NOV. 25,.2e•e2009 9 ( Tbe la f1 Yrv ao of ~ Ik SOT MQATEOFA FEB. 2, IREYi5ED^ ELEVATIONS (NAVD88) aban Anom eoa we from AW/ o6wnWranc ~g ad or Irarw date obfafoad Irma airy p(PIFZt~ o $ FEB. 2010 20/0 IkddillorisJ r1wa(ore Ask kefoo a ad or adwow.* sy 0 REVISIONS) ELLING FOOTPRINT = 745 sq.fl. 2 MARCH 1, 2' RAINFALL u+r ^ Appwa# 30, 2010 (additions) 0.167 FEET J&A k 8, 2010 trovw my E* AVATION INSPEcT - DRAINAGE REQUIRED - 124 c(0. '1m~ G OCT. P7, 2p0 i=VKIOFRS) FOR S ION REQUIRED • tUSE f2) 23' INFIL TRA TI CHAMBERS u't, A`9-" Jan. 7, 2011 MV I SI M SEPTIC SYSTEM CROS ECTION SANITARY SYSTEM (34' _ 169 TO filc CCTED 710 rn HSE. (3 BEDROOMS) HOUSE BY UN07GROLWD PIPING g„ M W.10 HEALTH DEPARTMENT w y JAN 2t,l1 (~rsvlslonsl EL as 1r° yr°d' ' Et: 7 ~c 06 TMA©ICOA SONS _k A#W 7, zarl o v/IONS~ ; E r MARGam' E 7.i E.7 ST - E at u7m a as ar r ?a ANC)ftf a Ile c o n y E \ o. Clip I- 1000 GAL. PRECAST SEPTIC TANK 5 As ooN s .2 'A, E' qty \ op d 5- BV • 2' DEEP LEACFNG ppq,s we c_oN ~,,tNSU,nNG. N Cn CERTMD TO, MATH 3• SAND COLLAR ISM AL 1 \ S=~ U yK: FILL FOR SEPTIC W~rrp ~cCN r~ \ °F v 10 \ d Vi HEM ODY DY • PROP EL or Conlow M+e ' y0' \ 6'cr jQ._ _ G _ >t v r_ b c, AP i v \ M TEST BORING lee ode~ Z~ 1 A5j0N = 61 •5U80 yl0 ~y MaDardd Goosdknca 2"Z a o-o~, \ ON 1 . , , 1(m5/09 N~ 1 V+N THE G EL 5.3 nOD MENt Af NFl1~~ ~E DN AN O DARK BROWN £ FLAC \~EQf pOVR"C RKSSO ` 1 LOAM OL ` N 8, ° ~CS~ \ COON E NO. 5 BROWN CLAYEY \392p~ Y t5 y IIUsj~~US( o \ AS SAM 3. AS ko. BROWN S`AWY ARC CABS 4. CLAY FN1E TO p,REt~NHAM ox c~RavEC N~p M T R" OFNE/y WITH 11 _ _sw_ `~`N+~ .nJE IAA i~ T. Mr rr ~ 4. 'WATER IN BROWN EL 0.9 4'r~ . OF "1 M TO COARSE \ Mo m I slio% •A.. rp M B WATER W PALE FLOOD ZONES FROMFIRM NO BROWN FNE -TO 36103CO501 H 9125109 P / 49618 Ir MEOMI SAhD SP NAVD 88 ANY ALT£RA77% OR ADOl77 TO THIS SURVEY IS A 140LA77ON A ECONIC "VE OF SECTION 72090E 77YE N YORK STATE EDUCA77ON LAW. (631) 765-5020 F 6 65-7797 ELEVATIONS ARE REFERENCED NA VD 88 EXCEPT AS PER SECTION 9-SU8bINS(ON 2 ALL CERT7F7CATIONS P.O. BOX 909 • HEREON ARE VALID FOR MAP AND COPIES THEREOF ONLY IF AREA-12,661 ~Q. FT. SAID MAP OR COPIES BEAR 'THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STREL~T ¦ =MONUMENT WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N. Y. 11971 109-119