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HomeMy WebLinkAboutLepera, Charles gf?fF0(,~ ELIZABETH A. NEVILLE, MMC !``lO~ CO~jy Town Hall, 53095 Main Road :i P.O. Box 1179 TOWN CLERK y : Southold, New York 11971 REGISTRAR OF VITAL STATISTICS p • .1C Fax (631) 765-6145 MARRIAGE OFFICER Telephone (631) 765-1800 RECORDS MANAGEMENT OFFICER www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK D TOWN OF SOUTHOLD D TO: Southold Town Building Department OCT 2 2 2013 FROM: Carol Hydell, Southold Town Clerk's Office BLDG. DEPT. TOWN OF SOUTHOLD DATED: October 22, 2013 RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4171 for a Cesspool/Septic Tank Construction Permit submitted by: Charles Thomas for Charles & Susan Lepers 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. ~ * * ~ * s s s + t 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 Signature Dated ELIZABETH A. NEVILLE h~o~0$~Ffo(,~ COG¢ Town Hall, 63096 Main O Aoa TOWN CLERK y. P.O. Box 1179 REGISTRAR OF VITAL STATISTICS v~ Southold, New York 11971 MARRIAGE O OFFICER Fax (691) 766-8146 RECORDS MANAGEMENT OFFICER Telephone (631) 786-1800 FREEDOM OF INFORMATION OFFICER 1( southoldtown.northfork.net OFFICE OF THE TOWN CLER$ TOWN OF SOUTHOLD TOWN OF SOUTHOLD BUILDING DEPARTMENT P.O. Box 1179 SOUTHOLD WASTEWATER DISTRICT Southold, N.Y. 11 971 - APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK , Residential @ $10 / or Non-Residential @ $25 _ Application No. rw I Permit No. Applicant Name U;:-5 Applicant Mailing Address 1PI2 i t7 077 Septic Tank ?or Cesspool__IZ- Brief Description of Proposed Construction or Alteration ) t~.-- V SI/11~. w.- Location of Proposed Construction/Alteration: Owner of Property: el- Lev mo~z Owner Mailing Address: (j1 O IOW - l'I1~Nl'1N~ ~rV I~17 1~ [~'~J Owner Property Address Name and phone number of contact person X14 VC-L T40 yHgg l _7 Z 74c13 Tax Map No: Section IZ4:, - Block _ ©T Lot 4,1 Cross Street ~t CaI?' NOTE: LOCATION MAP MUST BE SUBMITTED H APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY DEPARTMENT APPROVAL- Ignature of Applicant Date Received by: I l CERTIFIED TO SUSAN LePERA FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK ' No 5 C- ST09 m T ~ a n f ~ m. v S Mkt TEST HOLE DATA McDONALD GEOSCIENCE i UARai 20, 2(kW EL 16.9' DARK BROWN SANDY LOAM OL 0 Zp. tf(~ BROWN 9LTY SAND SV Y PALE BROWN nNE SAND SP ^/)e ::J a; A !per i ~yy 1 EL 27' wA TER 14.2• 1REA=18,095 SQ. FT. R..~. .s. ' ,.m mm. ~ wA7ER IN PALE BROWN FINE SAND SP 11 1r LEVATIONS REFERENCED TO N.G.V.D. VY ALTERATION OR ADD17ION TO THIS SURVEY 1S A WOLA77ON SECTION 72090E THE NEW YORK STATE EDUCATION LAW~S I`-` KCEPT AS PER SEC77ON 7209-SUBDIVI5ION 2 ALL cERnFlcnnDNS 'Lot NUMBERS REFER TO "~18, ,.fir r S" FILED ER£ON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF IN THE SUFFOLK COUNTY/CL EI: N'.AUGUST 4ID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR HOSE SIGNATURE APPEARS HEREON. 14, 1929 AS FILE NO. 2.,., am familiar with the STANDARDS FOR APPROVALr ND CONSTRUCTION OF SUBSURFACE SEWAGE FAMh Y RESIDENCES N0. 49618 ISPOSAL SYSTEWS FOR SINGLE nd will abide by the conditions set forth therein and on the ECONI (631) 765 f19:' 31) 765-1797 errnit to construct. P.O. BOX 909 he location of wells and cesspools e:hown hereon are 1230 TRAVELER STREET 06-229 nom' field observations and or from data obtained from others. SOU THOLD, N.Y. 11971 St 'VlJY OF PROPERTY A T LA UREL y Y Y Y Y TOWN OF SOUTHOLD Y Y M[TL,ANDS Y y , S UFFOLK CO UNT Y, N. Y. T 1..~ AL • .1000-126-04-4.1 SCALE.• 1'=30' SEPTEMBER 29, 2006 wmwuRD mc~' of ~w~hn +~-ruNDS AS COVSIX7# ar we suO ON M AaCw 7~ soo14 17, 2W5 FEBRUARY 26, 2008 (TOPO. & BUILDING ENVELOPE) pp+~p MARCH 26, 2008 (B.O.H & WTL.AND FLAGS) APRIL 29, 2008 lCER71FICATIONS) ,ncxn SEP71C SYSTEM (3 BEDROOM. ,000 GALLON SEPTIC TANK n EACHING POOLS 6' DEEP x 8' DIAHETER SUFFOLK Coups" 0 ' 'i PERM 17 fOF +aP.F~.. k o~A At DATE\-~\ N C~` Na, NjtS ~ 'APPROVED D Nl~. / PbFi MAX!miu 0 'fie p1 Q~~ EXPIRES TwPrC`sEARh )ri?JA SAC P N ` E ~J PG \ \ ` moo. aPP ~ l i eae~^ev' ended until 11 - 14 a > r 61 H~ ®35 /CY