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Home My WebLink AboutWalden, Robin o~gUfFoLt ELIZABETH A. NEVILLE, A' NIC ti~ Gy Town Hall, 53095 Main Road TOWN CLERK p P.O. Box 1179 Go Southold, New York 11971 REGISTRAR OF VITAL STATISTICS O Fax (631) 765-6145 MARRIAGE OFFICER 'y Qt' Telephone (631) 765"1800 RECORDS MANAGEMENT OFFICER www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department D JAN 2 3 2014 FROM: Carol Hydell, Southold Town Clerk's Office DATED: January 23, 2014 zinc oEPT. RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4181 for a Cesspool/Septic Tank Construction Permit submitted by: Robin L. Walden 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 r I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE Q DISAPPROVE Comments: Final approval required from the Suffolk County Health Department f Signature / l)3 493 Dated ~SUFF01.f O O i ELIZABETH A. NEVILLE fi`t` Gy Town Hall, 53095 Main Road TOWN CLERK p P.O. Box 1179 ca Z Southold, New York 11971 T REGISTRAR OF VITAL STATISTICS 15~ MARRIAGE OFFICER , • fi't` Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER O Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER Ol # ~a southoldtown.northfork.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 Application No. Permit No. Applicant Name Applicant Mailing Address q 9Q Ce~c~ eJ cd c j~L Septic Tank or Cesspool_,,.- Brief Description of Proposed Construction or Alteration Location of Proposed Construction/Alteration: Owner of Property.e_Zo4zw*N U. W c t 1~c~ Owner Mailing Address: e~~ ~`d 5 6 Owner Property Address: ~Y _Ch f Name and phone number of contact person fob %h Wa,\Aoc l to 31 a8• 9 -S,Y* Tax Map No: Section %000 Block H 1 Lot b 1- 11A Cross Street U)\\'P(ytrAV__' QYV.~ NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY TH HEALTH DEPARTMENT APPROVAL 7z- - /Jau Z" - - 4 Signature of Applicant Date Received by: ' Test Hole N b~yy McDonald Geoscience LOT NUMBERS REFER TO "MAP OF 'WASHINGTON HEIGHTS° SCDHS Ref.# RIO-13-0027 3nB/I3 FILED IN THE SUFFOLK COUNTY CL~RK'S OFFICE ON - EL i9 DECEMBER 29, 1927 AS FILE NO. 651. • , Dork brown Loom SURVEY OF PROPERTY Send A OREENPORT Brown SC 81 TOWN QF SOUTHOLD ine t o - i4,r Cow" Sand SW Av a SUFFOLK COUNTY, N. Y. Water in Palo Brown 1 1 41-01-14 Floe to Corse Sand 4~ r y< 1 sr n" SW s1 2It r 14 c AcA 7' PROP. SEPTIC SYSTEM G~ ( 2''11ECROOMS) ` 1 - 1000 gal PRECAST SEPTIC TA 2 ' WO x effe-five depth LEACHING QS ArugJG NP ~y0 / e?~` ~ ADOL~ 3'obove GROUND jN P 't~ p WATER WITH 3' SAND NG - COLLAR (SW) ~t+ l S4,~p'E Ut 3 s ~ 49 N Per S. c. 1 so; tt*_~ Z A VIA 56. C, UT, J aR- U, VOS G vial N la 9~ t Q *904 ~ .e CERTIFIED TO: ROBIN WALDEN ADVOCATES ABSTRACT, INC. STEWART T 01 U TO 0\c ELEVATIONS REFERENCED TO AN ASSUMED DATUM. y~PtEaE rtiyQ~ o~A i. MFT~G ~F `o,~~-LNG ! am familiar with the STANDARDS FOR APPROVAL AND CONS77?UC77ON OF SUBSURFACE SEWAGE RAIN RUNOFF CONTAINMENT DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES rA, PRROP. HSE. 952 SO.FT-. and will abide by tie conditions set forth therein and on the PERVIUOS DRIVE. 1190 SO.FT. permit to construct. 9 52 x I x 0.17= 162 CU.FT. ~.4% 1190 7 f42 952 x 0.7' x 0.11 = CU. CU.FT. The location of wells, cesspools & public water shown hereon are 304 CU.FT. from field observations and ?r from data obtained from others. /17 LAND 304/42.2 = 7.2 VF ANY AL7ERA17ON OR ADO77OV TO WS SURWY IS A WOLA77ON ONlC ~ YORS, P. C. . NO. 49618 PROVIDE I DW 8'0 x 8 DEEP OF SEC 7701V 7209OF THE NEW YORK STALE EDUCA77OV LAW. SU EXCEPT AS PER 9EC77On( 7209-SU0IkM57OlV 2 ALL CER7/h7CAnONS (631) 765-5020 FAX (631) 765-1797 HEREON ARE VALID FOR WS WP AND COPIES 7W REOF ONLY IF P.O. BOX 90,9 AREA=8,811 aSQ, FT. SAID MAP OR COPIES BEAR 7ME IMPRESSED SEAL OF THE SURVEYOR TRAVELER STREET F,3_118 SIQVA n1RE APPEARS HEREOIJ 7230 . S JO 7- L~ N. Y. 11971 13-118 Test Hole by McDonald Geoscience LOT NUMBERS REFER TO "MAP OF ''WASHINGTON HEIGHTS" SCDHS Ref.# RIO-13-0027 H 3/[B/13 FILED IN THE SUFFOLK COUNTY CL9RK'S OFFICE ON O FDork EFioeato EL 19 D ECEMBER 29, 1927 AS FILE NO. 551. SURVEY OF PROPERTY Is A T GREENPORT B• TOWN OF SO UTHOLD rown ENU~ r~ coarse Sena sw AV a 14 SUFFOLK COUNTY, N. Y. Water in Pals Brown 1000-41-01-14 Fine to Coarse Sand DMA 17• SW S'CALE'.' 1'=30' TIRO, 2013 d'~ A 8, 201 ( ADD(TIONS) PROP. SEPTIC SYSTEM oG dIMJEI4,-2 (ADDITIONS) ( 2'BECROOMSl O ~yi~tio_o mGc I - 1000 gal PRECAST SEPTIC TANK G ~PjEFtI ~iga ir. ~ypN tNff,ES 2 8'0 . W~.ebdeplh LEACHING Ot A\,gJ ove GROUND P WITH 3' SAND G / ZEp?pflryr*pAWM0FtlCCT'•0N FOR A COLLAR (SW) a yN s giiiipi;" IF'e vmsmom ONLY J - U or N5E• 5~~„ 2 6 2013 K8. REF. NO. PRA pRO~22 t e 'a9R_ a \ t. 5v- 21 EL e ~ - \ - e Fir` G * d f-wimp ri o MUNOFBE9RC0M5 y \ qo UGC `~y FOR MAXI • c N % EXPIRE' THREE YEARS FROM DATE OF APPROVAL tit o ow m ° 156 P RD c ~ got ZP~~° JUN 1 9 23'3 0 ,'0s0 W lo~E~vNG SUFF. CO. HEALTH SERVICES 511 ~,ez 561 cAYenoly TNgveCnoN RBQuIReD OFFICE OF WASTEWATER MGT. j FORANITARYSYSPBM CERTIFIED- I-111-HEATO: LTH DEPARTMENT ROBIN WALDEN ADVOCATES ABSTRACT, INC. l D 0T 2 JO~~C NP RI ST E 0 W y0 L MZN P ELEVATIONS REFERENCED TO AN ASSUMED DATUM. y~P ~j.MET2C lo~\,\NG l am familiar with the STANDARDS FOR APPROVAL o~ 9 AND CONS77?UC77ON OF SUBSURFACE SEWAGE i DISPOSAL SYSTEMS FOR SINGLE FA MIL Y RESIDENCES SEA CE RAIN RUNOFF CONTAINMENT PROP. HSE. 952 SO.FT. and will abide by the conditions set forth therein and on the ATF Mr_r PERVIUOS DRIVE. 1190 SOFT. permit to construct.` 952 x I x 0.17= 162 CU.FT. The location of wells, cesspools & public water shown hereon are L4NE) 1190x0.7' x0.17=142CU.FT. ~ 304 CU.FT. from field observations and ?r from data obtained from others. 304/42.2 = 7.2 VF ANY ALTERATION OR AODITION TO THIS SURVEY IS A VIOLATION Y.S. LIC. NO. 49618 • PROVIDE 1 DW 8'0 x 8 DEEP OF SECTION 72090E THE NEW YORK STATE EDUCATION LAW. PECONIC SUN YORS, P. C, EXCEPT AS PER SECTION 7209-SUBDINSION 2. ALL CERTIFICATIONS (631) 765-5020 FAX (631) 765-1797 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF P. 0. BOX 909 AREA=8,8'U 11 SQ. FT. SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STREET WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N. Y. 11971 13-118