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HomeMy WebLinkAboutMalter, Michael ~SUFF01 ELIZABETH A. NEVH LE, MMC C TOWN CLERK =~0 OGy Town Hall, 53095 Main Road ro P.O. Box 1179 REGISTRAR OF VITAL STATISTICS ~ Southold, New York 11971 MARRIAGE OFFICER Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER www.southoldtownnygov OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD I TO: Southold Town Building Department R7 2 310913 FROM: Carol Hydell, Southold Town Clerk's Office DATED: April 22, 2013 to RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4214 for a Cesspool/Septic Tank Construction Permit submitted by: Mark Schwartz for Machael Maltm 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 * * * # 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 S' loe 3 Dated . o~gUFFO(,~~o ELIZABETH A. NEVILLE ti`t` Gy Town Hall, 53095 Main Road TOWN CLERK o= '.Z P.O. Box 1179 y Z Southold, New York 11971 REGISTRAR OF VITAL STATISTICS O Fax (631) 765-6145 MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER ~Q a0 Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER 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 @ $25 _ Application No. 7 Permit No. Applicant Name u/ T_ Z_ Applicant Mailing Address ~Gi 6 60t G Septic Tank or Cesspool Brief Description of Proposed Construction or Alteration /149? f ray Location of Proposed Construction/Alteration: Owner of Property: 2%r- ezn-= Aq~IZ Owner Mailing Address: 4:4-To /V. C&47,& -C Owner Property Address: SAS C - Name and phone number of contact person ~U7" 4 ~O J Tax Map No:16'60 Section 161 Block 09 Lot 7 Cross Street NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SUR H HEALT E NT APPROVAL ~ 7/' D¢ /Z z e- _//12 Signature of Applicant D to r/ Received by: III MORONI ilimililini~l I III 111 11 MINN IN i~l N GARAGE SANITARY SYSTEM (0.5 BATH) SURVEY OF PROPERTY AT NASSAU POINT 1 1,000 GALLON SEPTIC TANK 1~ 8' DIA. x 12' DEEP LEACHING POOL TOWN OF SOUTHOLD WITH 3' SAND COLLAR 3' ABOVE GROUND WATEF' SUFFOLK COUNTY, N.Y EXISTING WELL TO BE ABANDONED 1000-111-09-07 SCALE. 1=30' FEBRUARY 2. 2012 APRIL 11, 2012 (PROP. GAR.) APRIL 16, 2012 (REVISIONS) AUGUST 28, 2012 (REWS10NS) OCTOBER 9, 2012 (FOUNDATION LOC. do REN MARCH 20, 201$ (revision) DF '50"E ONS N78~' -7 x,x~x v t ° ^ry -_~2 _ Ito CE ' Z 1 GRAVEL TEST HOLE DATA i e~.e. -a Q \ BY MDD 2~ ~20E2 SCIENCE 00. 2 BROWN SILTY SAND SM N +TS.s W~ \EL PALE BROWN FINE SAND SP O Q \ \ 'd O \ \ N A5 ~g( Pax 72- - - UJOV OVERFIEAD W/ UPOT ~x_ was \ _ ~c ~SB 365""W ti o Elevations referenced to N.A.V.D. '88 ° o l am familiar with the STANDARDS FOR APPROVAL G ° AND CONSTRU ON OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES and will abide by the conditions set forth therein and on the permit to construct. S, TO ROAD We' CANS Su The location of public water, wells and cesspools-shown hereon ore C from field observations and or from data obtained from others. ANY ALTERA77ON OR AL017701V TO THIS SURVEY IS A 14OLA77ON OF S£C71ON 7209 OF THE NEW YORK STATE EDUCA71ON LAW. EXCEPT AS PER SECRON 7209-SUBDIWSION 2. ALL CERRnCAnCNS A oC A~QQw'7GA + F7. ~y HEREON) ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY lF AREA V.7 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF WE SURVEYOR TO 11E LINE WHOSE SIGNATURE APPEARS HEREON. I . SCDHS Ref# RIO-12-0029 TWjt4(; WALLS wow CIWG Poco-s ON LEA 26 14 1 18 VIAL LO .10 se I 64ING p4.13 WALL O/L (t)*EUUtAG) *V IS OT4 UWtI SIONS) S5,11C Loco FE 2-614 Y.-X- WOOD STAIRS x CR 11CREA OF I DOSTING SEP11C TEM ,jr, AV ILO-V w .2! ?m I STOPE 10 I.CQ t4jtg; WALL 381 Fool P O.V WT ime W LO-T 28 (OVI&LDOG) 0*" PERNT FOR APPROII COt-,tsTPUG~ric~,I FOR A SEPTIC LOCA notI UtAKH DATE 10. S OF NEIV APPIWIM IT'I WA 1350ROOMS S THREE Y~:PFZ FRO!~,, IDI, E OP AP OVAL ~er Line(s) MUST Be Inspected By The tztk ffolk Counti-D-ept. Of Health Services. '311852 Ii4U ~J? i -5700, 48 Hours In Advance, To Schedule Inspection(s). .496it N. YS LIC. NO. 49618 LOT NUMBERS REFER TO "AMENDED MAP A OF NASSAU C YORS, P.C. POINT CLU13 PROPERTY INC" FILED IN THE SUFFOLK -5 0 F-AX (631) 765-179 909 COUNTY CLERK'S OFFICE ON ALG-UST 16, 1922 AS MAP NO. 156. 1 J*O 7RAVELER STTEEr SOUTHOLD, N. Y 11971 12-110