HomeMy WebLinkAboutMahoney, Dan
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ELIZABETH A. NEVILLE, MMC hyQ~ OGy Town Hall, 53095 Main Road
TOWN CLERK p P.O. Box 1179
H Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS p • .LC Fax (631) 765-6145
MARRIAGE OFFICER Telephone (631) 765-1500
RECORDS MANAGEMENT OFFICER ~0( AW ~a www.southoldtowuny.gov
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN LERK
TOWN OF SOUTHOL f~
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TO: Southold Town Building Department i I MAR 1 7 2014
FROM: Carol Hydell, Southold Town Clerk's Office
s_, r.
DATED: March 17, 2014 ~ rMID
RE: Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 4226 for a Cesspool/Septic Tank Construction
Permit submitted by:
Mark Schwartz for Mahoney
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.
' r ~ * * * r * ? * s * r
I have reviewed the application and to ation map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
N
Comments:
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Signature
03-7/
Dated
• r9
O~gUFFOL,~cO
ELIZABETH A. NEVILLE Town Hall, 53095 Main Road
TOWN CLERK p P.O. Box 1179
REGISTRAR OF VITAL STATISTICS C42 Southold, New York 11971
MARRIAGE OFFICER ' O I. Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER 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.
Permit No.
Applicant Name
e~/~~K J Lf~nl t~2 TZ-
Applicant Mailing Address Yid 6OX 9,P3
CV~6op ~ Ny 19.Es-
Septic Tank &--or Cesspool ?
Brief Description of Proposed Construction or Alteration DES( 6 ~i'/JT1~6
G!211"T EC_0' e 2 E~~ G 6E /~yl l 0 iy6c1/
Location of Proposed Construction/Alteration: ~j
Owner of Property: PA'V ~///?GI,y~Q / (LJ lfDi(/~ y
Owner Mailing Address: 3,r F-1-
/5-44-27- IvieR C Aj Al S/ I/ ZJ ?
Owner Property Address: .3 9-3 D .ST/G G ~yti~
G~TG"ffdG v,E
Name and phone number of contact person e*,w/G ~G[ 1 7 ¢ -
Tax Map No: Section /3 7 Block C Lot / U
Cross Street -r4 +eo~ g e4C/'_
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH H TH EPARTMENT APPROVAL
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Signature of Applic t ate
Received by
i
I am familiar with the STANDARDS FOR APPROVAL
AND CONS7RUC77ON OF SUBSURFACE SEWAGE /lam
• DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES r
and will abide by the conditions set forth therein and on the
permit to construct. /y SURVEY
/~TO~rF~U l CPROPERTY
The location of wells. cesspools & public water shown hereon are AT li OOVE
from 6e/d observations and or from data obtained from others. TOWN OF SOUTHOLD
ELEVATIONS REFERENCED TO N.A.V.D.
LOT NUMBERS REFER TO "MAP OF SECTION TWO PROPERTY SUFFOLK COUNTY, MY
OF M.S. HAND" FILED IN THE SUFFOLK COUNTY CLERK'S SAGPJ . 1000-137-01-10
OFFICE ON MAY 12, 1939 AS FILE NO. 1280. SCALD 1'=30'
'''~~~CCCC 4 JC/NE 6, 2012
N APRIL 10~ 2013 (PROP. NEW HSE.)
o'`~. S~ ~ FP iys ~~J oGy~
y 4 ~o SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
~q ye` J J PERMIT FOR APPROVAL OF CONSTRUCTION FOR A
1,\41 O M ~L9~ SINGLE FAMILY RESIDENCE ONLY
'Gl 5 QO• 9~ DATLr 2 7 20 ~i.S. REF. No. p
0
a f~L 1
Dp SO
PROPOSED
SYSTEM NEW SEPTIC 0 q y pR Q APPROVED Q L t alto
(4 BEDROOMS) r6
FOR MAXIMUM OF
C Q ' dA 1X I A ?0 BEDROOMS
I - 1000 GAL. PRECAST r o• EXPIRES THREE YEARS FROM DATE OF APPROVAL
SEPTIC TANK <
I - 8'0x 12' EFFECT DEPTH
WITH 3' SAND COLLAR (SW) Q+~ 4ij
3' ABOVE GROUND WATER ~`l E~?
EXISTING CESSPOOL TO A
BE REMOVED OR FILLED ~Nb o,~ ,~~c•
IN TO SCDHS SPECS.
bandonment of existing sanitary system must be in TEST HOLE DATA
comformance with department requirement Submit BY Mcoorb/1 s/~osclENCE
G completed form WWM- a as proof
DARK BROWN Law.. a
• EY Q o.s' BROWN SKrr SAD sM
Ok~ zs'
BROWN
RAIN RUNOFF CONTAINMENT CEOF NE6y)0 PALE FINE SAND SP
p~ L NEW HOUSE - 1,321 SQ.FT. g~P at. fill '
1321 x I- x 0.17 = 225 Ct1.FT.
AG d+ + 2$6/22.3 = 10 VF G'
L-jIr
PROVIDE 2 DWS. 6'0 x 5' DEEP ylrP
9 Voa ~P~~1 OR EQUAL p, WATER ENCOUNTERED
J JG ~tib. ass~a
JUL 15 2013 QJO c .
HEALTH ANY ALTERA77O,N OR ADDITION TO THIS SURVEY IS A NOLA77ON N. , S. LTC. NO. 49618
41
W SERVICES CONIC - YORS, P. C.
OF SEC77ON 7209OF THE NEW YORK STATE EDUCAT70N LAW. 631 7
ATER EXCEPT AS PER SECTION 7209-SUMW-VCN 2 ALL CER77FICA770NS ( ) 65-5020 FAX (631) 765-1797
AREA=8,751 SD. ~.HEREON ARE VALID FOR TIMS MAP AND COPIES THEREOF ONLY IF P. 0. BOX 909
SAID MAP 024 COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR ¦ =MONUMENT 1230 TRAVELER STREET
L~ WHOSE SYONAIURE APPEARS HEREON. a =PIPE SOUTHOLD, N. Y. 11971 12-188