HomeMy WebLinkAboutRaffel, Karen ELIZABETH A.NEVILLE,MMC ��� �/,y Town Hall,53095 Main Road
TOWN CLERK P.O.Box 1179
C90 2 Southold,New York 11971
REGISTRAR OF VITAL STATISTICS O Fax(631)765-6145
MARRIAGE OFFICER 'y �`' Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER0.� `1►a www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK = -
TOWN OF SOUTHOLD
i
TO: Southold Town Building Department JUL 25 2014
FROM: Carol Hydell, Southold Town Clerk's Office ROG. DPPT.
10'41!OF MUTHOLD
DATED: July 24, 2014
RE: Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 4248 for a Cesspool/Septic Tank Construction
Permit submitted by:
Karen M. Raffel
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:
Signature
-7 3ci
Dated
ELIZABETH A. NEVILLE Town Hall, 53096 Main Roa
TOWN CLERK O P.O. Box 1179
y Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER Gy Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER Ifo �� Telephone (631) 766-1800
FREEDOM OF INFORMATION OFFICER 1 �` southoldtown.northfork.r►et
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 a) $25 L�7
- Application No. L
Permit No.
Applicant Namc--�4L-�I CA
Applicant Mailing Address_-__ 1.5 � (�
Septic Tank--or Cesspool----
Brief
esspool_Brief Description of 'roposed C'oii�tru,ction or Alter ionIL51
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j/
Location of Proposed Cores ruction/Alto t' 11: I
Owner of Property: C(t��v1 �
Owner Mailing Address: '
Owner Property Address: _� � � U' T'
Name and phone number of contact person
Tax Map No: '�'G'C' Section t7� C-1c, Block �� Lot ;+
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVF- H HEALT +PARTMENT APPROVAL
Signature of jplicant Date
Received by: � 12- � I � �
SURVEY OF PROPERTY PROPOSED SEPTIC SYSTEM(Z =mw) N
[1] 8 FT. 0 x 12 FT. DEEP LEACHING POOL
A T CUTCHOG UE
BACKFILL WITH 3' SAND (SW) COLLAR
3' MIN. ABOVE GROUND WATER
TOWN OF SOUTHOLD [1] 1,000 GAL. PRECAST SEPTIC TANK
SUFFOLK COUNTY, N. Y. RAIN RUNOFF CONTAINMENT:
1000 103-04-37.1 DWELLING: 1,611 Sq. Ft
1,611 x 0.17 x 1 = 274 Cu.Ft.
SCALE: P-30' Provide 2 DWs. 8'0 x 4' Deep
JUNE 11, 2014 Connected by Gutters do Leaders
DVCWND w/
� owd
DY1ElUNP� WAS
TO
oic
VAST
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES 1�4
PERMIT FOR APPROVAL OF CONSTRUCTION FOR A E
SINGLE FAM,iLY RESIDENCE Ott;:�_�� A D EL' 174
JUL 1 1 2014 RQ
DATE . .H REF. Nd O. /(� -t `C � EL, 16.1' EMOR IN 5 I40V
APPROVEDAPPROVEDP� WA � 1QQ•QQ FN,
M
FO:Z M IN M Or BEDROOMS 7g'13+5Q*E EI- 18.7
EYPIRES T' ,EF:YEARS FP.OM DATE OF APPROVAL N �1
Mme• 9; 'N o
EL• 17' EP. LP. �t o
�y 15Q.Q0 ®►+aF u D, a c°"►WATER�
w EL 17'9 1 ' 1 .gyp PUBU�
.
.9. LOT 15
06
c c�D 0.. 20.3 Ass ,�,�p� N�,E �a cq
DWEL�To FtJBI� WAS ?.. 1'R FIN-
CIS
FL. FL 20 15•O,
Os '► et.1
LDT Sc 1 DW.
1
� 1 1
1 1
TEST HOLE DATA 1 LOT 14 1
McDONALD GEOSCIENCE + =
05/19/14 1 ZONE X 1 0 5' E
' 1
EL. 17.9 DARK BROWN LOAM
I, �-` {`RVafimf n10n z0°'
BROWN SILT ML For Sanitary
quirOd
2.5 �
0y Meal ,
m nt 11 iNG IT,,,,P.oPE
00.
PALE BROWN FINE SAND SP o
LOT 12 o o
Dw�'�D w/ "�"
16.8 t80' +
WATER IN PALE BROWN FlNE SAND SP
17' OQ� B5'E
FE.
NOTE: WATER ENCOUNTERED 16.8' BELOW SURFACE BADE 1OQ•
FOW
N. 0.5. 6 S79'lS5eVl DM To PLOic M
E� t6.3
FLOOD ZONES FROM FIRM 36103CO164H LOT 22
ELEVA77ONS ARE REFERENCED TO N.A.V D. DWWND W/ WELL
LOT NUMBERS REFER TO "MAP OF SUNNY SHORES" 150 +
FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE
ON AUG. 30, 1960 AS FXE NO. 3231.
I am familiar with the STANDARDS FOR APPROVAL`Y' ick
AND CONSTRUCTION OF SUBSURFACE SEWAGE
DISPOSAL SYSTEM FOR SINGLE FAMILY RESIDENCES ,
e
and will abide by the conditions set forth therin and r
on the permit construct.
AREA=20,000 80. FT.
L/C. NO. 4
ANY AL TERA77ON OR ADDI TION TO THIS SURVEY IS A VIOLA 17ON MORS, P.C.
OF ON 72090F THE NEW YORK STA TE EDUCATION LAW. • (63 -5020 FA 631) 765-1.
• EX AS PER SECTION 7209—SUBDIVISION 2. ALL CERAFICATIONS
HER ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF P.O. BOX 909 �---
t-.,� ...o no nnoicc DceD TUC* ru00FccFn CrAl nF nac criRVFYnR 19.in TPAVF*1 FR S7RFFT .1 • �.