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HomeMy WebLinkAboutSzymczak, Nicole UFFOL/r ELIZABETH A. NEVILLE, MMC �� �/y Town Hall,53095 Main Road TOWN CLERKC P.O. Box 1179 COD = Southold,New York 11971 REGISTRAR OF VITAL STATISTICS ro • Fax(631)765-6145 MARRIAGE OFFICER y� �► RECORDS MANAGEMENT OFFICER �l � .� Telephone oldt nny.g00 FREEDOM OF INFORMATION OFFICER www.southoldtownny.gov OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SEP 12 2014Jf TO: Southold Town Building Department E FROM: Carol Hydell, Southold Town Clerk's Office DATED: September 11, 2014 RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4261 for a Cesspool/Septic Tank Construction Permit submitted by: Nicole Szymczak 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: Final approval required from the Suffolk County Health Department Signature Dated I e ELIZABETH A.NEVILLE I``Z` mfr —Town Hall,53095 Main Roa TOWN CLERK q P.O. Box 1179 y x Southold, New York 11971 REGISTRAR.OF VITAL STATISTICS �• MARRIAGE OFFICERD,j, • * Fax(631) 766-6145 RECORDS MANAGEMENT OFFICER �fQl �OTelephone (631)765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.nef OFFICE OF THE TOWN CLERK Y TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT - APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @$10 x' or Non-Residential @$25 Application No. g2Ce Permit No. Applicant Name lwL(-,, SZY4Nl C,79,K Applicant Mailing Address V b c,,, Sr� W-e0 Std t K V1 lg5 C� Septic Tank. or Cesspool r Brief Description of Proposed Construction or Alteration 1 Q j�� I Yl K hok) C wk-o\ V1�� D(\M L)La�( eta r 2 Location of Proposed Construction/Alteration: Owner of Property: 1 Owner Mailing Address: J�J Owner Property Address: �3s C)b �162 O Name and phone number of contact person A �C a l g %W1___C 2 - Tax Map No-.' Section ( 1 O Block 0 S Lot Q Cross Street j i k) S L4fo i NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL V\ Signature o plic t Date Received by: wtri SCDHS Ref, # RIO-14-0044 PROP. HSE. �y j FIN. FLR EL 12 [�I Ix LU .�- I,IJ EL 9 EL 8 FW.;GRADE E! 8 CO I'1 4J �� S T IE IE L G iE L.S J66 v GROUND WATER s.2 '6 3' min 6 CA.- _� 4/ EL 0.8 WLU O L / SEPTIC.SYSTEM CROSSECTION Ln 0 o (� BEDROOMS) R#- � 1 - It Q0 Gal. PRECAST SEPTIC TANK W / IL' 4 - LEACHING GALLEYS 8.5' x 4,75' x 3' 'Op. 3' AEVVE G,40UND,,WATER WITH 3' SAND ?SWI COLLAk S a of 9s / 0+ Nr, 141 41 .9� � 9 .4 G\1 wpt ?0, Q 3 o ` ..tP �, �UAJ✓ cdNc © �' a'= o qj 41 Yl 10 �• &y / / ✓ QQ r,y a 3 o QQ°¢ //400, V r E� 4, � to j / C� 1 Q Qi N, o �l// rO,ds 0� D ���Oc/C 1�Q r�/ , 1 ,. `• oW. SAZ rORgG �� �m QO 4' W h gCltA �oss� /'V/70* EYcA V -0 WQ - - wE-44/% rp t qk q• ; C SBL/c wq r <<•VG . �q ygN s- FR/ R O CPS wF�4. /SO• , O RAIN. RUNOFF ' CONTAINMENT. TesfBorin HOUSE" 2457, s ,I.I. 9 2457 x ? x 0.17= �18 cu.ft. by McDonald Geoscience .4/6142.2 = 9.9 VF 2/27/14 PROVIDE.3 DWs 8'0� x 4' deeep EL 4.4 Loam OL 0 or`equal Brown ..� 1 SUFF011 VOUPITY DEPARTMENT OF HEALTH SERVICES Brown Sandy Clay LOT IS CLEAR—PLANTED WITH GRASS CL PtRMIT FOR APPROVAL OF CONSTROCTION FOR A 8 PLANTINGS -' TO REMAIN 3.6' -PROPOSED ELEVAn01V Water in Brown Sandy SINGLE FAMILY RESIDENCE ONLY C/ay CL - L,G• •LE11CIAd0 GALLEY, 5• 1 • EXPANSION LEACWS GALLEY' DATE H.S. REF. NO. 910 t 1 '-O o q � Water in Pale Brown r ( .Fine to Medium t SURVEY OF. sand M APPROVED 11' FOR MAXIMUM Of BEDROOhts PROPER T Y EXPIRES THREE YEARS FROM DATE OF APPROVAL AT NEW SUFFOLKLOT \ . PROPOSEDRA HOUSE- 2457 sq.ff. - TOWN OF SOUTHOLD 2457/19597 = 12.5% SUFFOLK, COUNTY�b - 1000 -, 110. - 08 - 04 On'n"t Ofcxisting Sanit S FLOOD ZONES FROM FIRM � „ , comfotmance��d azY ystcm must b in 36103C0163H SCB�@� _ 30 Completed form WWM merit requi en Subm t March 10 20 -- _as mDQf I am familiar with the STANDARDS FOR APPROVEL APRiL 9,2014 l;addition J AND CONSTRUCTION OF'SUBSURFACE SEWAGE - APRIL 22, 2014 (REVISIONS Water Line (s)SYSTEM FOR SINGLE FAMILY RESID04CES 41 2s, 2olq rR�VIs1ON ) (S) - S._T Be In and will abide by me conditions set forth thererin, and on JUNE 10 2014 (revlslons) Suffolk County p�At Health By The the permit to construct. JUNE 17, 2014 (rev"islons) Gall$$,2 ServiC JULY 21, 2014( revlslonsl O 'S . Q Hours In Advances. ' AUG. I 2014 (revisions) T � AUG. 6; 2014 (revlslons) Inspection(s). AUG. 21, ?.714 (REVISIONSI = WETLANDS FLAG LANDWARD EDGE OF FRESHWATER WETLANDS ASsr DETERMINED BY SUFFOLK ENVIRONMEN-TAL CONSUL T1NC�i �� i c INC. ON MARCH 4, 2014, j*',C CO ELEVATIONS ARE REFERENCED, TO NAVD '88' AREA = 191597 sq ft. ANY AL TERA TION OR ADDITION TO THIS SURVEY /S A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW, EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS N.Y.S. LIC. NO. 496/8 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR WHOSE SIGNA TORE APPEARS HEREON. ECONIC S EYORS, P.C. ADDITIONALLY TO COMPLY WITH SAID LAW THE TERM ALTERED BY' 15/61 765 -,.5020, .. `MUST BE USED BY ANY AND.ALL SURVEYORS UTILIZING A COPY P. 0. BOX 909 OF ANOTHER SURVEYORS MAP. TERMS SUCH AS "INSPECTED'AND 1230 TRA VEL ER S TREE T 'BROUGHT-TO-DATE' ARE NOT /N COMPLIANCE WITH THE LAW. SOUTHOLD, N.Y. 11971 96-130 . Sheet f 2 '