HomeMy WebLinkAboutHabitat for Humanity ELIZABETH A.NEVILLE,MMC may► Gy Town Hall, 53095 Main Road
TOWN CLERK o= P.O.Box 1179
W Z Southold,New York 11971
REGISTRAR OF VITAL STATISTICS p • .�C Fax(631)765-6145
MARRIAGE OFFICERTelephone(631)765-1800
y� `►
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER www.southoldtownny.gov
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: S f
outhold Town Building Department �j �j� SEP 2 6 2014
FROM: Sabrina BornSouthold Town Clerk's Office
TOWPJ Or"SOii7H01_D
DATED: September 26, 2014
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4266 for a Cesspool/Septic Tank Construction
Permit submitted by:
Habitat for Humanity of Suffolk
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
I!
Signature
/66C//
Dated
o��suFF94�o
ELIZABETH A.NEVILLE „`1� Gy Town Hall, 53095 Main Road
TOWN CLERK p P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �
Southold, New York 11971
MARRIAGE OFFICER � • �`Z`` Fax (631) 765-6145
RECORDS MANAGEMENT OFFICERTeleP hone (631) 765-1800
FREEDOM OF INFORMATION OFFICER �'� �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 @$10A_(/ or Non-Residential @ $25 Application No. .
Permit No.
Applicant Name
!_�Ll -r_�V
Applicant 'ling Address -e
ffi
lea
Septic Tank_v/ or Cesspool U // /
Brief Descri tion of Proposed Construction or Alteration�e Li`l'!//V tT�
-- — M m m
Location of Proposed Construction/Alteration:
Owner of Property )
Owner Mailing Address: Q
co q3 041,A )-k W' d M, -e /04d �rgs,3
Owner Property Address:
Name and phone number of contact person
Tax Map No: 10 0 D Secti n Block�_ Lot
Cross Street Ma d 04
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SUWa -
H DEPARTMENT PROVAL
plic Date
Received by:
--G
WELL
S.C.T.M. NO. DISTRICT: 1000 SECTION: 15 BLOCK: 2 LOT(S): 14 DRAINAGE CALCULATIONS:
4
DWELLING ^ A) PROPOSED DWELLING =1,170 SQ.FT.
W/WELL WATER 1,170 x 0.166=194.22 < 195cf REQUIRED
Ln o (2) 8'DIA x 3' DEEP DRYWELL=253cf PROVIDED
H�
VACANT \
135'
0 \L07 5 WEA S
PROPOSED DWELLING & GARAGE = 1,170 S.F. – T
3-4 BEDROOM SANITARY SYSTEM 1
1,00 GAL. SPETIC TANK
U.P. I (2) 8'DIAx6'OEEP LEACHING POOLS
N8301 1 '50"E 150.00'
CL 14.4 _ 2
'^ EL 14.1 EL 10.5 I
4
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�1 O 1 J a OLA0'DEEP� 50' Op
VACANT
40, 01
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COVERED I OPORCH t o VACANT
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1 , J a AG4CULTURAL W/BARN
/ EL 13.0 1 �` :''PRO.,,,... '' EL 12.9 i U IND SEPTIC/WELL
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OL WELL SANDY LOAM 0.5' G3�
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d.,T y — w Y 11 w 5 t4f E V I...ria..3]2 w+�4:IS 7!i..,is
C YDS Ld ry�y� €"'.',.�ii41 F02 APPi��l°t�V:P.L 01' C�A��'� [�r 1�€s} "
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BROWN ^ 700 . Op e , O Y �� _C! FOR A
y t I...r�„
SW MEDIUM 1 �q `0dule /I Ct,il'„ It'11i 1/EC08'� fA.€,]r].�;
GRAVEL ° '(" pS� T1Ce, AFP € g 2014
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GROUND WATER
WATER EL 0.3IN
N-
SW BROWN
MEDIUM ` l`ti :
SAND r � ,.,.., i
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W `l_1""1�5i.. '�• nit _tj' P[-� F
GRAVEL 17' .r _– _�._ .3
AUG. 20, 2014
K. WOYCHUK LS
ZONED R-40
NON—CONFORMING LOT
MAX LOT COVERAGE 20X /
FRONT SET BACK 40' MAIN READ ` \ I E–WAJE&MPPLY. WELLS;-BRYWEL S AND CESSPOOL
SREAR SET IDE SETBACKS 5oMIN (35' TOTAL) N y.S. RT. 25 LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS
AND OR DATA OBTAINED FROM OTHERS.
AREA: 20,250.00 SQ.FT. or 0.46 ACRES ELEVATION DATUM: NAVD88-------------------
UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW, COPIES OF THIS SURVEY
MAP NOT BEARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION
LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE.
THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS
AND/OR SUBSURFACE STRUffURES RECORDED RECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY
SURVEY OF: LOT 4 Y� CERTIFIED TO: HABITAT FOR HUMANITY OF SUFFOLK;
MAP OF: GREEN ACRES AT 0
FIDELITY NATIONAL TITLE INSURANCE COMPANY;
FILED: APRIL 13, 1962 rQ
SITUATED AT: ORIEN '`i�•I � ��� ��'
V
TOWN OF: SOUTHOLD + � KENNETH M WOYCHUK LAND SURVEYING, PLLC
SUFFOLK COUNTY, VIEW AK:AY Professional Land Surveying and Design
P.O. Box 153 Aquebogue, New York 11931
PHONE (631)298-1588 FAX (631) 298-1588
FILE 13-1 6 SCALE: 1 1= 0' DATE: JULY 22, 2013 N.Y.S. LIS O. 050882 maintaining the records of Robert J. Hennessy do KenneUmM. Waychuk