HomeMy WebLinkAboutNorth Fork Investors • O��gUFFO(,�C
ELIZABETH A.NEVILLE,MMC �� OGy Town Hall,53095 Main Road
TOWN CLERKp P.O.Box 1179
y 2 Southold,New York 11971
REGISTRAR OF VITAL STATISTICS p Fax(631)765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER ��l .��� Telephone 765-1800
FREEDOM OF INFORMATION OFFICER www•southoldtldtownny.gov
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OFFICE OF THE TOWN CLERK ;
TOWN OF SOUTHOLD
f ! �i
tLit! DEC - 9 2014
TO: Southold Town Building Department
riilc li'_:�T.
FROM: Sabrina Born, Southold Town Clerk's Office
DATED: December 9, 2014
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4284 for a Cesspool/Septic Tank Construction
Permit submitted by:
North Fork Investors
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
i
Signature
/z/ i
Dated
4 ELIZABETH A.NEVILLE �`Z`� OGy Town Hall, 53095 Main Road
TOWN CLERK p P.O. Box 1179
t/a Southold, New York 11971
REGISTRAR.OF VITAL STATISTICS
MARRIAGE OFFICER Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER y?f�l �aO� 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 @ $1O�/— or Non-Residential @ $25 Application No.
Permit No.
Applicant Name
Applicant Mailing Address ` Zl 1
Septic Tank or Cesspool
Brief Description of Proposed Construction or Alteration D� W �'�
Location of Proposed Con truction/Alte tion:
Owner of Property: d 'Zr L' e LLI
Owner Mailing Address: d
U
Owner Property Address: -'I �6- dIn n u vyGi-n 1�d
Name and phone number of contact person !'�+\�� VJ i : 7 q ZD
Tax Map No: Section j Block b Lot
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURV Y WITH HEALTH DEPARTMENT APPROVAL
ignature of Applicant Date
Received by:
N LOT NUMBERS REFER TO "AMENDED MAP A OF NASSAU AREA-45,428 90. FTor tO43 ACFE3 WELL
POINT, OWNED BY NASSAU POINT CLUB PROPERTIES, TO TIE LNE9 — — ` DOL N5 .+ SURVEY OF PROPER
INC FILED IN THE SUFFOLK COUNTY CLERKS OFFICE SEPI 0A T NASSA U POINT
• ON AUGUST 16, 1922 AS FILE NO. 156. — — X49.1'
• TOWN OF SO UTHOL.
�77C "' - - `" D.5 N SUFFOLK COUNTY,
[']e,%wAx>ERau cbuR TS Am �'(J au ) LOT
PUBLIC WA R o 262.70 5*S R. \
r1] f,500 a4UOv�� TAW LUNG WITH P OA E-W. �
1000-111-08-17
\ `''- SCALE 1'-30'
DWE �\ c J1JNE 4, 2013
,8.36�ZOME cN�NUNK fVcE r'\ m OCT. 1, 2014 (PROP. do BOH.INFO)
I V N 45 OCT. 30, 2014 (REVISED SEPTIC)
O LOT
�O� \. P�
OCT 3 12014 4, oiWN_s.
\ = DWELLING WATER
EL-37 FR. SHED s.8'� ` g IMTM PUBLIC r ,MTM1N
SUFF.CO. I-TH SERVICES Mon
OFFICE{1 5 F `A R MGT.
0'7-*-. OI:HEALtH SER�IC6d \ (NO pp r OfPROP
• \•3 5. QEPAR'CMEKT FOR�► \ 0 110
��•35.2 METAL
SUFFOLK COUNSY GONSTRUCTiCN O LOT 145 SHED 3.8' O
ERMtT FOR APPROVAL OF 51pgKCE pt`lI.Y P� \
p FAMILY RE
RAIN RUNOFF CONTAINMENT: SINGLE \
DWELLING: 1.185 Sq. Ft. PROPOSED 2 STORY HOUSE PIPE FE.COR.
1.185 x 0.17 x 1 = 201 Cu.Ft. ` i F(.$•RSP'NOS (4 BEDROOMS) 0.3'W \ 0.2'W.
1 0.3'S. '
Provide 2 DWs. 8'P!x 3' Deep T � PROP.
Connected by Gutters do Leaders Ir ED B OI ODMS %~�
i pW 1 STRY. GARBAGE
�►U>►OF IPROVXL �,J � ❑
R MRRF YEARS Fg0tll DAi OF�' COW `"- ',>s
.. - � to
• TEST HOLE DATA �,' �"" �� ---'PROPOSED
1,/i STORY t�'3
McDANALD IEOSaENCE i STOR FRAME HOUSE V1
09/13/2014 (F.FLR.EL.42.1) �►
' Jas' Os
EL 32.9 BROWN SILTY SAND SM �.� `'t` �pttox EPS ,ao' �`, t� O WATER
3' �� o� � NG WITM
PUB
�
S ,. D � P/O LOQ+�
PALE BROWN f7NE T I' O o COVE 3 C
TO MEDIUM SAND SP tiO ys L.y P/0 LO E EWING a �
o�s� r Say= To BE a
IP. ASAMXMM
� �� IM HOLE
10
EL 3ZVV.
sar�ilar,53 �>r;M be 76.50.
• =PIPE �mpletod form h depa t re,�;r� . an
■ =MONUME -st=_as1 SU it 2' r0,
ELEVATIONS ARE REFERENCED TO AN AS
I AM FAMILIAR W17H 7HE STANDARDS FOR APPROVAL ` o r-{W.� .�• �E►-.31.4 ISO' �
AND CONS7RUC770N OF SUBSURFACE SEWAGE DISPOSAL TIE UNE 1
SYS7EMS FOR SINGLE FAMILY RESIDENCES AND WILL ABIDE EI-20.6
BY 7HE COND177ONS SET FOR7H 7HEREIN AND ON 774E 578.3620 ` Ropp IC BAY ROAD
• PERMIT TO CONSTRUCT. N86'54#50'W GRAj,� - -- ---- ,- --� LIC. NO.
ANY AL7E'RA7701V OR ADDI77ON TO THIS SURVEY IS A KOLA TION 31.57 LIj i� `�� -
OF SEC77ON 72090E THE NEW YORK ST47E EDUCA770N LAW. (dG ! PECONIC S, P.C.
EXCEPT AS PER SEC7)ON 7209-SUBDIWSION 2 ALL CER77F7CA770NS 0^` ! (631) 765-5020 FAX (631) 765-
HEREON ARE VALID FOR 7N/S MAP AND COPIES THEREOF ONLY IF CLEL17.5' P.O. BOX 909
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR r c - ?^'-, 1230 TRA VFLER STREET ./�_./
WHOSE SIGNA7URE APPEARS HEREON. $OUTHOLD, N. Y. 11971 l l