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Home My WebLink AboutWarlan, MichaelELIZABETH A. NEVILLE, MMC TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax(631)765-6145 Telephone (631) 765-1800 www.southoldtownny.gov OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: I Southold Town Building Department FROM: Sabrina Born, Southold Town Clerk's Office DATED: March 24, 2015 RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4294 for a Cesspool/Septic Tank Construction Permit submitted by: Drew B. Bennett. P.E. for Michael Warlan 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 w� Dated ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR, OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.northfork.net Residential @ $1or Non -Residential @ $25 Application No. Ll Permit No. Applicant Name Drew B. Bennett, P.E. Applicant Mailing Address P.O. Box 1442, East Hampton, NY 11937 Septic Tank or Cesspool Install one (1) 1,500 gallon Brief Description of Proposed Construction or Alteration septic lank an ' Location of Proposed Construction/Alteration: Owner of Property: MochaPl Warian Owner Mailing Address: 201 East6nt_hStreet Apt 10A New York. NY 10021 Owner Property Address: 1145 larkcnn Street Name and phone number of contact person (631)-907-009' Tax Map No: Section 117 Block 9 Lot $,1 Cross Street 515' west of 5th Avenue NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY W4F1j HEALTH DEPARTMENT APPROVAL f(r- - vx- - Signature of Applicant Date Received by: • pUI3LIQ W_ATER pUSUC W_ATER NEW SUFFOLK AVE., PROPOSED POOLDECK I % i PROPOSED POOL AREA OF SANITARY -EX. BE ABANDONED BY MPI REMOVAL 6 40 r_ 1. ..',>. 6 ____. r. , ;- ,, STONE PA71C IRI POSED AT GRAM 7 DR WELL 24' 25' Lf-) 4 C-027 STONE PATIO AT GRADE 26' LS WITHI n " �, K_ N I 11Z /10/ Z 50 MIN 2W L '28' "M '2 lo P STONE PATIO AT GRADE DECK Q0 Ln 20 /PROPOSEDSAN y ITA MIN.1 MIN,, 1,500GAL., 8'X5'ST, I ol (2)8'DIA.X8'DEEFyLPS JBLIC WATER /� PROPOSED ED PARKING 22.5' to 7( 8- DIA. X 81 DEEP PRE-EXIOIN W616 D SHED/ SWIMMING POOL 1`40 PLUMBING DRY WELL EL. +32.0' PROPOSED VEL PARKING co WATER SE1ViJ6E TO BE EXTENDED m lom 'x2' PRE :5 m T10 NEW STRUCTURE 0 m < BASINS 1, 32' stc)�, Cl) PAVED DRIVEWAY Water Llne(s� MUST Be inspected % The Suffolk County Dept. Of Health Services' Call 852-5-00, 48 Hours In Advance To Schodul,e Iw4xxtw(s) A t V" N 74024120" W • 0 -,445 JACKSON STREET F.F. EL +34.0' V-0' MIN. MA�OCKING cAST In EL. +31.0'-/ PUBLIC WATER FINISHED GRADE EL +32.5' FINISHED GRADE EL +32.0' 1'-0" MIN, 2'-0- MAX. 4'-0' MAX. L PROPOSED POOLDECK I % i PROPOSED POOL /� PROPOSED ED PARKING 22.5' to 7( 8- DIA. X 81 DEEP PRE-EXIOIN W616 D SHED/ SWIMMING POOL 1`40 PLUMBING DRY WELL EL. +32.0' PROPOSED VEL PARKING co WATER SE1ViJ6E TO BE EXTENDED m lom 'x2' PRE :5 m T10 NEW STRUCTURE 0 m < BASINS 1, 32' stc)�, Cl) PAVED DRIVEWAY Water Llne(s� MUST Be inspected % The Suffolk County Dept. Of Health Services' Call 852-5-00, 48 Hours In Advance To Schodul,e Iw4xxtw(s) A t V" N 74024120" W • 0 -,445 JACKSON STREET F.F. EL +34.0' V-0' MIN. MA�OCKING cAST In EL. +31.0'-/ PUBLIC WATER FINISHED GRADE EL +32.5' FINISHED GRADE EL +32.0' 1'-0" MIN, 2'-0- MAX. 4'-0' MAX. L 0 X. KARL, L.S., LAST R SED APRIL 5, 2014. :RFORMED PRIOR TO ST RTING ANY WORK. DAMAGE TO EXISTING TILITIES, AND SHALL NATION IN THE VICINITY OF EXISTING UTILITIES INATE WITH UTILITY COMPANIES REGARDING AND APPURTENANCES AS REQUIRED TO ION, COORDINATION, PERMITTING AND :XISTS FOR FULL DEPT "OM•PRISE.D. OF SAND -MD GRAVEL 7, SILT, & CLAY- TSILfi 4 CLAY ,� FENCE AROUND THE tXCAVATED AREA UTILITIES SERVICES TO PE REMOVED OR �.AP ALL CONDUIT AND PIPING. EROSION AND SEDIMENCf CONTROL MEASURES '_ PLAN FOR SPECIFICATION. Abandnnmt of existing sanitary system must be in comfonman a with departlmeni rcgwL- hent Submit completed rm Wwm _ _ as pr°°f. -, 141 .o DJ 9 7� E na DATE COUNTY DEPARTMENT OF HEALTH SERVICES 'FOR APPROVAL OF CONSTRUCTION FOR A SINGLE FAMILY RESIDENCE ONLY 6 2015 H.S. REF. N0. R,1C�-! S-C3yO�S W C: V CCS : U) A W 00 = .C/) � ^^ v ♦ C= OD o 0 Cho Q' CU CU to 3: KSI c .CU C: CCS D U) a) CU U C/) 0 LU O Z Q OR MAXIMUM OF �,_, BEDROOMS EXPIR S THREE YEARS FROM DATE OF APPROVAL N � RESERVEd FOR SCDHS APPROVAL STAMP U) V LOW)Uj N N O O O Q� O N Q' a) CU U C/) 0 LU O Z Q OR MAXIMUM OF �,_, BEDROOMS EXPIR S THREE YEARS FROM DATE OF APPROVAL N � RESERVEd FOR SCDHS APPROVAL STAMP U) V