HomeMy WebLinkAboutLandman, David & ChantelELIZABETH 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: Southold Town Building Department
FROM: Sabrina Born, Southold Town Clerk's Office
DATED: June 24, 2015
I
f
JUN 2 4 2015
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4327 for a Cesspool/Septic Tank Construction
Permit submitted by:
Robert Chipley for David & Chantel Landman
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
4
DISAPPROVE Ve
Comments: Final approval required from the Suffolk County Health Department
Signature l
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
_Town Hall, 53096 Main Roa.
P.O. Box 1179
Southold, New York 11971
Fax (631) 766-6146
Telephone (631) 765-1800
southoldtown.nortMork.net
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residdntial @ $101 or Non -Residential @ $25 Application
. pp n No.
Permit No.
Applicant Name F05E
Applicant Mailing Address_ 5031 -rFiEX t.CjZ. Aff_
Septic Tank. or Cesspool
Brief Description of Proposed Construction or Alteration h(tvV Sr�7�c Sy yu) (=off ,rP�ov�
L�uS G &W 51 S T14 6 0 1 ' I S OO (,At,. S16PT e-TaA,k -T - ~,-17
Location of Proposed Constraction/Alteration:
Owner of Property:_
Wy i o
� Ck(M M L
LAntpM ^r j
Owner Mailing Address:
('Z"W
I -MA r! fZi7.
SUrnrnl-r N;r 079ol
Owner Property Address:_ (e (o l o -'!;0U1\J2VcCt0 AVS.
• Soy r �I OLD N�
Name and phone number of contact person RO gcIZ7 1-14(FL£y `?.z'3L46
Tax Map No: 1600 Section S5 Block D $ Lot
Cross Street (-%- LAk.
NOTE: LOCATION MAP MUST *BE SUBMITTED WITH APPLICATION. NEVA
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
Signature of Ap is Date
Received by:
The location of wells and cessppols
shown hereon are from field observations
and from data obtained from others
and there locations are not guaranteed.
WATER IN
STREET UE USA
PUBLIC v
PRK ) EL 19
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VV,P 4E. �_
Nuc p UN S E , V 1� N 7g@21 �0 EL 18 \ 640.s9's 1I_
P CP ,e�1G WP�� ��wAtR3SAI�l.
tPUC�. O 4� Ls1. 56-11 �
RAIN RUNOFF CONTAINMENT � ,y ` ��- 01\
10 00.
HOUSE - 2150 sq.ft.
2150 x 0.17 x I = 365.5 Cuff.
p, o �� A
365.5142.2 x 8.7 VF ` - ._ , �'
Vul
PROVIDE 2 DWS 8'0 - 5' deep 41-
��'` 4 -
or equal
\ s
GRAAWO PLAN
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4• APPR01e,
FA IL 2Y 0 'NA)o
M/Sym QUX a- 85 ®
LE. vr"• EXCAVATION if 3Si° TION S6EQUIR 3 � �,J �F 0
24.0 'Ertao FOR SANITY Y SYSTEM i O.
BY HEALTH D PAfZT ME! 1
L BAAWTH8r A. 9.3
d�pAIEJFR GROUN.) WATER 00. ` /pp-
= Q EL. 1
PROPOSED SEPTIC SYSTEM ELs-la
(5 BEDROOMS)\� • / f
(- 1500 GAL. PRECAST SEPTIC TAW O<<� `ZO
2 - 810 x 8' DEEP LEACHING POOLS WITH 2 /
3' SAND (SW) COLLAR. REMOVE MATERIAL iso
DOWN TO SAND (SW) AND BACKFILL
WITH CLEAN SAND (SW) ` b�
TO BE BUILT TO SUFFOLK COUNTY 2/0
DEPARTMQIRT OF HEALTH SERVICES CERT�lEU TQ' /,(� �w ��t'w
SPECS. DAVID LANDMAN , Go
CHANTE'L L NDMAN ' 0 c /% �aai°a, 25 1
BRUCE A. PA'YNE ASSOCIA TES, INC. ��
STEWART TITLE INSURANCE COMPANY 'S-y`Fo �
Title .26045BS �y
l Qtr.
SUR VE Y OF PROPERTY o ;
AT w
SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y. \V
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/I N�
100 - .5,s - 08- e.1 � 4 D
' �� N
Safe: 1" = 50 = " w
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES T 2, 2013 1 0l 25' N
PERMIT FOR APPROVAL OF CONSTRUCTION FOR A Sept. 9, 2014 (revisions) 25' 4
MARCH 10, 2015(prop.. house)
SINGLE FAMILY RmDENcF. ONLY APRIL 28, 2015)SEPTIC SYS.)
DATE 1AM Z H.S. REF. NO. Ad " l � "-v O
APPROVED
FOR MAXIMUM OF BEDROOMS
)EgPIRES THREE YEARS FROM DATE OF APPROVAL \`
TEST HOLE / am famlUar with the STANDARDS FOR APPROVAL
5/18/01 EL. 23 AND CONSTRUCTION OF SUBSURFACE SEWAGE 't�
BROWN CLAYEY
SAND SC
�. REDDISH BROWN
CLAY CL
BROWN SANDY
CLAY CL
BROWN CLAYEY
SAND SC
RGHEST EXPECTED
WATER 1N BROWN
CLAYEY SAND SC
-WATER IN BROWN
FINE -:TO COARSE
SAND SW
DISPOSAL SYSTEMS FOR SINGLE FAM1L Y RESIDENCES
2• and w111 abide by the condlllons set forth therein and on the
permit to construct.
LOT NUMBERS ARE REFERENCED TO 'MINOR SUBDIVISION FOR \ h� ppb \,�. co
OOROSKI FAMILY UMITED PARTNERSHIP' FILED IN THE OFFICE
20' OF THE SUFFOLK COUNTY CLERK AS MAP NO. 11497
ARl:'A - 82,823 sq.fl:- 63,823 sq.fl, excluding wellands
z2 61,000 sq.fl, exclUdirtg 15% slope
ANY AL TFRA DON OR .ADQ1T10N TO THIS SURVEY IS A VIOLATION
OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW.
E')(CEPTAS PER SECTION 7209 - SUBDIVISION 2. ALL CERTIFICATIONS
39' HEREON ARE VALID FOR THIS APAP AND COPIES THEREOF ONLY IF P -CONICS ORS
SAID MAP OR COPIES BEAR THE SEAL OF THE SURVEYOR (6311 765 - 5020 F -
WHOSE SIGNATURE APPEARS HEREON. P. 0. BOX 909 _
45' 1230 TRAVELER
ELEVATIONS AND CONTOUR LINES ARE REFERENCED TO SOUTHOLD, N. Y. 119
rT,
OLE FROM FILED MGP -_THEFIVE EASTERN TOWNS TOPOGRJ MAPS ' NGVD)
___ _ ��