HomeMy WebLinkAboutLyons, Matt ELIZABETH A.NEVILLE,MMC ,'�4.7. u"' ,, ail l Town Hall,53095 Main Road
TOWN CLERK ; = ; P.O.Box 1179
02 v 14 ? ' $ Southold,New York 11971
REGISTRAR OF VITAL STATISTICS `` ® :i:'":1;. *V��� Fax(631)765-6145
MARRIAGE OFFICER ;4 . ;4• •'' ®�°,0 Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER ®.` • V:,,' www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER -------;.„...0
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD 1 � C E 11 n� �
D V
TO: Southold Town Building Department
_ OCT - 5 2015 e,/
FROM: Carol Hydell, Southold Town Clerk's Office
BLDG.DEPT.
DATED: October 5, 2015 TOWN OF SOUTHOLD
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4328 for a Cesspool/Septic Tank Construction
Permit submitted by:
Chuck Thomas for Matt Lyons .
Please-review-the application and location map and advise if this office may{issue the pernut.
-- - - - -- - --- --- -
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
---j-----7--
Signature - u��
Dated
,.0°oilAa�oS11ff0(,e®
4
ELIZABETH A.NEVILLE tt :I`
Town Hall, 53095 Main Road
TOWN CLERK �� ® P.O. Box 1179
REGISTRAR OF VITAL STATISTICS 4 W ..--,s:r' .• '� Southold, New York 11971
MARRIAGE OFFICER
. ® *. 0 Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ,4 * ie, Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER = '1 * 1 g ,d
' southoldtown.northfork.net
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10 ✓ or Non-Residential @ $25 Application No. H 3 o2 v
Permit No.
Applicant Name C 4.1i.ek 6O t 4 .5
Applicant Mailing Address ? o 50X. 0/1
dAPIAES voVz.-4, ?Ni t( (K4:7
Septic Tank ( or Cesspool 1
Brief Description of Proposed Construction or Alteration S qJE {ictSDNh S Z
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Location of Proposed Construction/Alteration:
Owner of Property: VvtAn' Lyorif7 (5/ 0 50 a-- _ G 3 ? 3
Owner Mailing Address:
Owner Property Address: o
p..l Sv-oL-(c_
Name and phone number of contact person ck_. liott ,A5 '12'7- -11613
Tax Map No/090 Section Hi 7 Block p-7 Lot /q
Cross Street .(I1.7� S' —
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY TH H TH DEPARTMENT APPROVAL
/0474 cc—
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Signature of Applicant Date
Received by:
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south Toad •• '
now or formerly 4.7+1 /
dadd e.Simpson
BY PUBLIC WATER. (P. �n• II? PUBLIC WATER
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4 HOUSE
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110' O 10073 ,
Eon pips at
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DATE: FEBRUARY 27,2012
/ Elev:23.0'
DARK BROWN LOAM OL
3 -
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BROWN SILTY SAND SM '
101' ,
WELL WATER
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HOUSE PALE BROWN
FINE SAND SP
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17'
NO WATER ENCOUNTERED
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"r' "::;. ..:;.::::Y U.1lr?ART IAENT 0 HEALTH SERVICES
y- ?; '?' C4h'=�T RUC T ION FOR A
S 'a�: ..:5 s�AMlLY REsI'.i1.F.CE ONLY 94'
Dr 12-11315 nCF•. • /�0'f 2- 0010
AP-PRO-1.11:D D i L1v WELL WATER
r� F 4 BEDROOMS
iJ FZ rl...,.�t ii i.. HOUSE
EXPIRES THREE YEARS FROM DATE OF APPROVAL
o• _ _ w
APPROVED IN ACCORDANCE WITH A D 0 4
STM# 1000-117-7-1
REVIEW DETERMINATION DATED 5/601
AREA=5,115 Sq.ft.
0.12 Acres.
■ =concrete monument set . - .,
i'°"pipe towel Abandonment of existing sanitary system must b, t
• =spot elevation ^ c.� i 50' !
formanee with department requirement Sub
cotev
completed fo �'dt'd1�S- 4,proof. ,
` 94'
/
101' 4
PUBLIC WATER CSI
N
HOUSE
94'
52' / wail l
0
mowortarmwy
si:E �iT1"ACIyOi�EC1Al CC1I'�9®['Y"tON cn mpiesta.kh.rdt
BUILDER TO PROVIDE: lot o ro..
GRADING PL•.N AND/OR PLOT FLAN R_
budchardi
* 1 - 1000 GALLON SEPTIC TANK • lo,egl WELL WATER
V HOUSE
* 1-8'OX X 12' DEEP LEACHING POOL EXCAV'.,TION INSPEGTION,RE UIRED o a
• OR SANITARY SYSTE. 94' ,3 63.
NOTES: .. . B HEALTH DEPART4r g ?).
tDOW orronn.oy I
w
* ZONING DISTRICT: R-40. PUBLIC WATER 1,4 tV
-
HOUSE RI
* ELEVATIONS ARE IN AN ASSUMED DATUM. �Lq PUBLIC WATER \
HOUSE \ Fk-
* SUBJECT PARCEL IS LOCATED
IN FLOOD ZONE X AS PER FEMA FLOOD MAP. .
Water Line(.) ��l.t q ..- Inspected By The 94'
* EXISTING SEPTIC SYSTEM IS TO BE CuffoIk County Dept. + f F•lez ith Services.
REMOVED. Call 852-5700, 48 Furs In Advance,
* LOCATION OF THE THREE(3) HOUSES To Schedule I ,��^rection(5). PUBLIC WATER
ADJACENT TO THE SUBJECT PARCEL -.- _ c HousE
WAS REQUESTED BY OWNER. \ \
* EXISTING HOUSE IS TO BE REMOVED.
* EXISTING SHED IS TO BE REMOVED. 52' 94' \
* PROPOSED SEPTIC TANK SHALL BE DESIGNED
TO BE TRAFFIC BEARING WITH TWO(2) HEAVY •
DUTY LOCKING CAST IRON COVERS.
50'wide KING STREET
* PROPOSED WATER SERVICE UNE SHALL BE
SLEEVED. ,
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