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ELIZABETH A.NEVILLE,MMC ie p:. ; V. Town Hall,53095 Main Road
TOWN CLERK 1 = - -♦ -•,, ; P.O. Box 1179
I e4 �' s $ Southold,New York 11971
REGISTRAR OF VITAL STATISTICS ‘ 'f ' w $ Fax(631)765-6145
MARRIAGE OFFICER . . , '-'s
RECORDS MANAGEMENT OFFICER �A4 *o®l Telephone(631)765-1800nny.go
�,.' www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER -------,..,,..I
OFFICE OF THE TOWN CLERK- - -�- .
TOWN OF SOUTHOLD ti! `i_
TO: Southold Town Building Department
r
SE? 2 3
20ti16 \ ,
FROM: Sabrina Born, Southold Town Clerk's Office J .,
DATED: September 23,2015 l •
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4339 for a Cesspool/Septic Tank Construction
Permit submitted by:
—PST.`ontracting LLC .
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
' /7",..
Signature 4 :/1 '-it‘r
/o//s
Dated
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Y
,,,,,,,,
ise
ELIZABETH A. NEVILLE ,ZO �V
Town Hall, 53095 Main Road
TOWN CLERK % cm % P.O. Box 1179
t v) Z 1 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS O yC$ Fax (631) 765 6145
MARRIAGE OFFICER .., 4s e i Telephone (631) 765-1800
RECORDS MANAGEMENT OFFICER �Q a i
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 @ $10 tl or Non-Residential @ $25 Application No. Li 337
1 Permit No.
Applicant Name S Cc�TC=.c\--' LLC_
Applicant Mai ling Address a s ce r\---K- 1 S P t..L.- k `\lam-e- 1•-)1
Septic Tarik /or Cesspool
Brief Description of Proposed Construction or Alteration N J . S.Nyl ..rj- 1 \,,;:,,,,
Location of Proposed Construction/Alteration:
Owner of Property: Ic>-tArk ;5 20... t-k, 1I
Owner Mailing Address: �.o -0 0 . co-,,r\Z 1/4) o�c/t
\i,_J.:-3 fjtu-.-z- N`r In _
• Owner Property Address: $.-- M 4—
Name and phone number of contact person V..&-:_e, L_ \ACX \ -
Tax Map No: Section v� Block 1 Lot I C3
Cross Street L - -c -cV 'A-e____
NOTE: LOCATION MAP MUST BE -SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVE H HE• . TF DEPARTMENT APPROVAL
9111rS
9," . fature of Applicant Date
Received by: d
,
LOT AREA = 22,500 SQ. FT. PROPOSED 2 STY FR DWELLING W/4 BEDROOMS • ; iiI' . ;
GAR FL ELEV 57.0 SANITARY SYSTEM 1000 GALLON SEPTIC TANK, 1 LEACHING POOL 8'DIA. x 12' DEEP `
( ) ELEVATIONS ,,..0,FEL ELEV. 59.0 ..„,,,,,t,„:'",
NOTE DATUM N.A.V.D. 1988 0 r--t 'mss','
t
PROP FIRST FLOOR = 1572 SQ. FT.
PROP SECOND FLOOR = 765 SQ. FT. kt.t°
TOTAL = 2,227 SQ. FT. k)' ;)t
PROP GAR FLOOR = 541 SQ. FT.
LOT NUMBER 32 LOT NUMBER 33 LOT NUMBER 34 LOT NUMBER 35
VACANT - PARKLAND DWELLING - PUBLIC WATER DWELLING - PUBLIC WATER DWELLING - PUBLIC WATER
(51 a) SALTAIRE WAY (523)
x x
existing water main
edge of pavementI
(53.6) S 16°59'30"E 100.00' (566)
FD
I I I o 427.15' }
m
ga 0 m + R=25.00'
"' L=39.27'
e ! I( o TEST HOLE
O I n (55 3) st n _ W
O a 00 Z
Lr) (57.0) 22 0' I porch (57.0)
t Lfi
N co 25.96' / N
— 18'—N GAR N Cr)
PROPOSED 2 STY in w
7-83' FR DWELL r
ei CC
"' I E E U
Li
55.0' a m
Cr
II W (57 0) (57.0) N -s O rn Q
N3 3 N m Lil i I -
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MON (64.3) (65 2) MON
ch Imk�' a ch link
osN N 16'59'3•"W 100.00' s
....+.....-�.- 2 T s
SUFFOLK COUNTY DEPARTMENT OF
HEALTH SEI�VIl�I N+'MBER 1 1
PERMIT
FOR APPROVAL.OF CONSTRUCTION FOR A V CANT
SINGLE FAMILY RESIDENCE ONLY
201`' ��11
- �A 3- H.s. REF. NL D\ r!_ -00�7
--
APPROVED EXCAVATION INSPECTION
FOR MAXIMUM OF
BEDROOMS FOR TITh MED
ExPIRER THREE YEARS FROM DATE OF APPROVAL eY HEALTH DEPARTMENT
TEST HOLE BY McDONALD GEOSCIENCE
6-8-2015
0 Dark brown loam OL
1' THE OFFSETS (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TO THE
PROPERTY ONES ARE FOR A SPECIFiC PURPOSE AND USE AND THEREFORE ARE NOT JOB No. 15-83 FILE No. SALTAIRE ESTATES
HOECESAINIU.S.
Brown clayey sand SC PLANTINGINTENDED TO GUIDE AREAS, ADomoNTEERECTION TO BUBDINGSFFN
OR , RET
ANY OTHERNG CONSTRUCTION PATIOS,
SURVEYED FOR IOANNIS ZOUMAS
UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION LOT NUMBER 21
15' 7209 OF THE NEW YORK STATE EDUCATION LAW
Brown siltysand SM MAP OF SALTAIRE ESTATES
GUARANTEES INDICATED HERON SHALL RUN ONLY TO THE PERSON FOR WHOM THE
SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL SITUATED AT MATTITUCK
23' AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE
Brown fine to LENDING INSTTTUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS TOWN OF SOUTHOLD - SUFFOLK COUNTY N Y.
medium sand SP OR SUBSEQUENT OWNERS
29' SCALE 1" = 40' DATE 6-16-2015
COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR
COMMENTS No water encountered EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY
FILED MAP No 4682 DATE 8-3-1966
CERTIFIED ONLY TO: TAX MAP No. (REF ONLY) 1000-100-1-18 DISK 2015
HAROLD F. TRANCHON JR. P.C.
NOTE:
LAND SURVEYOR
Location of water mainsr\
& adjoiners water supply f"°�`"'by others and are not /7/11.4-41; t "= 1866 WADING RIVER—MANOR RD. WADING RIVER,
guaranteed. NEW YORK, 11792
HAROLD F. TRANCHON JR. PENNL LIC. No0489211159 E 631-929-4695
T
ID . " _