Loading...
HomeMy WebLinkAboutJeselsohn, Paul ,o� s1WFOL, c ELIZABETH A.NEVILLE e�s OG'yal Town Hall, 53095 Main Road TOWN CLERK o P.O. Box 1179 y Z Southold,New York 11971 REGISTRAR.OF VITAL STATISTICS v MARRIAGE OFFICER �, Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER � iNg • ',,•�, Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER ,�'� southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 3210 R Residential X Non-Residential Fee $ 10.00 Septic x Cesspool PERMIT ISSUED TO: Name : PAUL JESELSOHN Address 1: 41 5TH AVENUE City St Zip NEW YORK NY 10003 Descripton of Proposed Construction or Alteration SANITARY SYSTEM FOR ONE FAMILY DWELLING. APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES. REF #R10-03-0137 Name Of Owner JESELSOHN, PAUL & F DUBOIS Mailing Address 1 41 5TH AVENUE City St Zip NEW YORK NY 10003 Property Address 1 55 SANDY BEACH ROAD City St Zip GREENPORT NY 11944 Tax Map No. section 43.00 block 4 lot 45.000 Cross Street BAY AVENUE Building Permit Number Cross Reference: issue Date: 9/02/04 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) r � , lFF ilii 1 ,oStFFoi,-co=\ 3a % ELIZABETH A.NEVILLE ��� al Town Hall, 53095 Main Road TOWN CLERK y Z P.O. Box 1179 Pr"REGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER 'yifJ 0��1 Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER =Ol �� Telephone (631)rthfork.0 et FREEDOM OF INFORMATION OFFICER s OFFICE OF THE TOWN CLERK JUL 2 2 2034 TOWN OF SOUTHOLD RECEIVED TO: Southold Town Building Department AUG 2 6 2004 FROM: Linda J. Cooper, Southold Town Clerk's Office Southold Town Clerk DATED: July 21, 2004 Transmitted herewith is a copy of application No. 3351 for a Cesspool/Septic Tank Construction Permit submitted by: Paul Jeselsohn & Francis DuBois Please review the application and location map and advise if the project has received Suffolk County Health Department approval and if this office may issue the permit. Please complete the form below and return it to me. Linda J. Cooper * * * * * * * * * * * * I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE DISAPPROVE Comments: , ;��I�T�� `i/�� ,_1 - / Signature 01-02) 2.") Dated OFFICE OF THE TOWN CLERK C31��(�' '= , } Town of Southold �� CQG Application No. Judith T. Terry, Town Clerk Town Hall, 53095 Main Road a ;� $10.00 - Residential P. O. Box 1179 to M ;' $25.00 - Non-Residential Southold, New York 11971 O �'?1 *Telephone .t 0"/ (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ DATE 7/020/04' OWNER NAME: PAUL dE e-LSoH J Fmicts Av8o1S OWNER MAILING ADDRESS: �� �' (/E; illtf. Nl' • (U003 OWNER PROPERTY ADDRESS: 55_8/1i.f 4 /E?V /&f 6(26-Pik/Pole T- OWNER TELEPHONE NUMBER: ( 2(2) - TAX MAP NO. : Section � � Block 04 Lot 45 SI CROSS STREET: -yip lone E ' (Y AD TYPE OF SYSTEM: Septic Tank V New V Existing Cesspool New Existing Residential V Non-Residential LOCATION MAP: Must be attached hereto before permit may be issued. (Locate building and system; give north arrow and feet of distance, approximately, to building and closest road.) Se S/r PLAIN nature of Applicant RECEIVED BY: J v" Town Clerk's Office 4)-01CHDATE: BY MARK McDONALD v■ ■ "- v"--1 1 11.11171110T EST HOLE GEOSCIENCE SCTM# 1000-43-04-45 Abandonment of existing sanitary system SOUTHOLD, NEW YORK 11971 PROPERTY: 55 BAY AVENUE to be witnessed by Health Department. I NO SCALE GREENPORT,NY. TEST HOLE DATA 19/19/03) 10:30 AM 3.5FT. MIXED SAND AND LOAM OWNER: PAUL JESELSOHN AND FRANCIS DUBOIS ttt • 41 FIFTH AVENUE U N/0�� 3.7 FT GRAY CLAY CH _ APARTMENT 7C t • EXIST.SHOPE". t NEW YORK,NY. 10003 TO He BOB GEROULANOS e k, TEL.NO. s SHED VICKIE GEROULANOS • d4 5 FT. WATER IN GRAY CLAY CH V SITE: 7,680.43 SQ. FT. =0.176 AC. C 41x4'MIEG ST GONG. WATER IN GRAYISH BROWN AREA u ll DItYW11.GCNNEGTED 8 FT. CLAYEY SAND SC • 4.. _ TO DOWNSPOUTS 4 d .. I ZONING: R-40 u la ROOP DIRAINASE 100.02' o .V • i, b FLOOD: AE 10 S �m 7, ----_ WATER IN PALE BROWN FINE d 1 a d 14 FT T• C•AR AND W ZONE ° C rt �5�1 SURVEYOR: JOSEPH A. INGEGNO _ ":!� '\ 1380 ROANOKE AVENUE _ •. .. Z NBN WATER LINE �, 7 ,.- 1rj ,ic rte OPEN n r �(} Dll1.lNb TO DC b'-0" 1 t 34`_t" '° RIVERHEAD, NEW YORK 11901 a © . !tow ii DEMOLIS ED PROPOSED N d ,N• Ili tom!WV STl7R1'DPIELLIM . f , LICENSE#49668 0 A u' M L'Xh511tib roar PlflNT 11 LJ • J N EXIST.GONG. , N DATED: DEC. 17, 2002 Y NOTES: STOOP TO PP T _ _ PIROPOS D PIN. x " I, O U 1 d ' ci41 �s N R R dN +ba �° 1. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUM LI X A. u X 7"' f Y Y �, , Irrl t 12 pd „a. * ,.� 1 \ , LOCATION MAP 4 � • a a \� 7 3 C i /''''< i ar I�iSiATAd t sous SHALL ee ovro SUFFOLK COUNTY N OF HEALTH SERVICES d • `; �� t)\' 6 a ^� i Wt1H �No R 1.0 vi SRANflAGGL4"TA9LE TO dGDHb.rat A A f?I/WETla!51)C rev-6RCJ1' TBt THAN 33' EXIST.GONG. 4 THE Pow. sc�!€ � Y z�as yw� E 4aa+ u CRL' J ,- } °. - ' 4_ • 27.2,Sk,,; weer TO!� (EX mikes tco m -.� a -� ,�. , Na 1. V IE+OvEO---- Z_3 i > � .fir.ik cO -0'5-6 a. DAA I< ° IP EX t''l • N Iwo SAL.�S 116 TANK � ,,/ > 6 Pr.DIA x 2 PT.HIEN -� q. • X Zg"( LEAGH841,roma EX 1125Twib-, lb, ,, LOGA110N i a .OP4/f)6 PT.DIA x Z Pr.DIA, , FCR.NICA � x;;1:1 OF ./.., SIL M...0.sP~ S a _—, a rxrAN6lON looms • G a > "tib EXPIRES THREE YEARS °.' IH DA I OF APPROVAL 7-- ."6,. .._ , •.' GONGS _ _ --'`a ° •G(lRY�JC. - AT TIME OP / d ,.-a X' r lAN510M SYSTtSN A e ?a A ;v 3 . ° a '' N }'FZO. G�T' E:J��P. €O4� IPEC'�IO�I`€�EG�l1iRFD r:'� • /0 J X –0 —BUILDING WALL FF EL 10.0 C p� N IN �y may/ •RE '4.1 •6'�� co GRADE LINE ELEVATION 8.75 r-r. � �I a• a 4 +` , 7 " EXISTING GRADE ELI=NATIO d Al N 89°07'00" W / \ GRADE ELEVATION 9.21 FT a • 21 .99' • d a 1 I MIN. 2' MAX. I _— e - - . ` ` GRADE 8.13 FT. SEPT. . '4e0 ' 44 A Ne• 4 a I/8 /FT. TOP OF POOL 1.3 FT. R n 4,6 4-, a . 4 TANK LEACHING/ SCi , i n ,..:" y' ... e X ••. •; A• d •. X� I AN FOOL SITE . . E. +7.-15 L1 IE. +7.05 BOT OF POOL 5.3 FT. ao. te® - � N IE. +7.5 IE. +6.97 WI, GROUND WATER 3.3 FT. SHEET NG. �� •"�.•. ' "b° SEPTIC PROFILE i.../` (N,T,S.) FINAL DRAWING