HomeMy WebLinkAboutReiersen, Eleanor (2) SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3299 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : HUGO A CANO
Address 1: 20 HIGHLAND PLACE
City St Zip FARNIINGVILLE NY 11738
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-05-0014
Name Of Owner REIERSEN, ELEANOR
Mailing Address 1 6 GOLDFIELD STREET
City St Zip MELVIT,T,F, NY 11747
Property Address 1 275 RAMBLER ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 88.00 block 5 lot 30.000
Cross Street MAIN BAYVIEW ROAD
Building Permit Number Cross Reference:
Issue Date: 5/18/05 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
.11. ,
I�,„:,,,,FF0,„,,
.-0,-. 3Q611
ELIZABETH A. NEVILLE ,e j y� Town Hall, 53095 Main Road
TOWN CLERK % CO, Z $ P.O. Box 1179
��� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS � � Fax (631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER `_yw£l sig.
$'�ss'
,��� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER -•-,."16„, ,•,s' southoldtown.northfork.net
. ' `7._ --- 2 zl -- OFFICE OF THE TOWN CLERK
4. 1
SOUS �' TOWN OF SOUTHOLD
TO: So thofd 1 own.Building Department
...1 n
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: February 28, 2005
Transmitted herewith is a copy of application No. 3442 for a Cesspool/Septic Tank Construction
Permit submitted by:
Eleanor Reiersen
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 /J
Comments: A+-� 4-7°,76444.41.-*
2I-(-42\ / «G�%
Signature �”
D 3 0 3 ,S`
Dated
t
�,, OFFOL
'-
ELIZABETH A.NEVILLE %1IeqiTown Hall,53095 Main Road
TOWN CLERK ,. P.O.Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER �► Fax(631) 766-6145
RECd MANAGEMENT OFFICER = 4). 'i Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER ' if/ ,,0 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,/ or Non-Residential Residential @$25Application N4$(41?
Permit No.
Applicant Name -Ur'�� �AC) (I\ce(-1
Applicant Mailing Address o 4( IV PLV-AcMw‘`1 1\1\10-3--1
Septic Tank or Cesspool n
Brief Description of Proposed Construction or Alteration NC\A) IONS rvi Ci 1 O�
Location of Proposed Construction/Alteration:
Owner of Property: F. N a \E kSE'V .
Owner Mailing Address: 6 G c F la 0-
t. R\kQ
Owner Property Address: L'S VAMatetr Q.D
smiA(ld JY
Name and phone number of contact person
Tax Map No: 1000 Section on,0 Block OS•00 Lot 030 .0 0
Cross Street MP% ‘2,4\y\101\i
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SUR r f`ALTH DEPARTMENT PROVAL
€D../D,& os
_• : of Applican D/ joS
o
Received by:
1
GROUND ELEVATION 18.5 s ' SURVEY OF LOT 22
gm' BROWN SILTY SAND _ _—_—_—___—_—pc e- WATER MAIN ____ MAP OF TERRY WATERS
SP BROWN FINE TO ' r
MEDIUM' SITUATED AT �"' ' `''�`4, �' ' •
' '
- — —.to,' MAIN BAYVIEW ROAD , :GBRSCCLABAYVIEW, TOWN OF SQ F Q
— _ — —187' SUFFOLK COUNTY, NEW YORK ±`
SC WATER IN GREYISH BROWN
— CLAYEY SAND O
WELL
sP- —WA2 d�`` F: 12/29/1958 MAP NO. 2901
IV MEDIUM SAND S.C.T.M. NO. 1000-88-5-30
z'0;., k, AREA = 17,376 SQ. FT.
TEST HOLE �, e ! ELEVATIONS ARE IN N.G.V.D. PLANE.
BY: MCDONALD GEOSCIENCE t x ,+ PLEASE NOTE PROP. SEPTIC SYSTEM
DATE: 01/04/2005 tom+
it is the applicant's responsibility to 1 - 1,200 GAL. SEPTIC TANK
NOTE: maintain adequate anita.y r istance ' 12'
UNSUITABLE SOILS MUST BE REMOVED AND REPLACED 1 - 8 DIA. Z DEEP LEACHING POOL
WITH A THREE FOOT CLEAN SAND AND GRAVEL COLLAR between all water eupply and sewage If/ 50% EXPANSION
AROUND THE LEACHING POOLS TO A DEPTH OP AT LEAST .
SIX PEET INTO A STRATA OP TYPICAL LONGdisposal facilities.
ISLAND SAND AND GRAVEL. p \
m
1 NI \ O \ ` o SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
a C CESSPOOL �v �,._ PERMIT FOR APPROVAL OF CONSTRUCTION FOR A
tb
' DWELLING\- WELL WATER ' - '�0\ -)\/)- SINGLE FAMILY RESIDENCE ONLY
CV 4 ca h ' \ T 23 SHED N \ _e \`R�
m ..�.�.c 1 %9.77' .2.7' J ` ,`V`�
.73 .. _.�...+.«� �.,� ti �` �. DATE-3\ 3H.S. REF. No, - -4Q\
EL T\ EL.20.1 -� •`1,,
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a 4 a E,�CC�►vFD' �s1TItiY EN APPROVED
w ti 121 I PR! . ex uya:%TTH DEP Irv.,, �.-
-4 \�\ �� ��5. FOR MAXIMUM OF BEDROOMS
a ,aO' \ 8..5 ���'�" �'G~ EXPIRES THREE YEARS FROM DATE OF APPROVAL
P O �, 0 say' I
ril
R /\ c 50.0'
I O p �TQ PORCH) 9 •
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Iv Ore
a4fw a " .ROP. q N. CO x s C.D.H s ENDORSEMENTS
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v) ' � \ N TEST a, BASE \\ O V. t i EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT
®ROLE 4 BEDR00.' \ / 41 n o o GUARANTEED UNLESS PHYSICALLY EVIDENT ON 7HE PREMISES AT THE TIME OF THE SURVEY.
r4 :34 raza \ n y
SURVEY'IS PREPAREINDICATD AND ON HHEREON ISRUN BEHALFTO ONLY
THE 77TLE COMPANPERSON(S)
GOVERNMENTAL FOR WHOM E
CA aa r3 \ FP. EL. 21.0 PROP. \ "h
' '� �/� • GF. EL. 19.5 • SEPTIC N. 1r o o AGENCY AND LENDING INSTITUTIONS LISTED HEREON, AND TO 7HE ASSIGNEES OF 7HE
q I V,et
1 SYSTEM p Z LENDING INSTITU77ON. GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INS77TUTIONS OR
'`3• o Ci o --1 . \ p SUBSEQUENT OWNERS. THE OFFSETS (OR DIMENSIONS) SHOWN HEREON FROM THE
STRUCTURES TO THE PROPERTY I / / x' PROP. PERVIOUS DWY. FIC PURPOSE AND USE AND
N CO A ''4 THEREFORE ARE NOT INTENDED TON GUIES DE THEE ERECTIOA N OF FENCES, RETAINING WALLS,
I l 28.0' o POOLS, PA77OS, PLANTING AREAS, ADDITIONS O BUILDINGS AND ANY OTHER CONS7RUC77ON.
• \ '"1 ALL LOCATIONS OF AND DISTANCES TO WELLS AND CESSPOOLS ARE BY LOCATIONS FROM
/ ►. I / \ HOMEOWNERS, FIELD OBSERVATIONS AND/OR INFORMATION OBTAINED FROM OTHERS. SINCE
m MOST ARE NOT VISIBLE THESE LOCATIONS AND DIMENSIONS CANNOT BE CERTIFIED.
Ifil:56 ( p • UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLAAON OF SEC77ON 7209
I ' �_ 150' MIN. •
N / • \ LAND SURVEYORS SIGNATURE AND RED INK OROF THE NEW YORK STA7E EDUCATION LAW. IEMBOSSED ES OF SSEAL SHALL NOT BE SURVEY MAP NOT ANG THE
�- -
E EXIST.O I •-.........___
1 EL 17.9 I 1 EL 19 8 CONSIDERED A TRUE VALID COPY.
o WE \� N 55'02'40"W 177.75' / PAT T. SECCAFICO
t; ed I LOT 21
PROFESSIONAL LAND SURVEYOR, P.C.
I 4 4 DWELLING - WELL W TER /
��E OF NEW - SUCCESSOR TO -
co DONALD TASE, LS
w chi' w \ P� SECcgo 0, RICHARD WILHELM AND ASSOCIATES
I / * ��a,e PAUL T. NCANALIZO .S. EORTHSTAR RT A.CKART L.S.
O 18:111
� �� GOOD GROUND SURVEYORS P.C.
Ii':1l o••- s328A Main Street107-5 W. Montauk Highway
1.
tib \ CESSPOOL Center Moriches, NY 11934 Hampton Bas, NY 11946 .II
Zs0
0 O' c ' Fax (6(631)878-7190
8-8 9020 PhFax:• 63, 728-6707
WELL \ 'AND SO°
FILE NO. T50423 SCALE: 1 = 30' DATE: 01/04/2005 N.Y.S. LIC. NO. 049287
COPYRIGHT - 2004 PAT T. SECCAFICO P.L.S., P.C.
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