HomeMy WebLinkAboutAnderson, John (2) r '
�O,1%OF SOUryo
ELIZABETH A. NEVILLE ° �0 lQ Town Hall, 53095 Main Road
TOWN CLERK 4 *; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS % cSouthold, New York 11971
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MARRIAGE OFFICER G iQ�1� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICERTelephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER `OIyCOUNI,W lli�
, 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. 3393 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JOHN ANDERSON
Address 1: P 0 BOX 1329
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
-APPLICANT PROPOSES TO CONSTRUCT A SINGLE FAMILY DWELLING AND
APPURTENANCES
-FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT
Name Of Owner JOHN ANDERSON
Mailing Address 1 P 0 BOX 1329
City St Zip SOUTHOLD NY 11971
Property Address 1 OARISH DRIVE & NORTH BAYVIEW
City St Zip SOUTHOLD NY 11971
Tax Map No. section 71.00 block 1 lot 33.000
Cross Street WEST OF DAYTON ROAD
Building Permit Number Cross Reference:
Issue Date: 11/29/05 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
ELIZABETH A.NEVILLE ts '` O Town Hall, 53095 Main Road
TOWN CLERK l 1l ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS
va bicSouthold, New York 11971
MARRIAGE OFFICER 4 '*\' 'ICC CS Fax (631) 765-6145
RECORDS MANAGEMENT'OFFICER l 'ii Telephone (631) 765-1800
FREEDOM OF,:IN OI 'IAT ON OFFICER -yCOU ,v�, •
southoldtown.northfork.net
1 1 26 OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
‘,.._. ----
1_T-91- Southold Town Building Department
FROM: Michelle L. Martocchia, Southold Town Clerk's Office
DATED: November 21, 2005
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 3542 for a Cesspool/Septic Tank
Construction Permit submitted by:
John Anderson do Suffolk Environ. Consulting
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 v
DISAPPROVE
Comments: V ,-
?oee.......4:5v,‘/..... .. .,.
Signature
.22 .Zoer`
Dated
�gpFFO(,,'0
ELIZABETH A.NEVILLE /, h`Z`� 4 Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
;
Z Southold, New York 11971
REGISTRAR.OF VITAL STATISTICS ` 4P
MARRIAGE OFFICER Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER = O��i�� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER -.. ' * *0.0' 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 x or Non-Residential @$25 Application No.
Permit No.
Applicant Name John Anderson(c/o Suffolk Environ. Consulting, Inc. )
Applicant Mailing Address P .O. Box 1329; Southold, NY 11977
Septic Tank x :or Cesspool
Brief Description of Proposed Construction or Alteration Applicant proposes to
construct a single family dwfIlling and appurtenances
Location of Proposed Construction/Alteration:
Owner of Property: John Anderson
Owner Mailing Address: P.O. Box 1329; Southold, NY 11977
Owner Property Address: s/s Parish Drive North; Bayview.
Name and phone number of contact person Matt 'vans: 631 -537-5160
Tax Map No: Section 071 Block- 01 Lot 033
Cross Street 280 ' west of Dayton Road
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
. CONSTRUCTION REQUIRES SURVEY ALTH DEPARTMEITT APPROVAL
ature of Applicant Date
Received liy: Lia . <(z Q
we/I we i/
. SCDHS Ref.# RIO-05-0027 .x
8
FIN. FLR. x
• EL20 Ni 1r �
e!IG 1n. gro-oce eic.6 fie[ kt
1'' t --�6' /k�P SURVEY OF PROPERTY
L� la 6E 1sT ST LE 12.2 T ('4'6//
N Ll~ 1p L.P. B� N w�/e, sf�\,. AT BAYVIEW
.'EL. 3' iiT� /o.RT� TOWN OF SOUTHOLD
,i .- SEPTIC ROSWATER CTION - - --16.41,506-----x=15.&- SUFFOLK COUNTY, N. Y.
1-1000 GAL PRECAST SEPTIC TAMC RI V.� 1000-71-01-33
I 2-LEAG7/NG POOLS- 8'I x 6.5'DEEP
740,°, _ _ _ _,� SCALE: 1'=30'
NO WELLS WITHIN 150'OF SEPTIC '1,
i OCTOBER 4, 2004
SYSTEM CO / r. $ LI ).-- - FEBRUARY 3,2005
CO .� _ , I May /4, 2005 (revisions)
/ 0 c< /
J /
\� / /VI 1 a4, "-'J / 280 p0' •
SERVICES
TEST HOLE / '-t---------1
C9 Q' I � SaFFOLK COUNTY DEPARTMENT OF HEALTH SER CE
11/16/04. p / / 1 '1 .--/- �V
e/// 2 -4/ '® // /•J a' `�'- '16 Qj t�'PERMIT FOR APPROVAL OF CONSTRUCTION FOR A
aING E FAMILY RESIDENCE ONLY
DARK BROWN SANDY LOAM 01. ki / i i � 05 /Q�O'o5-UDZ7
- - — -1" 2 f / Q i / iii ATE G .N
BROWN SILTY SAAR SM S CI 1 J •
3 N APPROVED ../ *DV,
—- BROWN FIE To MEDIUM SAID SP
�� 9 // FC , 1''i° / q�' FOR MAXIMUM OF BEDROOMS
- 0
PALE BROWN FIVE TO COARSE ,�G EXPIRES THREE YEARS FROM DATE OF APPROVAL
- / ........... ..
SAID WITH srox GRAVEL SW = O �'A'Q F, ,� % — / '
/
8...-.t) /, / W
WATER N PALE BROWN FINE TO +
COARSE SAID 1877'5-10% *RAVEL SW ^ h i / ''{/r 721 _ -<'<_: �J8.
8 _
. -- — — e/� j i i Q / am familiar with the STANDARDS FOR APPROVAL
i
V AND CONSTRUCTION OF SUBSURFACE SEWAGE
_ — . 39_/ DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES
— ——— �- — — -2� Q and will abide by the conditions set forth therein and on the
t
'o — --- s3 permit 10 construct.
is \ / � i � b O
N/p� l .o�d/ i i t I — — i 26 163. iYe�/ c-_r
`10Sr- ,� 22' 0 - The locations of wells and cesspools _ .
ti P. ¢ 4, c.rJ N 24-- _ shown hereon are from field observations
4/4. ° .6, ' and or from data obtained from others. �;'
QUA/4/ /C"�Y 2
AREA=24 185 SQ. FT. 14 dr 47/ kr". ,• ? -
LIC.ZZe . NO. 49618
ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VYOLATION A• C PEC• `lr�.��/i- P.C.
OF SECTION 72090E THE NEW YORK STATE EDUCATION LAW. AN�j/A, (631) -7f---41! Cr'It' l'f 'X (631) 765-1797
EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CER77F/CAT7oNs ■=MONUMENT P.O. BOX •
HEREON ARE VAUD FOR THIS MAP AND COPIES THEREOF ONLY IF
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR l®= PROPOSED CONTOURELEVA TIONS REFERENCED TO N.G. V.D. 1230 TRAVELER STREET 04_,�84
WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N. Y. 11971