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HomeMy WebLinkAboutHamilton, Jeremy SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 3510 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : AGNIESZKA DROZDOWSKA Address 1: PO BOX 93 City St Zip MATTITUCK NY 11952 Descripton of Proposed Construction or Alteration ADDITION TO EXISTING 1ST FLOOR ADDITION OF NEW 2ND FLOOR-ATTACHED ONE CAR GARAGE FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT Name Of Owner JEREMY & LAUREN HAMILTON Mailing Address 1 1535 PARK AVENUE City St Zip MATTITUCK NY 11952 Property Address 1 SAME City St Zip 0000 Tax Map No. section 123.00 block 2 lot 3.100 Cross Street MARRATOOKA ROAD Building Permit Number Cross Reference: Issue Date: 3/15/07 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) /,�,� .ice���s �� pf S0!/l6,1 ,�% ELIZABETH A. NEVILLE • '`� l0 1� � Town Hall, 53095 Main Road TOWN CLERK , 4 4, % P.O. Box 1179 N bc ` Southold, New York 11971 REGISTRAR OF VITAL STATISTICS G Q � MARRIAGE OFFICER ��O � I Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER `: 4 4I* i° Telephone (631) 765-1800 FREEDOM OF INFORMATION—OFF/GER -. oUIU 1,, •••• southoldtown.northfork.net FEB z Q OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD --1 TO: - - Southold Town Building Department FROM: Michelle L. Martocchia, Southold Town Clerk's Office DATED: February 20, 2007 RE: Cesspool Construction/Alteration Application Transmitted herewith is a copy of application No. 3667 for a Cesspool/Septic Tank Construction/Alteration Permit submitted by: Agnieszka Drozdowska . 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: 4-freltio4+1. 2iil.r ..40 i .. Signature &y3/1 7 Dated SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK residential @ $10 or ❑ Non-Residential @$25 Septic Tank ❑or Cesspool ❑ Application No. 3 6( 7 Permit No. 3.51 0 Applicant Name: ti,i Ck - H - Applicant Mailing Address: 'P CD . 3o 9 Brief description of Propsed Construction or Alteration: 4 7 P,TJDL) r�U �� -i-t C6 r?T F,L f X171• • UD. _I+.: - : TTA ,i _ii' _fiat r _ Location of Proposed Construction/Alteration: Owner of Property: ZIS E1✓Ny $ L D gp c ` P -N I LTO C Owner Mailing Address: t 5 2)5 F—K, A 0E,10u: OTT' I-100.41, sol_ //95,2 Property Address: 15 1 o mac\ 1i,4----7-lrOCk, U17. /1 Name and Telephone No.of Contact Person: G31 -(.29 g- /1 Tax Map No.: /0W Section: k.,2,5 Block: 22 Lot: 3) Nearest Cross Street: /c ( ) Ar. cCepk__ NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL. Si_;ture of Applicant Date Received b n /2.0I� _ . SURVEY OF PROPERTY 0 N SITUATE: MATTITUGK TOWN[: SOUTHOLD SUFFOLK COUNTY, NY septic E neighboring W closest ----- SURVEYED 08-21-02 AMENDED II-08-06, 01-10-2001 S SUFFOLK COUNTY DEPT. OF HEALTH SERVICES REF # RIO - 06 - 0103 SUFFOLK COUNTY TAX # 1000-123-2-31 CERTIFIED TO: Hamilton Lamm mmHamilbon Land Now or Formerly oh I.aod 1�t10 Dwelling Land Now or Formerly of: Gordon J. Hass Septic 150+ Alfred Bariattl d Shirley Bariattl Dwelling Dwelling Septic 150+ .O57'00"E 100.00' ---------------- 4,1.18• WOOD POST• •7 OTW I SUFFOLK COUNTY D3 PAT N OF :: . _32RVICES -— —____ __ PERMITF*�;:APPROVALCrCCI `77.":77:::1FORS `- - ISO' TOSEPTIC___-- --— SINGLE FAMILY REaID•'_' ©AT :\ -).„ 1-1 k`.J ' #" `J<�\� CA. X0.3z FTWPOSED ''--- _----------- y8L sep-TIG (n ^? E VAC\ 0 - —-, I� 0 APPROVED V\ < W. W 00 W FOR ML:,. . , q—__.. _. d _ W W ExPII?r, 1HI.,e, . . :-,c y ::� :n °:AIE:F�, ,<-� �:`: L O ri v r 0 /, 7r TEST HOLE o 0 0 & MCDONALD GEOSGIENGE d 3 Q 1 co 0 a , DARK BROWN coo u° 0 i ` . 1, OL SANDY LOAM " o o Q TM o `l BROWN CLAYEY co Q m �`-11 9 4 0 1 4' SG SAND C5 N Q 3 I { o co o co PALE BROWN n o FINE SAND EXISTING WELL TO BE ABANDONED PER Q i I'1 SP SCDHS STANDARDS GLS ; G.E. deck It P 5 --' - -__ b_ ---------i ! 8 �O' � 4 EXISTING, SEPTIC TO 2 StorFramey VI BE ABANDONED PER Gp Q' SCDHS STANDARDS iQ a (•�� �O "� O "+ O Or--o EI.�=18� x 41 " PRaPo� ma � _�,' ' HDDr►10115 ---- - i!1 0 IIIIICirildilivikaft:—le---.--1! clzWisli it IIb DrNeway and Walk ��,/ 6 1.6. t; 1311 A •tiA-11 -� 7,- '7 SCkStIfIQ f9fT10V6CI 4,i � . 1. ci { / o asphalt 8riveway / _1 ® 385.00' s1=IG,. , i1 1 00 � / 586. 11"w 11. edge of pavement ir)ark Avenue =I,, 1I a 1 NOTES: i,Th • � a•. m....., MONUMENT FOUND , .==z.`,et Voly=from Mort= rya/ IMS York 9t.t.lardb.Loft*EXISTING SEPTIC SYSTEM TO BE vacant 100' + s ABANDONED IN ACCORDANCE WITH dwelling stomped teal WWI W rgWd,r.p to p.valid true SCDHS STANDARDS. atImp- tire« Y!�G.C..t�"Ro.k.ler L «y tlr""'9..:y oma'°°°' ,."'.�aNp �•4 bn" p.r�an tae•he":tlr.;e: Y 1 ELEVATIONS.REFERENCE SUFFOLK """' a.await...a ae bb,,bwew..cwsrra COUNTY TOPO MAPS ,a.,.,,,,,.m,,,t,,,,,,,,. ,,,e AREA = 25,000 S.F. or 051 ACRE JOHN C. EHLERS LAND SURVEYOR $ 6 EAST MAIN STREET N.Y.S.LIC.NO.50202 GRAPHIC SCALE I"= 30' "g'• RIVERHEAD,N.Y. 11901 369-8288 Fax 369-8287 REF.\\Compagserver\pros\02\02-269 updated 09-28-2001