HomeMy WebLinkAboutSouth Fork Properties SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3513 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : SOUTH FORK PROPERTIES
Address 1: PO BOX 684
City St Zip SOUTHAMPTON NY 11969
Descripton of Proposed Construction or Alteration
SEPTIC SYSTEM FOR A NEW SINGLE-FAMILY RESIDENCE
FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT
Name Of Owner SOUTH FORK PROPERTIES
Mailing Address 1 PO BOX 684
City St Zip SOUTHAMPTON NY 11969
Property Address 1 560 KENNEY'S ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 59.00 block 3 lot 3.500
Cross Street NORTH ROAD
Building Permit Number Cross Reference:
Issue Date: 3/15/07 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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11,�o�
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ELIZABETH A.NEVILLE O Town Hall, 53095 Main Road
TOWN CLERK * P.O. Box 1179
1
REGISTRAR OF VITAL STATISTICS ; G Q ,,�
Southold, New York 11971
MARRIAGE OFFICER % . 11 Fax (631) 765-6145
RECORDS MANAGMENT OFFICER l 111 Telephone (631) 765-1800
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FREEDOM OF I RMATION OFFICER '�COUN COUNT( southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TB: Southold Town Building Department
1-PK6M: Michelle L. Martocchia, Southold Town Clerk's Office
DATED: March 1, 2007
RE: Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 3670 for a Cesspool/Septic Tank
Construction/Alteration Permit submitted by:
South Fork Properties
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:
.416"';‘1464--€1 : "rfr‘fr."'igi
Signature
ec /3 07
Dated
�,0';gOFFOtti-
ELIZABETH A. NEVILLF, 4 O r; Town Hall, 53095 Main Row'TOWN CLERK 11/QQf P.O. Box 1179
•
REGISTRAR OF VITAL STATISTICS ; Southold, New York 11971
MARRIAGE OFFICER :��y Fax(631) 765-6145
:
RECORDS MANAGEMENT OFFICER 4n1 _A�� �� Telephone(631)765-1800
FREEDOM OF INFORMATION OFFICER - � o•' 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 @$25 Application N l 0
pp Permit No.
Applicant Name 114 Yost PcP02:tiEJ
Applicant Mailing Address / O Vox 6:V1 tSo i 4i'''Prcv✓ ivy I/767
Septic Tank ✓or Cesspool
Brief Description of Proposed Construction or Alteration _Sepric sysrtM rot ,4
N6w SING k-FGM,tY 26.5106A/6e
Location of Proposed Construction/Alteration:
Owner of Property: m4 JvLK 17abnge-r165
Owner Mailing Address: f D gea C��l
A)y 1190
Owner Property Address: ,5C0 K6A1^/6,, l2, .50vtfo(2'
Name and phone number of contact person itis-rbv Neitht1A/b - �1.7-7 00
Tax Map No: Section -5-'7 Block 3 Lot 35
Cross Street Aloh-tN 1264l*
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
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of Applicant to
Received by: 3) 1 1 Cr?
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SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES s0
OFO cA� 4�. ��
PERMIT FOR APPROVAL OF CONSTRUCTION FORA 4139/ ,-,<'. 4 's, ".'
SINGLE FAMILY RESIDENCE ONLY `) q—/'
�- 0 SURVEY OF PROPERTY
DATE p- tq-09. HS • :4.• 0. 0.".°14-•1 a
`� SITUATA'D A'I'
APPROVED 11, �� Ui ,f �)I,1
>r- TOWN OF SOUTHOLD
FORMAXIMUM I' .,Bu: c �T SMS ��-P- SUFFTO COIF SO NE °JJ Yr)PV
�t El G. i i�(i(/—`./ri (j,3 �a
a.;v..: a i:1,E.L i s.i:i.:-' �L; i7i 4. Y t 1.kik T,A 3 re4Ai'Kt 1ir co. SCALE t"- 40'
_ � ' c, _ SEPTEMBER 30, 2003
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,. 0)0' 6'' 11-.. i.- 2:. 2rl'v4 Alli !, II..OT'(l') 11'i',! Ar 13!/H ',AIF
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EXCAVATION INSPECTION REQUIRED `
'0' �o
�I �LQ� ‘1' 7AREA = 37, 0123 sq. f1 j
FOR SANITARY SYSTEM 7 cj 077
Memo.. 0
BY HEALTH DEPARTMENT 004.05 P �� `�
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CERTIFIED TO:
THOMAS FISCHER
. LAWYERS TITLE INSURANCE CORP
NORTH FORK BANK
/
,..,,,;531Z f. NOTES,
;i \ t. ELEVATIONS ARE REFERENCED TO AN ASSUMED DATUM
\'.IEXISTING ELEVATIONS ARE SHOWN THUS: -.
\ fie. /' % 2. REFER TO FILED MAP FOR TEST HOLE DATA.
° / 3. MINIMUM SEPTIC TANK CAPACITIES FOR_ A 1 TO 4 BEDROOM HOUSE IS 1,000 GALLONS.
/ �rF,j, 1 TAM(; 8' LONG, 4'-3• WIDE, 6'-7 DEEP
\ • r1-4•P // \'5'' 4. MINIMUM LEACHING SYSTEM FOR A 1 TO 4 BEDROOM HOUSE IS 300 so ft SIDEWALL AREA.
�, 0 i POOL, 12' DEEP. 8' dla.
VI
PROPOSED EXPANSION POOL
��0�' /33 0,.+ / of 4< �\,`� \ 0 PROPOSED LEACHING POOL
�GO��+ 4 �- .� ���9 // / �' G ��\a ���,\� P y�4p� �/%PROPOSED SEPTIC TANK .
f`,` 5 THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD
yet, • �:' Qssi �b Q /, 9 CION�v OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS.
4
F
�8
'�.. )' o� TEST HOLE DATA
�GS, 4' > �. / �� �, (TEST HOLE DUG BY McDONALD GEOSCIENCE ON JULY 27. 2004)
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Gt 'I, . ,,\ 41/4_ ••'•t�: ' �O `/ O.' `0,tP I._.___....._—. 1K BROWN LOAM 01 PREPARED IN • �.., • WITH THE MINIMUM
�,``lL `sem. 1� DARESTABLISHEDSTANDARDS FOR SURVEYS AS
��' sO BY AND APPROVED AND ADOPTED
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��J • ! �� _- - • NEW WAX STATE LAND
— b0 BROWN CLAYEY SAND SC 0
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,O6 PALE BROWN FINE
G4 \i T_ • TO COURSE SAND it! y;>
\ r"-e/ N.Y.S. tic. No. 49668
%„.• _ *! O) UNAUTHORIZED ALTERATION OR ADDITION .
YY THIS SURv1:Y A YIOIATgN OF ^w.. -
�L f cb `fes. '' ,i,''1"°*
0 SECTION 7209 OF THE NEW YORK STATE
TION LAW.
'9� ! S 4' EDUCATION
Oe G
�'pJ i l V` ... i.__-_. _-_ 27' COPIES OF THIS SURVEY MAP NOT BEARING Jo eph A. Ingegno
/ "�( ���0 n . �� LTHE LANO S NOT DBECOt6SEAL�gERED and Surveyor
// y ,t`'EI, TOO A VALID TRUE L NO
��1 (%�... ., via CERTIFICATIONS INDICATED HEREON SHALL RUN
.i 4.s ONLY TO THE PERSON FOR WHOM THE SURVEY
T9 IS PREPARED,AND ON HIS BEHALF TO THE —
Of 1 t 1RLE COMPANY, GOVERNMENTAL AGENCY AND I Title Survey's - Subdivisions - Site Plane - Construction Layout
. \
OS / 4 }(Y t T"9 tY1«a i LENDING INSTITUTION USTED HEREON.AND
G ,i,['i I O''j y,i �U TO THE ASSIGNEES OF THE LENDING RiSTI-
/ A IWTON. CERTIFICATIONS ARE NOT TRANSFERABLE PHONE (631)727-2090 Fax (631)727-1727
N 8T59'S0" W ! THE EXISTENCE OF RIGHT OF WAYS
33.74_ �/
AND/OR EASEMENTS OF RECORD. IF OFFICES LOCATED AT
MAILING ADDRESS
ANY, NOT SHOWN ARE NOT GUARANTEED. 322 ROANOKE AVENUE PA. Box 1931
RIVERHEAD, New York 11901 Riverhead, New York 11901-0965
I
— -- -- -- 23-352A
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