HomeMy WebLinkAboutFisher, Nancy ELIZABETH A. NEVILLE, MMC Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax(631) 765-6145
MARRIAGE OFFICER Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 4021 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : DANIEL L. FISHER
Address 1: 38785 MAIN RD
City St Zip ORIENT NY 11957
Descripton of Proposed Construction or Alteration
ADDITIONAO EXISTING SYSTEM APPROVED AS SUBMITTED. MAINTAIN REQUIRED
SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES AND WATER
BODIES.
H.S. REF NO. R10-11-0038
Name Of Owner NANCY L. FISHER
Mailing Address 1 38785 MAIN RD
City St Zip ORIENT NY 11957
Property Address 1 38785 MAIN RD
, City St Zip ORIENT NY 11957
Tax Map No. section 15.00 block 8 lot 1.001
Cross Street RYDER FARM LN
Building Permit Number Cross Reference:
cgjas4q44.4.&,
Issue Date: 1/14/15 Elizabeth A. Neville
Southold Town Clerk
"0 QF SO(/j5,
ELIZABETH A. NEVILLE,RMC, CMC � '- OIO ; Town Hall, 53095 Main Road
TOWN CLERK jig lg , P.O. Box 1179
y Southold, New York 11971
REGISTRAR OF VITAL STATISTICS G @ t
MARRIAGE OFFICER •
Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER �I Telephone (631) 765-1800
tv
FREEDOM OF INFORMATION OFFICER =�C�UW 1�,������ Fax
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
AUG 8 2011
FROM: Carol Hydell, Southold Town Clerk's Office
BLDG. DEPT.
DATED: June 7, 2011 TOWN OF SOUTHOLD
Transmitted herewith is a copy of application No. 4021 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Daniel Fischer
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. Thank you
Carol Hydell
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: Maintain required setbacks from adjacent wells,buildings,property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED.
RECEIVED
JAN 1 2015 ignature
Southold Town Clerk /� ��
ted
Born, Sabrina
From: Bunch, Connie
Sent: Wednesday,January 14, 2015 10:29 AM
To: Born, Sabrina
Subject: RE: Pending Cesspools
It was approved.
From: Born, Sabrina
Sent: Wednesday, January 14, 2015 8:45 AM
To: Bunch, Connie
Subject: RE: Pending Cesspools
Thank you for helping me with these Connie. I appreciate it. I do have a question about one that you had sent over the
other day. Permit#4021 for Daniel Fisher did not have Approve or Disapprove checked off but it was signed by Pat on
8/10/11.
=—ctfrzifza �`1'(. .l oV2
Clerk Typist
Southold Town Clerk's Office
53095 Route 25
P.O. Box 1179
Southold, NY 11971
Ph: 631-765-1800
Fax: 631-765-6145
From: Bunch, Connie
Sent: Wednesday, January 14, 2015 8:29 AM
To: Born, Sabrina
Subject: Pending Cesspools
Hi Sabrina,
Permit#4262 for 35-1-14 Morris Cesspools is on hold due to violations.
Connie
1
•
ELIZABETH A.NEVILLE - /47 %,\
,Town Hall,53096 Main Roo
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICSi
tb• if Southold, New York 11971
MARRIAGE OFFICER \, 1 c,Fax (631) 766-6146
RECORDS MANAGEMENT OFFICER 4 011
FREEDOM OF INFORMATION OFFICER _ . ` le Telephone (691) 786-18Op
#eeee o���,,,�' southoldtown.northfork.riel
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$l0or Non-Residential @$25 _ Application No.40 Z
1.
Permit.No.
Applicant Name Aq ,,z_e/ L /1;s GI!e v
Applicant Mailing Address 5176' s Na ,1-, Ira d
01---/ fl 4-
Septic Tank or Cesspool
Brief Description of Proposed Construction or Alteration a ,a lid, //eacA
/etrcl Ik �J `/.�shi/ 2 �»y moo/�,�.� /
�� / r, er✓ 4A,cA/rig p00/ as joGrfuiricei 6A.a/fh imi rfio, /So ' e.
h,�,yhbar�,�j `✓e/ 5
Location of Proposed Construction/Alteration:
Owner of Property: ./Va r, c L /c e A e f/
Owner Mailing Address: 5879 5 /LA,n 4),a u el
6r t;).,1-- /V X //9 5
Owner Property Address: S4 A-K) .e
Name and phone number of contact person ,Ya r,,el L. �.Sc�iey 9q51.-D 32 9
Tax Map No: /d'Q Section/,_ Block , Lot A, /
Cross Street A2,/eir,- iu r n, A a a/
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY H HEALTH DEPARTMENT APPROVAL
.6/
0 /7
Si ature of
gn Applicant ate
Received by:
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p 106 S do f� ` P" `t s� ,k /��� 0 Tess Bortng
2� _ � � °�°c�d`\ �•. ti�' • ....� �Q � ,tia �/5 �' o cr 11/12/09cn. cEos4
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IP=r " PREL1 AR Y PLAN OF
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FIS - R PROPERTY
�' �� 0�� AT ORIENT'
0< 7s,
TOWN
OF SOUTHOLD
De
SUFFOLK COUNTY, N. Y.
1000 - 15 - 08 - 11
41 b,:;% Scale 1" _ 40 .
0' IO' 23' .0' /00'
UT/LIT/ES
ELECTR1 AY'R"L 12, 1990
TEL£Pi%ONE
CABLEV/S/ON Dec. 7, 2009
GAS Jan. 14, 2010. (frees)
SEP TIC SYSTEMS March '6, 201 D (oddifFons)
PRIVATE WELLS Aug. 5, 2010 (revisions)
FEMA FLOOD ZONE X
EL EVA TIONS ARE REFERENCED TO NA VD88
AREA = 1.6682 Acres
ANY AL TERA TION OR ADDITION TO TM1S SURVEY IS A VIOLATION
OF SECTION 7209 OF THE PEW YORK STATE EDUCATION LAW.
EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY
IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR
WHOSE SIGNATURE APPEARS HEREON.
January 14, 2015
Daniel Fisher
38785 Main Rd
Orient, NY 11957
RE: 1000-15.-8-1.1
Dear Sir/Madam:
Enclosed herewith is the Construction, Alteration or Modification Permit for a Septic
Tank/Cesspool System for which you applied.
AFTER the system is installed but prior to being used, an OPERATION PERMIT IS
REQUIRED. The operation Permit is issued by the Southold Town Clerk's Office. The fee is
Ten Dollars ($10.00) for a residential system and twenty-five dollars ($25.00) for a non-
residential system. Your check should be made payable to the "Southold Town Clerk". An
application form is enclosed. Please complete the requested information and return the
application, proper fee, and LOCATION MAP (map must indicate the location of the
cesspool(s)/septic tank(s), giving approximate distances in feet from any buildings to the pools
and distances between the pools.
Should you have any questions concerning this matter, please do not hesitate to contact this
office.
Very truly yours,
cSagzina s14. _Bow
Clerk Typist
Enclosures
r 1
SCDHS. Ref # R/0-11-0038
1) 1 i HSE.
FIN. FLR.
EL. 14
EL It9 frt GRADE EL its
IE
II. 1/4.7F-7:
/*• l' I EL 111/B'IFT EL 1rAPPRovED r. �c1 aT
PrE l� 1 17C IE 10.0 ER9 L.P.
rAr�r a�� �
cRou_ WA TER EL 1 l els I ��
1 N NCWEST EXPECTED
APPROVED (BARN) ��Ct
CROSSEC770N NEW SEPTIC SYSTEM
/ SEP TK' TAMC B = 4' LIOU6t):THEP
TH
""�-- 2- LEACHING POO:18'I 6' DEPJ� y . `1
j
Vit. BY Suffolk fouti: �t , .._.. �.k .(0 Q'✓
--�--•--._.,,. Paxtment oex'
alth Services `��
11 2FIN. FLR.STY HSE. �� C k \e,
s� EL 16.7 • -r`
ff 4t-
-- t•I &tlrp EL I1.1 FINISHED GRADE EL //.Y'
4.
fry q� Ur/rr.lex •
E 10 APPROVED E705T.
\\‘‘.1\ i SPE 8'I sT E 9.0 E 6.1 E� f OW t z 4
4. GROUND WATER EL. 1.1 i‘
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0 HIGHEST E7fPEC7`£D `;,
. r \\N
AN CROSSECTION IMPROVED SEPTIC SYSTEM
\o ( 2 Sly. Fr. House)
I - ETRV6 SEPTIC TANK 810 ■ 4'LIQUID DEPTH
-a 70SO 3 - LEACHING POOLS 8' i * 4'DEPTH BOTTOM OP'
'W O LEACHING POOL (WITH 3' SAND COLLAR! 3' ABOVE
O GROUND WA TER
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/IC gb *.uw.y a�,a u.i.x. of .. ...................... ., _ ._ ... s
o- Water Line.f,$) z ., Ay The
Suffolk County Dept .Uf dealt.h Services.
by IMcDON LD GEOSC1 NCE To Schee u e nspe
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DARK 3RO,IN LOAm
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BROWN SILT OL _ _ _ ,„..e...,._��...e....,.__...-.�._._�..
5 SUFFOLK COUNTY DEPARTMENT OF HEALT H SERVICES
BROWN FINE TO PERMIT Ftpr'. APPROVAL OF CoNF,TRUC ION FOR A
COARSE SANG SW
1
11.4' EL / SINGLE FA;hiLY RES DENCE Y-1" 1\
WATER-IAL EIRE NAL
F/NE TO COARSE
SAND SW I DATE 46111.211 �`, r�E;a, NC. �1
IIO - II-003
18' I.
APPROVED
FOR MAXIMUM
��OFF 0 BEDROOMS
EXPIRE -E 1j-q;1 i ROM DATE OF APPROVAL •
RTY
fOLD Abandonment of existing sanitary system must be in
comformance with department requirement Submit
N Y completed form RIWM-pO as proof.
/00r
gill ' SIGNIFICANT TREES
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