HomeMy WebLinkAboutKempton, Gail •
SCUTHCLD VIASTEVIATER DI SPC6AL PERM T
OCNSTRt.IOTI CN CR ALTERATI CN PERM T
SEPTI C TAMC or CESSPOOL
Per m t ND. 4236 R Fesi dent i al X Non-Fesi dent i al
Fee $ 10. 00 Septic X Cesspool
PERvI T I SSIJED TO
Narre : NARK SO-MARTZ
Address 1: P O BCD( 933
Q t y St Zi p CUrCI-IDaE NY 11935
Dascr i pt on of Pr oposed Const r uct i on or Al t er at i on
SAN TARP SYSTEM FCR SI NSE FAM LY DI'ELLI NG
APPR VED AS SWM TIED AND AS APPROJED BY THE SIFFCLK OCINTY DEPARTMENT
CF HEALTH SERA CES Fl NAL APPRO/AL FEW RED FROM THE SIFFCLK COUNTY
HEALTH DEPARTMENT. FEF #R10- 13-0074
Narre Cf Owner GAI L KENPTCN
Mii I i ng Address 1 95 M D/t1XD ROAD
City St Zip CUTCHCGJE NY 11935
Property Address 1 95 M D/'XCD ROAD
a t y St Zi p CUTCJ-Kx1.E NY 11935
Tax Map ND. section 110. 00 bl ock 3 I of 32. 000
Cr oss Street FE-QUASH AVEN.E
Bui I di ng Perri t Nunber Cr oss Ref er ence:
I ssue Qat e: 5/ 15/ 14 EI i zabet h A Nevi I I e
Sout hold Toni a er k
oi
ELIZABETH A.NEVILLE,MMC /Atm G.f, Town Hall,53095 Main Road
TOWN CLERK ; p ; P.O. Box 1179
y Z Southold,New York 11971
REGISTRAR OF VITAL STATISTICS : A ��
O Fax(631)765-6145
MARRIAGE OFFICER : y ��
RECORDS MANAGEMENT OFFICER 9 •*`al ei� Telephone(631)765-1800
FREEDOM OF INFORMATION OFFICER ��� www.southoldtownny.gov
OFFICE OF THE TOWN CLERK:
TOWN OF SOUTHOLD
TO: Southold Town Building Department
MAY - 52014
FROM: Carol Hydell, Southold Town Clerk's Office
DATED: May 5, 2014
RE: Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 4236 for a Cesspool/Septic Tank Construction
Permit submitted by:
Mark Schwartz for Gail Kempton
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: Nor 1*
Signature
/
Dated
1j •
ELIZABETH A.NEVILLE Town Hall,53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold,New York 11971
MARRIAGE OFFICER Fax(631).765-8145
RECORDS MANAGEMENT OFFICERtirTelephone(631)765-1800
FREEDOM OF INFORMATION OFFICER -_ ' ,•'' southoldtown.northfork.net
'
•
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
•
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$idX or Non-Residential @$25 Application No. V'Ilk
Permit No.
/40Applicant Name e K Cc- 2
Applicant Mailing Address ft' 3 3
Septic Tank 1/Or Cesspool
Brief Description of Proposed Construction or Alteration Nit✓ fre r 77 C .t'y✓',i iti .
t ,* New elV ' r
Location of Proposed Construction/Alteration:
Owner of Property: 04 IC • re Ai '- -,N
Owner Mailing Address: 9 r M/D Ad CO. 120 4 0
Cujt" tfy
Owner Property Address: £f y/£
O
Name and phone number of contact person /k21- JcItrAmtetr Z 734-14 e
Tax Map No: f 000 Section /1 0 Block OJ Lot 3' t
Cross Street re Qv/ft*
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SUR Y WITH ' /y ,T;' : 'ARTMENT APPROVAL
• / OcOz. / ¢
Signat re of Ap i't Date. •
Received by: .7 "`��
1
1
1
(DWELLING WITH PUBLIC WATER)
(DWELLING WITH PUBLIC WATER) SURVEY OF PROPERTY +
OAD m A T FLEETS NECK �/_
MIDLAND Abandonment of existingrani " E TOWN OF SOUTHOLD
/'�
Z
�=item
conformance with department ►s4.1 in
EL. 13.0' (PUBLIC WATER IN STREET) completed form anent submit SUFFOLK COUNTY, N. Y.
rm�'�M-- _ ,,f 1000-110-03-32
EDGE PAVEMENTSCALE: 1=30'
176.57' EL. 7 4 NOVEMBER 20, 2013
°SAD u,Km a e' N50'03'20"Er� C
11 �`�, r co STILLWAT SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
ON.
Z 10.2''WW �F-I- N �� _ VENUE PERMIT FOR APPROVAL OF CONSTRUCTION FOR A
Z G4 It 2 q - o AVENUE ay
s I. Q� NEST HOLE �� - -- SINGLE FAMILY RESIDENCE ONLY
r EL9.1'
0 t ^ . 03 y ,f, F - IP' FY
--di UTILITY FEB 2 0 Z014 //�� '�jj
O �I, .�-�/ POLE
DATE /REF
. 1+10. K/� - /3—x7 y
9 03 RI r 3% //lir--- --lir3";21'
�. . •.;`�. � O PROPOSED C APPROVED ��LN Z % ', q 16.�'/ DRIVEWAY _ r-c) fC7 'C-7
FOR fvtAX ,UA OF 1 13E DROOl`n.�'i
1 ASPHALT DRIVEWAY -D 0
�: /(1, mi ,.c!'�� �;r'r / j .r D EXPIRES T H / YEAR9 FROM DATE 0- APPROVAL
,45 C DD i
) � ��4 _I-_�_ ir 529• � ` C7
Z .. - f
(Ex►snNc
) g Z D
' j ��% «" ______ %; m PROPOSED LOT COV RA at��
Sb M i 4/ - d > vHOUSE - 2354 sq. t. xCav n ins... EL. 16.7' 5' �: EL 13.8' BRMONC, 2354/16320 = 14.496 Inspect'
' Sanita R ui
r
� '�" p�.... >r� � OOC�00 a c � For ry System
red
0) MON. — S5425 50 W ROW OF a-.• 1 175.29 ROW OF 7 37 �0 1 ystem
EL 6.5' v ROOF RUNOFF CAL LATIONBy Health p
0 EnECwsnr+c ' c 6 2354 sq.ft. ePart o f
-Fla (i 1 move))(DWELLING WITH PUBLIC WATER) r 2354 x 1 x 0.17 = . .0 cu.f f.
p 73• N/o� > C, PROVIDE (2) DWs. 8'. x 5' depth
rj
"I_ r 1 r IMARIE & KEVEIN GIVERIN, CANDICE & SEAN YORRK g
m �
rn ARAD/NG PLAN EXISTING HOUSE & DRIVEWAY TO BE REMOVED
tc= r C4- APPROIEV FLOOD ZONE FROM FLOOD INSURANCE RATE MAP
.. c. ) F.F. EL 16' --.�
PAPIE TEST HOLE DATA
-I;;; o MAP NUMBER 36103C0163H SEPTEMBER 25, 2009
M BY McDONALD GEOSCIENCE of NEW
_••'� - + GRADE - '4' ELEVATIONS REFERENCED TO N.A.V.D. 1988. NOVEMBER 25, 2013 AY' O
} . ...4A.. - h4
# 12" LE ' ''L LE �E •• ~•
I am familiar with the STANDARDS FOR APPROVAL 9.1' DARK BROWN LOAM a O`�a� E7��
11.5" "0' 'aa' AND CONSTRUC110N OF SUBSURFACE SEWAGE •—i' BROWN SILTY SAND SM ,, Flf,: ;_ 3 lk
3' `�LEACHING • DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES 'M'3'BROWN FINE SAND SM * I Y
PROPOSED SEP77C SYSTEM i ';
b GR WATER 0! and will abide by the conditions set forth therein and on the ____ � ,.:.
A 0. 6. ' ..wevA
[1j LEACHING POOL 6' DEEP WITH .5CLEAN-k=-;- —— a. _T' permit to construct. .__-_9. WATER M BROWN FINE SAND SP (
SAND COLLAR. REMOVE MATERIAL DOWN % _
TO SAND SP AND BACKFILL WITH OLEAN SAND. a'DIAMETER The location of wells and cesspools shown hereon are WATER IN BROWN CLAYEY SAND SC 496
SANDfrom field observations and or from data obtained from others.
[1j 1,500 GALLON SEPTIC TANK. t � EL _11.9'•—21''GAR /IlkIC. NO. 49618
'EL -12' WATER IN BROWN FINE TO
TO BE BUILT TO SUFFOLK COUNTY DEPARTMENT OF ANY ALTERA710N OR ADD/TION TO THIS SURVEY IS A VIOLA 110N MEDIUM SAND SP CON/C MORS, P.C.
HEAL IH SERVICES SPECIFICATIONS. OF SEC7ION 72090F THE NEW YORK STATE EDUCATION LAW. 26' (631) 765-5020 FAX (631) 765-1797
EXCEPT AS PER SEC7TON 7209-SUBDIVISION 2. ALL CER TTFICA17ONS P.O. BOX 909
EXISTING SEPTIC SYSTEM TO BE REMOVED IN ACCORDANCE HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF 1230 TRAVELER STREET
WITH S.C.D.H.S. SPECIFICATIONS. SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR AREA=16 320 SQ. FT. 13-281
WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N.Y. 11971