HomeMy WebLinkAboutMahoney, Dan SCUTHCLD 1/ASTEVIATER CI SPO6AL PERM T
CONST LLTI CN CR ALTERATI CN PERM T
SEPTI C TAMC or CESSPOOL
Per m t Nb. 4226 R Fesi dent i al X Non-Fbsi dent i al
Fee $ 10. 00 Septic X Cesspool
PERM T I SSIED TO
Nave : IVPC SG-MARTZ
Address 1: P O BCD( 933
Q t y St Zi p CUTCI-CG E NY 11935
Cescr i pt on of Proposed Const r uct i on or AI t er at i on
SAN TARP SYSTEM FCR SI MOLE FAM LY WELLING
APPROVED AS SUM TIED AND AS APPITX/ED BY THE SUFFCLK CX1NTY CEPARTIVENT
CF I-EALTH SERA CES. Fl NAL APPRD/AL RECD RED FROM Tl-E SUFFCLK OCU TY
I- ALTH CEPARTNENr. FEF #R10- 13-0050
Narre a Owner CSN & Vl RQ NJ A IVA EY
Mei I i ng Address 1 35 FLCKD PLACE
a t y St Zi p EAST NCRN CH NY 11732
Property Address 1 3930 STI LLVATER AVEI.E
a t y St Zi p CUT(J-IOCUE NY 11935
Tax Mlp Nb. section 137. 00 bl ock 10 I of 10. 000
Cross Street TRACK AVENUE
Bui I di ng Per m t N nber Cr oss Ref er ence:
I ssue Cat e: 3/31/ 14 Elizabeth A Navi I l e
Sout hold Tow a er k
1.
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ELIZABETH A.NEVILLE,MMC t, Town Hall,53095 Main Road
TOWN CLERK C P.O. Box 1179
CA Z Southold New York 11971
REGISTRAR OF VITAL STATISTICS �t
O Fax(631) 765-6145
MARRIAGE OFFICER \-4;* . 01 Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER O! *tool
www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER -
--..'.'�
OFFICE OF THE TOWN,CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
iv%4,9 1 7 2014
FROM: Carol Hydell, Southold Town Clerk's Office
DATED: March 17, 2014
RE: Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 4226 for a Cesspool/Septic Tank Construction
Permit submitted by:
Mark Schwartz for Mahoney
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 lo ation map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: ..�.��
, AP"
Ir l
ropy
Signature
05 2-7 /
Dated
V ,,,,,,,,,,,,,
ELIZABETH A. NEVILLE 1tsCy`‘ Town Hall, 53095 Main Road
TOWN CLERK % p - % P.O. Box 1179
1 " Southold New York 11971
REGISTRAR OF VITAL STATISTICS v. f' '
MARRIAGE OFFICER ' O .0 I� Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER =,y**0 AY—.0 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER : 1
--- -.,,,.#0.•�1,," 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 No. oy„)
Permit No.
Applicant Name 19-/eg J -IC1/4/xhe Tr___---
Applicant Mailing Address pa d o2 9 2 3
C T-G ` ivy i 19 J'
Septic Tank ✓or Cesspool
Brief Description of Proposed Construction or Alteration OrAl 0 I 'iI- 7•v 6
___14-0(ii7 W evei j—fc-,ern PXCite gv<t-p /v e.1/_
l'ilv✓5
Location of Proposed Construction/Alteration:/ A,�
Owner of Property: p ew f tJ//R�/�ti/ 4 /"[�'i A/ __ fj
Owner Mailing Address: 3T FL 0 '£ /c?C 4-C-g-
''r /Welv)Ciii 7.
A/ r (( iz
Owner Property Address: 3 93 D ST/.L w47 e. /4-f/E
cc,z"ter v
Name and phone number of contact person Li '`' f- t-- ' — ./dc`✓
Tax Map No: Section /37 Block C / Lot / U
Cross Street 7Z 4C k 4- /
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH H TH 1 EPARTMENT APPROVAL
' Ve_.
e3/1c4
Signature of Applic� ate
Received by:
I am familiar with the STANDARDS FOR APPROVAL rp
. AND CONSTRUCT/ON OF SUBSURFACE SEWAGE
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES
and will abide by the conditions set forth therein and on the SURVEY OF PROPERTY
permit to construct. 4A,
-'Y\\06,,t, AT CUTCHOGUE
The location of wells, cesspools & public water shown hereon are
from field observations and or from data obtained from others. TOWN OF SOUTHOLDELEVATIONS REFERENCED TO N.A.V.D. X 4SUFFOLK COUNTY, N. Y.LOT NUMBERS REFER TO MAP OF SECTION TWO PROPERTY ,, , 100013701-10
OF M.S. HAND" FILED IN THE SUFFOLK COUNTY CLERK'S GB1.15., r SCALE: 11-30,
OFFICE ON MAY 12, 1939 AS FILE NO. 1280. �C� JUNE 6, 2012
4 4 cg APRA. IQ, 2013 (PROP. NEW HSE.)
Q q rp
N % ate , ,Z.,,,,,, '
,1, ,sSN S mitis `4 &
j , d 4. A J y0 SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
' ,� o�%z� 3E) NI, < ,\ PERMIT FOR APPROVAL OF CONSTRUCTION FOR A
T
��k O -e'er. s 5 a. i_ SINGLE FAMILY RESIDENCE ONLY
41/4.11:1 �� �+ 4
/ 'Cb. i� 1 � J D�� 2 7 20
-i.S. REF. No. '[�1� 13 -OO�O
PROPOSED NEW SEPTIC �� s ,�'` �y� O'� NCIA�'C� APPROVED a.A.A.A..�. a,
SYSTEM LL \.G rt• �� Q�a �p FOR MAXIMUM OF
(4 BEDROOMS) o �� OQ 1 �• e• t AllN,
qi` ,
(p BEDROOMS
EXPIRES THREE YEARS FROM DATE OF APPROVAL
1000 GAL. PRECAST 3 _A, \ e r5,/.Q, V0 0
SEPTIC TANK < ,k ��'�/ . 4 �r .
I - 8'0x 12' EFFECT.. DEPTH 7 \ 9
WITH 3' SAND COLLAR (SW) • ' .,.• ` •A� A, '
3' ABOVE GROUND WATER '�q )4,,,`, t �
•
EXISTING CESSPOOL TO .O 0 i c, 4 ra.
BE REMOVED OR FILLED k°f 44,•+ '� ; ,/ .c,"*_',;� ��ti ��
IN TO SCDHS SPECS. - ' �` ,
en
"2 ) `�" vlAbandonment of existing sanitary system must bein TEST HOLE DATA
0 .� + BY McDONALD GEOSCIENCE
v� ®�,� / �` 1 P� comformance with department requirement Submit '5/16/12
`�� F/ Q��` 5'�� G� completed form WWM- L1 proof.
DARK BROWN LOAM. a
,y • 0 • 0.5'
\q- ch'h � � y1 / � . QJ '..�� DROWN SILTY SAND SM
0N
2'j_ ,/ �J\{ / ��tg /' \G "4. PALE BROWN FINE SAND SP
d.
OF NE
C4 .� '4*‘ +/ �_ LJ Axcr RAIN LO NEW HOUSE RUNOFF 1321TS0 FT. ro' 1Z.ME%2AINMENT •S �0 -
4 h . / 1321 x 1, x 0.17 225 CU.FT. pd'' 'citoG�
Q� 225/22.3 10 VF . ..�'a . -,.07.:,` wAiER ENCOUNTERED
GB� �'
40-,4-\ PROVIDE 2 DWS. '6 0 x 5 DEEP * r , � •
/0' �e 91 OR EQUAL !. . II
(I - -;aye
9
G
.49G�0. ''
JUL 15 2013 J QJOJ •�.' 4' ` N. Y.S. LIC. NO. 49618
tIFFIF110.
ANY AL TERA TION OR ADDITION TO THIS SURVEY IS A MALA TIaN ' CONIC MORS, P.C.
Ham-A RVICES Ni- OF SECTION 72090F THE NEW YORK STATE EDUCATION LAW. (631) 765-5020 FAX (631) 765-1797
MG +C' EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF P.O. BOX 909
AREA=8,751 SQ. FT. SAID MAP OR COPIES BEAR 7HE IMPRESSED SEAL OF THE SURVEYOR • =MONUMENT 1230 TRAVELER STREET 1�_� pp
L. WHOSE SIQVATURE APPEARS HEREON. • =PIPE SOUTHOLD, N.Y. 11971 1 UU
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