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HomeMy WebLinkAboutSankvich, Allen SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 4139 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : ROBERT BOHN Address 1: PO BOX 55 City St Zip PECONIC NY 11958 Descripton of Proposed Construction or Alteration ADDITION TO EXISTING SYSTEM APPROVED AS SUBMI'r1'JL). MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. REF # R10-13-0029 Name Of Owner ALLEN SANKVICH Mailing Address 1 182 VIOLET AVE City St Zip FLORAL PARK NY 11001 Property Address 1 1240 LONGVIEW LN City St Zip SOUTHOLD NY 11971 Tax Map No. section 88.00 block 4 lot 45.000 Cross Street NORTH BAYVIEW Building Permit Number Cross Reference: Issue Date: 1/20/15 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) January 20, 2015 Robert Bohn Contracting P.O. Box 55 Peconic,NY 11958 RE: 88.-4-45 (Sankvich) 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, Sabrina Born Clerk Typist Enclosures Born, Sabrina From: Bunch, Connie Sent: Friday,January 16, 2015 8:18 AM To: Born, Sabrina Subject: More cesspool permits #4139 we don't have but it has final health department. 4234,4158 and 4154 we don't have. I • 1 4 � � gigcj.fFO(j'0 ELIZABETH A.NEVILLE,MMC ������G 04 Town Hall,53095 Main Road TOWN CLERK ; P.O.Box 1179 ti Z Southold,New York 11971 REGISTRAR OF VITAL STATISTICS ��, O � � Fax(631)765-6145 MARRIAGE OFFICER # 0���� Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER = 49.( 17,106 www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Carol Hydell, Southold Town Clerk's Office DATED: June 14, 2013 Transmitted herewith is a copy of application No. 4139 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Robert Bohn Contracting for A. Sankvich 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. * * * * * * * * * * * * 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. Signature Dated „ I/iii,, ELIZABETH A. NEVILLE s��`Z` - Town Hall,53095 Main Roa. TOWN CLERK I' P.O. Box 1179 REGISTRAR OF VITAL STATISTICS �y Southold, New York 11971 MARRIAGE OFFICER :.O 1 Fax(631) 766-6145 RECORDS MANAGEMENT OFFICERy 0" '1' Telephone(631)765-1800 FREEDOM OF INFORMATION OFFICER ' '1 * 19 southoldtown.northfork.net "' OFFICE OF THE TOWN CLERK TOWN OF S• T 41.11* TOWN OF SOUTHOLD BUILDING DE'sFIT P.O. Box $79' SOUTHOLD WASTEWATER DISTRICT Southold,N.Y. APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @$10 or Non-Residential @$25 Application No.LI ( Permit No. Applicant Name - rL. �� , is. Applicant Mailing Address / ' G /3 O N j r .- C-6 iti f ry t/ //q3 Septic Tank or Cesspool - Brief Description of Proposed Construction or Alteration 2- u b 6 t2'r-(/ A,604.7. lu Location of Proposed Construction/Alteration: Owner of Property: 11.,4` i// e-h Owner Mailing Address: / Y' Z L/l 1/4 �- U re-✓a L E /-1 �K // b o./ Owner Property Address: /2 L v rt-” r/f J 2 f� u_`1 k, t D w\-( Ikq —i I Name and phone number of contact person J2 iL. C I w 's 3 / Z 3 Tax Map No: /4D-tpj Section )j1) Block cL Lot 4c Cross Street Iv b(2 7 13,<' y C/! J NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES S • " : HE; w: DEPARTMENT APPROVAL /ct`/ 3 !' Signature of A. •, . Date Received I LOT 64 oJs v�v4 ��;s, MAP OF o� o��° von o�QO� TERRY WATER 4 �J�``S ��`�,--7. r0, ILE No. 2901 FILED DECEMBER 29, 1958 SITUATE ,, ,,\°4 $'G#P` oe ........_,........,,, / BAYVIEW .6\2 y 4.4) o - s • � -3,. oryry,�a po • 4/6&, s,, TOWN OF SOUTHOLD 5��4' ��� o• f`,,� '�s s3, SUFFOLK COUNTY, NEW YORK ,‹z- (e" �PJP �p 30'' S.C. TAX No. 1000-88-04-45 o SCALE 1 "=20' <,' P- A APRIL 14, 2013 ' v w' , * MAY 30, 2013 ADDED FUTURE EXPANSION POOL NY \ 1, AREA = 15,000 sq. ft. ��. / N. w GsF ?' 0.344 ac. <4., 7i / - , ty/ it 4. , Alb e / 4. ��2t' ,IIS. .• : �y ��. R 1 • 41111.111/,F4 SII. ► �V h O, Q`P� �IIIIIII �3p, j� • .k. • ' y�O(v1.� ')J We A� 6 \ ¢ o �/ • ." \ • . • OA" . .,,,, .#. D....N / ►• -ife il ..,-4 1,--- . 45::;- ., 0 /it, ...."f",., \ / + ► '4, , illt a A o�, c • / : . IC) 11/11 ••4V •.• • .47‘4, 110 41'1 sp. 4 0 SEPTIC SYSTEM TIE MEASUREMENTS /r.,40 ,, •'►• . • ' ••'• 4\'y �q HOUSE HOUSE '' • • .p r'.D CORNER QA CORNER© �So ��° / �� ' ���P SEPTIC TANK 20' 17' 'Off, . Gj ••D•.. .� . oy��'J`?' COVER / . , Q .. LEACHING POOL • , • • COVER 1 37 32 Jr'' LEACHING POOL ' COVER 2 29' 21' ► '• LEACHING POOL44' 36' • COVER 3 /I, Ca •' SUFFOLK COUNTY11 DEPAR r' NT OF HEALTH SERVICES H.S.REF.No. l U- L.iCj )„9 PREPARED IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR TITLE SURVEYS *" - .ED BY THE LIA.LS. AND APPR• '; ► • ► Based on the information•ubmitted,it has been determined that this FOR SUCH USE BY THE Na TITLE ASSOCIATION. �P a •,,z• y project does not require dditional sewage disposal or water supply g I AF T C 01 facilities. 0,i, 1.A. { WA 7, ,� Todd Maximum - ►►,,.. C * 2Q t''. �.s•,,�'; 2 1 R o olPfiee of Wastewater itgfment1.,sr 1117:4 y- •LAND S N.Y.S. Lic. No. 50467 OLK COON DEPARTME OF HEALTH SERVICES UNAUTHORIZED ALTERATION OR ADDRION Nathan Taft Corwin 10 TO THIS SURVEY IS VIOLATION OF RMIT FOR APPR• AL °�F CONSTRUCTION FOR A SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. Land Surveyor SINGLE FA sEgiENC ONLY COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. "S. REF. O' • •-W-• CERTIFICATIONS INDICATED HEREON SHALL RUN Successor To: Stanley J. Isaksen, Jr. L.S. ONLY TO THE PERSON FOR WHOM THE SURVEY Joseph A. Ingegno L.S. )VED IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND Title Surveys — Subdivisions — Site Plans — Construction Layout FO' MAXIMUM OF B:-•ROOMS LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTI- PHONE (631)727-2090 Fax (631)727-1727 R r THREE YEARS FROM DATE 0 APPROVAL TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. THE EXISTENCE OF RIGHT OF WO' OFFICES LOCATED AT MAILING "^r)RESS AND/OR EASEMENTS OF RECORT 1586 Main Road P.O. , 16 ANY, NOT SHOWN ARE NOT GUA. SEED. Jamesport, New York 11947 Jamesport, Ne.. (ork 11947