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Milazzo, Rose L Revocable Trust
SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 4063 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : ROSE L MILAZZO REVOCABLE TRUST Address 1: 137 KINGS ROAD City St Zip HAUPPAUGE NY 11788 Descripton of Proposed Construction or Alteration SANITARY SYSTEM FOR SINGLE FAMILY DWELLING. APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES. REF #R10-07--0066, FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT Name Of Owner ROSE L. MILAZZO REVOCABLE TRST Mailing Address 1 137 KINGS ROAD City St Zip HAUPPAUGE NY 11788 Property Address 1 1165 ISLAND VIEW LANE City St Zip GREENPORT NY 11944 Tax Map No. section 57.00 block 2 lot 20.000 Cross Street BAYSHORE RD Building Permit Number Cross Reference: Issue Date: 1/31/12 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) %cVFFOL 4'• ELIZABETH A.NEVILLE,MMC �� �� 4 Town Hall,53095 Main Road TOWN CLERK p P.O.Box 1179 t y 2 ; Southold,New York 11971 REGISTRAR OF VITAL STATISTICS O Fax(631)765-6145 MARRIAGE OFFICER #4/1 401 Telephone RECORDS OF MANAGEMENT OFFICER _ j �►`�Od�� Telephone(631)765-1800 * southoldtown.northfork.net 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: December 29,2011 RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4063 for a Cesspool/Septic Tank Construction Permit submitted by: Rose L. Milazzo Revocable Trust 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: Final approval required from the Suffolk County Health Department Signature JAN 3 2012 e)//2--C/2— Dated /. /ZDated BLDG.DEPT. TOWN OF SOUTHOLD t - oil OFF04 N:Po 00 ELIZABETH A.NEVILLE if,•. y Town Hall, 53095 Main Road TOWN CLERK p P.O. Box 1179 REGISTRAR OF VITAL STATISTICS �y Southold, New York 11971 MARRIAGE OFFICER , O � Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER =y " ,' Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER 491 4, -to, 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. LI©�� Permit No. Applicant Name 7.05e L--M i 4u-0 �t-yo,-G1(c T4 s Applicant Mailing Address lt 20 0 c) PQ vett r, �t/v ( <T?3 g Septic Tank or Cesspool r Brief Description of Proposed Construction or Alteration d 1�m,/tit o v Q n� c o T � Sona ( 7(5( Lb/ C c• Location of Proposed Construction/Alteration: Owner of Property: 50+-\(- Owner 0+'^(`Owner Mailing Address: I' Owner Property Address: 11 63 G ,, Th' 1199, y Name and phone number of contact person (Z05? tcrCo / 6 3 H 23y- ge7 3 Tax Map No: Section c? Block .- Lot a 0 Cross Street .fes (�^cQ L1 c' 1 LO4 c, bves,eyo 4 NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL Oso 1j, vJ6 zea -pcuocbSlt 1& r aSignatirfeDate Received by: SURVEY OF PROPERTY I N SITUATE: AR5HAMOMOGIVE / Lot 635 Water Line(s) MUST Be Inspected ByThe TOWN: �J` OUTHO�..D $ tl p AS Shown on A Ad S=� . DRAINAGE CALCULATIONS: 1 Suffolk County Dept. Of Haalth Services. a, - - SUFFOLK COUNTY, NY W E 700, 4$ Laura In Advance, SUFFOLK CO� d."4+ ' 'TCF HEALTH SERVICES PROPOSED ROOF (DWELLING) O k, i ;. w t?.'" i s'�'�:fi.'R. ,}3 .a 5 �'y - *_:3"t. f�"hs .'F" 2188 X 04 = 51.0 V.L.F. REQUIRED SURVEYED MAY I, 2006 To Schede e . PROPOSED ADDITION MAY 21, 2001 ei= 4,t�" - t> ,i � - -y«7O>+A S REVISED JAN. 8, 2001, , 2001 s_,,,.°r �.. . r..i 7,,I.,... 3 C r',° PROVIDE MAY 11 1 "� �`' I�a 2 81-0" DIA. X 3'-0" DEPTH DRAINAGE POOLS 3 OCT. 11, 2001, DEG. 21, 2001, JULY 20, 2010 AUG. 12, 2010, OCT. 05, 2010, Nov. 11, 2010 j�((' ¶•�aate��,,,��]] i «, If Cil1 ., k'io �t7-066( 6 V.L.F. PROVIDED DEC. 6, 2010 Island f1l ° I)�� ¢ .!__.._... -_. 1 r SUFFOLK COUNTY DEPT. HEALTH SERVIC: so'wide private road l •.. -- REF. it RIO - 0'l - 0066 , Ilea ;,, :'it`, ':h„,....1/4-,3._._1 `:+ LOT COVERAGE Ilii SUFFOLK COUNTY TAX MAP ; NUMBER 1000-5/-2-20 / EXPIRES f l akEE? A..!S Fii: M DATE OF APPROVAL LOT AREA TO EDGE OF WETLANDS 1,624 S.F. _ I CERTIFIED TO: AN- N85°40'30 I `—�~ - � EXISTING CONDITIONS: "W 310.16 EXISTING HOUSE 511 S.F. ROSE][. i"V��LE TRUST II' PORTION OF EXISTING ONE STORY 0 ,� 16' Right op y,� / DWELLING TO BE RECONSTRUCTED EXISTING DECK 84 S.F. ,• � _ AND RAISED TO EL. 13'(IN PLAGE) EXISTING LOT COVERAGE 515 S.F. OR '1.85 j Test Hole £ " g' PORTIONS OF EXISTING PROPOSED CONDITIONS: EL=11' / DWELLING TO eE REMOVED RECONSTRUCTED/RAISED PORTION OF EXISTING HOUSE 424 S.F. �S`0 \ ,\Q��� Land Now or Formerlyof: "----1-c\,.. PROPOSED ADDITION 854 S.F. McDonald C�eoscience fD , Nortel Baldwin Family ust -1- \ PROPOSED DECK 214 S.F. 4-6-07 �° 0 PROPOSED PERVIOUS Dwelling Town Water o """ ��� \,��\V 0 GRAVEL DRIVEWAY o TOTAL PROPOSED COVERAGE 1,412 S.F. OR 11.6% Brown °L OJ PROPOSED INATER`� tAIN Loom 1 �q- \ 588°12'00"E I" MIN 91 +.70 04 O I Silty SM C�9-�' `\ 4'7- ` „0"....1/ ��/ - ydQ9 w-- -, ;10 (. �-.�.`. CI \ Sand 3 AO Ccal- `\ `\ 1)•\ -- tTE T dc'je �o,- \ so, ro j�• ��-_ Q�, ° NYSDEC ADJACENT AREA COVERAGE 9 h fa `'�eK- ' �r q 5O?' ;I 1 ,.�-4 s ° LOT AREA BETWEEN 10' CONTOUR AND Br Finet 'E���m Vis° `--� �� PROPOSED:1 Two 'i s�!�' j� % 01.\ , TIDAL WETLANDS BOUNDARY = 2,871 SF Sand wwith SIN °7 s ♦ ..?'STORY ADDITI N '�,^c�o^y 1096 C),Grovel %". ----\ � � _ - - --- 4-FF EL. 13'� •7, ; See ty % ..{ , ' �� EXISTING CONDITIONS: 0, Popose, ,i? ^- 1 , ' s EXISTING HOUSE: 435 S.F. EXISTING DECK: 83 S.F. \ Tk ) \ 1V 74°/cf,c) „�aV Still.? =a �y EXISTING AA COVERAGE 518 S.F. OR 11.1q% °Ob��O `Y O /, / ;g; �o'° � 'o ass- Vp o o PROPOSED CONDITIONS: Hater •0\ \` �`- .k ZOht m Nit ! ° -nd� \ O, % PROPOSED HOUSE: 325 S.F. Flen to ,,,�� i Q e< Co�5e i .,.. x m— v 'r PROPOSED DECK: 186 S.F. Sand 1096 with 5N _ ® w�. /A/RSA rg I 1 ea Q 9-° PROPOSED AA COVERAGE = 511 S.F. OR 11.15% EXGA�lATIC3N II�S� EDT{QN RE le °° \ < FOR SANITARY SYSTEM 21\ '` �°SM6�oo' °.• q P'" �g 'L BY HEALTH DEPARTMENT x,0 HA,BPHeF a 1 b j ,2$ s, , 0\�K,PJ �S AND /� p \ C `C qn o • \� Q .) • OF NEW I 1c. 14 w \ 'Vl S� A,(' rN G EH,; ,f- Abandonment of existin aro ary system must be in owe1/4,,;;Qt F oo,, I s �. - NOTES: cornIbrr�a ee with depar`tme requirement Submit g To=''''e �y st , wn,,�\y op, \ ; i a MONUMENT FOUND completed form WWM-�as proof. ^ �� N '' ir 0 PIPE FOUND 3/,---SAND COLLAR 1r 1 n f :r 1 \ \ ��,y` 0 `SJ J1 9 sC "' Lk r•� r •I:ea an.raan a oeatmn:o a>w,.ey Y YAx AND FINAL ORAOE ee n ERADON 13A* o� \ LAN ti �f" c<M4 a licensed band surveyor*seal*a vroiotwn or..coon talc,tate Educt a or the Neth Talc AREA OF EXISTING SEPTIC A5 LOCATED BY OWNER.• INv-e+ INwer S� \ \ Ng9o/ may aPe> mt�ea� tn,>u�y nw7J• SFP1IC TAM _� 4, «ed wpm an orgxwi or .+e lana srveyar* EXISTING SEPTIC TO BE EXCAVATED AND BACKFILLED '�� / j ,0" >ta�ea,ea d°red to C MA x r oar ° v ha�b> his WITH CLEAN SAND PER S.C.D.H.S. STANDARDS :r ""'"" . / e, w /.�, W 'Certifications eedha can see.that ted rO{x.� 1'WLS 1x:TANx ___.._a vey was prepered N xcwdmce raitF lha ex """✓< - b d —, 4 thhee eed.°ror Practice ice For atna of Professional FEMA FLOOD ZONE LINE ANNOTATED es`^� �`l on his a hal Said w` s shall Twee-mem ea OROONCRIMILR 6dMON 3A aii5 aryl on his behalf to the insilwtwn listed hereon.me PROM FIRM MAP NO. 36103COI51 H = tae agency eo>orloran i.wuq e>envaon. Gerunco- , tiom o- t trarorerewe to aaa,eronai t,sinvnan, ® � AREA 10,622 S.F. OR 0.2431 ACRE (DEED DESGRIPQ IN JOHN C. EHLERS � �TT�, T T���vP�� ELEVATIONS REFERENCE NAVD '88 DATUM r.,,,,,,,„„ itit;k 3 ' t SEPTIC DESIGN LAND L dJ 1 02 +� 2 ( 6 EAST MAIN STREET - N.Y.S.LIC.NO.50202 GRAPHIC SCALE 1"= 30' - CSS t ` O '" � FREDERICK 5. KEITH N.(S.P.E. LIG. #3GG5' RIVERHEAD,N.Y. 11901 369-8288 Fax 369-8287 t _ �f.P`� SI���M��(. REF.-C:\Documents and Settings\Owner\My Documents\My Dropbox\ 06- 12-29-2009.pro jl