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McKay, Linda
SCUTHCLD VIASTEVATER D SPCSAL PER,l T CCNSTRUCTI CN CR ALTERATI CN PERM T SEPTI C TAN< or CESSPCCL Per nit N . 4176 R Ibsi dent i al X Nbn-Fesi dent i al Fee $ 10. 00 Septic X Cesspool PERM T I SSLED TO Nene : LI N]4 & SCOTT MCKAY Addr ess 1: 8 1-14RRI SCN AVENUE a t y St Zi p SCUTH4APTCN NY 11968 Descr i pt on of Proposed Const r uct i on or Al t er at i on SAN TAR( SYSTEM FCR SI N2LE FAM LY DVELLLI NIG APPROJED AS SIBM TIED AND AS APPROJED BY TI-E SLFFCLK CONN DEPARTMENT CF FEALTH SERM CES. Fl NAL APPR)/AL FEW RED FROM TFE SLFFCLK CGLMY F EALTH CEPART VENT. FEF #R10-13-0061 Mine a Owner LI Na4 & SCOTT MCKAY A i I i ng Addr ess 1 8 I-ARRI SCM AVEI J_E CI t y St Zip swTHAA 'TCN NY 11968 Pr oper t y Addr ess 1 BLCSSCM LANE City St Zip SCUTHCLD N( 11971 Tax Map Nb. sect i on 69. 00 bI ock 3 I of 10. 005 Cross Street JASM N= LANE Bui I di ng Per ni t N.inber Cr oss Ref er ence: I ssue Dat e: 1/06/ 14 El i zabet h A Nevi I I e Sout hold Town a er k /I///O`Os�ffO��Ae ELIZABETH A.NEVILLE,MMC 1,0 Gy Town Hall,53095 Main Road TOWN CLERK % P.O.Box 1179 ti Z Southold,New York 11971 REGISTRAR OF VITAL STATISTICS ;`se $ Fax(631) 765-6145 MARRIAGE OFFICER #4 0/ Telephone(631)765-1800 RECORDS FREEDOM OF MANAGEMENT ION OFFICER .�l �►a'd/ www.southoldtownny.gov OFFICE OF THE TOWN CLERK 1II r --7-7)TOWN OF SOUTHOLD I -= _ _ c-,..7 ;I ; .1 _ ! ' ,� TO: Southold Town Building Department '`0 ________i'' FROM: Carol Hydell, Southold Town Clerk's Office r, E E DATED: November 7, 2013 RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4176 for a Cesspool/Septic Tank Construction Permit submitted by: Linda & Scott McKay . 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 r i c�AC Signature /2//e3' ,3 Dated , ELIZABETH A. NEVILLE �I h`Z` 4�; Town Hall, 53095 Main Road TOWN CLERK Q - P.O. Box 1179 CA REGISTRAR OF VITAL STATISTICS �; Southold, New York 11971 MARRIAGE OFFICER : O �` �� Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER L y 00. Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER = Oi Jig #00. 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 @ $25 Application No. i 17G G Permit No. Applicant Name CN) /A_ °1- S£.©'# Applicant Mailing Address g thLi.rGVI So uol-Ui tt. u p -� 11C1 lc lob Septic Tank t/or Cesspool �y �Q� Brief Description of Proposed Cons tion or Alteration .j 03 Lc_ Location of Proposed Construct' n/Alteration: Owner of Property: ktAri A a S o+ nC1. Owner Mailing Address: S fh'f <--.- Owner Property Address: BID5So114 L Name and phone number of contact person`— ,14 St `J Se. erti. r� foo 0 Tax Map No: Section itEeetb,Zo Block 0 3 Lot /O• .� Cross Street 4:0-Kil LLL/ crfra►t--Q NOTE: LOCATION MAP MUST BE S MITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SU'VEY/Tj 'H HE �'H ► P TMENT APPROVAL `V�-�l u ,'r / / r Sign. ure of Applicant Date Received by: i , _," ,' PLOT PLAN OF ' HANDS ON SURVEYING 26 SILVER DRIVE LOT 4 FLAND RS,ROOK NEW YORK N 11901 •;7"E MAP OF TEL:(631)-369-8312-FAX:(631)-369-8313 • MARTIN D. HAND L.S • iii c3 c E L FL0WER,.HILL BLDG.CORP. COPIES OF THIS SURVEY R ERYMAP,EITHER PAPER OR ELECTRONIC,NOT BEARING SHALL NOT BE 9 Sri TERED CONSERVA TION SUBDIVISION CONSIDERED TO BEA ALIDCOPY ANDS INKELSHALLNOT BEOR EDUSEDLFOR ANY PURPOSi. > x OF BEACH PLUM HOMES Wf.N -8t SITUATE U =$ W v c SOUTHOLD CERTIFIED TO:SCOTT&LINDA MCKAY ua =u. TOWN OF SOUTHOLD SUFFOLX COUNTY,NEW YORK u 2 lot •• - . • • • 15 8 0 15 30 45 60 75 90 105 120 135 SCALE: 1"=30' DATE:SEPTEMBER 16,2013 • LOT AREA:33,712 SQ.FT. =0.774 ACRE JOB NO. 2013-264 MAP NO.11458 TEST HOLE#2 JASMINE LANE FILED:NOVEMBER 01,2013 REVISIONS: PER FILED MAP TOP EL. 19' ,Q SAND Soq R=25.00' SUFFOLK COUNTY DEPARTMENT 0'F HEALTH SERVICES �\4 00NAz 1`c OL LOAM L=39.27' PERMIT FOR APPROVAL,OF C'�I'"T` I,e'f0 d i n A /. c� v �' �,,. — 1.5' SINGLE FAMILY 9 „"tai 7-_ .414.`'. wl R* r `'�`� A✓ .ff OCT 282013 • t • . : t a DATE 1-1.',3, 's" F, Nr SAND& GRAVEL �- � "1 °ra(,' `' ;�` SW APPROVED gett.t.„,.Q____LckestA.,..0 TGF NE ¢N FOR MAXIMUM OF W . E:DRCOM.S -� _✓ EXPIRES THREE YEAR PROM ')ATE OF APPROVAL 1 l ' I 17' �'V L=17.45' LICENSE NO. 050363 MAP PREPARED FROM OFFICE RECORDS NO WELLS EVIDENT WITHIN 150'OF SUBJECT PROPERTY TEST HOLE#2 ON SURFACE WATER EVIDENT WITHIN 300' PER FILED MAP ® LOT5 CI) VACANT rvr^^J vJ 0 _IW d 1.20' S 77°19'20"E 190.02' �0 /\ -- - -- �- -- __ - -- EL.11' �A 56, I— -I / ' FE N 1 • I d _PROWDE _ BUIILOING ENVELOPE (1) �'D/A.X 6'DEEP EL.20' �' 1 : il LEACHING POOLS WITH 50%EXPANSION I Pa. • %`� 1,000 GAL. SEPTIC TANK 1 8 11 p ti Ni 50 1 O o) --1.;t 6 1Z of P R°N 1 20.41 PR° P° ED 0 W PR°goy`N�o1 sl g 1 i -4 IC �O o 15' .•\ D ,X-00- W IMpX. I Be••• 0 z 2 2 i k iiiti co 1 (n NI Od I J 15'NON-0ISTURBANCE/NON-FERTILIZATION 15' 1 EL.18_ -y BUFFER TO REMAIN IN NATURAL STATE 1 EL.12' N 77°1920"W 227.00' LOT1 VACANT DEVELOPMENT RIGHTS TO BE SOLD TO THE TOWN OF SOUTHOLD y k 7 ,