HomeMy WebLinkAboutRowe, Trevor AP 1
SCUTHCLD V1AS TEVIATER DI SPC6AL PERM T
OCNSTRUCTI CN CR ALTERATI CN PERM T
SEPTI C TAN< or CESSPOOL
Per ni t No. 4215 R Fesi dent i al X Non-Fesi dent i al
Fee $ 10. 00 Septic X Cesspool
-
PERM T I SSLFD TQ
Zine : TREVOR ROVE
Address 1: 390 AECHPN C STREET
Qty St Zip SCUTI-CLD NY 11971
Descr i pt on of Proposed Const r uct i on or Al t er at i on
SAN TAR( SYSTEM FCR SI NZLE FAM LY UI'ELLI NG
APPF)IED AS SWM TIED AND AS APPROJED BY TI-E SLFFCLK OCUNlrY DEPARTMENT
CF l-EALTH SERV! CES Fl M. APPRO✓AL REQUI RED FROM TIE SLFFCLK OaNTY
FEALTH DEPARTMENT. REF #R10- 13-0008
Mane Cf Omer TREVOR ROM & LQ S DERCBI ER
Mai I i ng Address 1 P 0 BO( 367
aty St Zip SCUTHCLD W 11971
Property Addr ess 1 390 MECHAN C STREET
a ty St Zi p SCUTHCLD NY 11971
Tax Map Nb. section 61. 00 bl ock 4 I of 15. 001
Cr oss St r eet MECH4N C Sil-thi EAST
Bui I di ng Per nit N.irrber Cr oss Ref er ence:
Issue Cat e: 4/07/ 14 B i zabet h A Nbvi I I e
Sout hold Town a er k
•�
0,o eg11FFO fr
ELIZABETH A.NEVILLE,MMC �� y0 r/y Town Hall,53095 Main Road
TOWN CLERK O= • qk P.O.Box 1179
y Z Southold New York 11971
REGISTRAR OF VITAL STATISTICS
"V �0�
p Fax(631)765-6145
MARRIAGE OFFICER ," Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER R! 4 •.0 www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD -) rt-, 7 \\/7J
TO: Southold Town Building Department MAY - 3 2013
FROM: Carol Hydell, Southold Town Clerk's Office
BIDE DEPT.
TEWD;Dr SO!'THO!.D
DATED: May 3, 2013
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4215 for a Cesspool/Septic Tank Construction
Permit submitted by:
Trevor Rowe& Lois Derosier
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 V/
DISAPPROVE
Comments: Final approval required from the Suffolk County Health Department
40
Signature
05— ?—Y° /3
Dated
,,,,/iii,
ELIZABETH A.NEVILLE e* . ,` - ,Town Hall, 53095 Main Roa.
TOWN CLERK i z .;. ,_ P.O. Box 1179
REGISTRAR.OF VITAL STATISTICS �.
Southold, New York 11971
MARRIAGE OFFICER .� 1� Fax(631) 766-6145
RECORDS MANAGEMENT OFFICER * ��N �� Telephone(631)765-1800
FREEDOM OF INFORMATION OFFICER - '� .0'0southoldtown.northfork.nef
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD TOWN OF SOUTHOLD
BUILDING DEPARTM J
P.O. Box 1179 THOLD WASTEWATER DISTRICT
Southold, N.Y. 11971
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$10 V or Non-Residential @$25 Application No. 44
Permit No.
Applicant Name '(2 cld.2 ('i)
Applicant Mailing Address 590 e-.
Septic Tank ,07--or Cesspool 'l/
- Brief De cript' of Proposed C49nstfuction or Alteration
Location of Proposed Construction/Alteration:
Owner of Property: -772E-Vo o L.l) 4o
Owner Mailing Address: j%'.'+l /fr 'fir,."%f i ' '!! P.0 X 3 7
Lc?)
� ^
L) IJ Ai I
Owner Property Address: / //o f� 3 c.11F
,W?)• //1 -1/4-4,/7 ) 9or4oLD
Name and phone number of contact person 7f1///,0' SvIZC-I--/I/t/ - 1 t$ Z3�
Tax Map No:/0°-#2 n 6 / Block Lot / 7 /
Cross Street A/-//14V/C sr F
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY H TH DEPARTMENT APPROVAL
S'.i ature of Applicant D e
Received by:
q
I
j
• ' GROUND ELEVATION 99.1' *NOTE: SURVEY OF DESCRIBED PROPERTY
EXISTING SEPTIC TO BE ABANDONED SITUATED AT
OL DARK BROWN LOAM PUMPED, CLEANED, REMOVED AND
— — — — —0.5' BACKFILLED WITH CLEAN SAND AND SO UTHOLD
/ GRAVEL AND TO BE INSPECTED BY �T
Sc BROWN CIAYEY SAND S.C.D.H.S. TOWN r OF SO UTHOLD
**NOTE:
- _ — _ —2• PROP. SEP17C SYSTEM SUFFOLK COUNTY, NEW YORK
FOR 5 BEDR. DWG. PROVIDES
1-1,500 GAIL. ST.
1-BOLA. 12 DEEP L.P. S.C.T.M. NO. 1000-61-4-15.1
PALE BROWN FINE ROOM FOR 50% EXP.
SP TO MEDIUM SAND AREA = 13,514 SQ FT.
NOTE: EXISTING WATER SERVICE LINE ELEVATIONS ARE AS
DATUM
FROM LOCATION BY CONTRACTOR AND
17'
SHOULD BE LOCATED IN THE FIELD
TEST HOLE BEFORE SEPTIC IS INSTALLED TO
BY MCDONALD GEOSCIENCE A MAINTAIN PROPER SEPARATION FROM
DATE: 12/17/2012 to "ATER SUPPLY AND DWELLINGS.
4isza vote,
1,e in item °st i T - .• MAIN ROAD
nt°g exi�ti�� a ti=temet Sm �s
r t tviiim, ^. ,oaf.
pband°n" ee wish dei '`,. _ +
c0mf° �wte ,�,r. R0 D NOW OR FORMERLY OF MECHANIC
THMANS DEPARTMENT STORE
cove
{° ' D NDTI OR FORDIERLI' OF •
w
UNITED METHODIST CHURCH OF SOUTHol� BUILDING - PUBLIC WATER03 STREET
DWELLING - PUBLIC WATER
FR. BUILD. W (50' WIDE)
till
N 59°21'16"E 85.71' FE:o.4 s N 67"47AorL� 107.75' 21 J U.P.
NYT.4
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cal
N ~ Uv PAT T. SECCAFICO
PROFESSIONAL LAND SURVEYOR, P.C.
DWELLING - PUBLIC: nAT IS1 E: ti y F pi - SUCCESSOR TO -
Water Line(s) MUST Be Inspected By The Da�Lo Tie L�
RICHARD WILHELM AND ASSOCMTES
Suffolk County Dept, Of Health Services. NORTHSTAR P.C.
E
//7
PAUL T. CANALIZO, LS., ROBERT A KART. L .
Call 852-5700, 48 Hours In Advance, GOOD GROUND SURVEYORS. P.C.
328A Main Street Hampton Atrium Unit D-4
e Center Moriches, NY 11934 186 W. Montauk Highway
To Schedule In$ ect« $ . Hampton Bo NY 11946
REVISED: 03/07/2013 p ( )
REVISED: 02/07/20137 Phone: (631 878-0120 Phone: 63 728-5330
Fox: (631) �78-7190 Fax: f 631) 728-6707
FILE NO. T33856 SCALE: 1" = 20' DATE: 07/21/1997 01/07/2013
Yo tier( f' ; �'o ter .r6',.1a 'cl7 1 N.Y.S. LIC N0. 049287
COPYRIGHT - 2013 PAT T. SECCAFICO P.L.S., P.C.