HomeMy WebLinkAboutCukor, Greg SCUTHCLD WSTEVATER a SPCSAL PERM T
OCIUSTRLCTI CN CR ALTERATI CIV PERM T
SEPTI C TANK or CESSPOOL
Per nit ND. 4164 R Fbsi dent i al X Nbn-Fesi dent i al
Fee $ 10. 00 Septic X Cesspool
PERM T I SSI.ED TQ
Nacre : SAM-ELS & Si ttLNAN ARCH TECTS
Address 1: 25235 IBJ N RC>4D
a t y St Zi p CUTCHOSLE NY 11935
Cescr i pt on of Proposed Const r uct i on or Al t er at i on
SAN TARP SYSTEM FCR SI MIE FAM LY EWELL! N3
APPRO./ED AS S EM TTED AND AS APPR)dED BY TEE SIFFCLK OCLNrY DEPARTMENT
CF F-EALTH SERA CES. Fl NAL APPRO✓AL FEaJI FED FROM THE SIFFCLK OCINTY
I-EALTH DEPARTMENT. REF #R10-08-0050
Nacre Cf Canner CFEG & MARTHA CL KCR
Mlii I i ng Address 1 5913 MFADOiN RD
Ci t y St Zip BALTI NCRE MD 21212
Property Address 1 7070 I NDI AN NECK LANE
CI t y St Zip PEOCN C W 11958
Tax (Alp Nb. sect i on 86. 00 bI ock 7 I of 6. 000
Cr oss Street ROUTE 25
Bui I di ng Per m t Umber Cr oss Ref er ence:
Issue Cat e: 1/02/ 14 Elizabeth A Nevi I I e
Sout hold Town a er k
,0° \�gUFFO(�-c
ELIZABETH A. NEVILLE,MMC ���* S, Town Hall, 53095 Main Road
TOWN CLERK % co= - . P.O. Box 1179
tH Z Southold,New York 11971
REGISTRAR OF VITAL STATISTICS %p *C�� ,, Fax(631)765-6145
MARRIAGE OFFICER `-ofo 0`''/ Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER :7491 jig `t►a� www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER '- ..,,,,,,
OFFICE OF THE TOWN CLERK i � - , ---7„
TOWN OF SOUTHOLD T � 1 l'' i' ' I
Ili 1
TO: Southold Town Building Department I OCT - 2 2013 .�
`
FROM: Carol Hydell, Southold Town Clerk's Office — --
DATED: October 2, 2013
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4164 for a Cesspool/Septic Tank Construction
Permit submitted by:
Samuels & Steelmand for Greg& Martha Cukor
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 -I
DISAPPROVE
Comments: Final approval required from the Suffolk County Health Department
G7�f
Signature
/c Lc
Dated
+' I� %SOFFo�t"-
• ELIZABETH A. NEVILLE ��,`�O c°may Town Hall, 53095 Main Road
TOWN CLERK A ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS � yj. , 7 Southold, New York 11971
MARRIAGE OFFICER : O .F �� Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER =y�4 aO�tes� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER = ! ,.�� 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.
L
Permit No.
Applicant Name SaiiI4t.F,IL.O ft` d"lt ee,(wt. t,li ,q"Y,t1j (ecT
Applicant Mailing Address �6' '',S " i, N or?of C(, at c Marie
Septic Tank ✓ or Cesspool 1
Brief Description of Proposed Construction or Alteration A-(ca k&i/X 1 frl,Pi.Gt .'e.1S - 4,04.
5 m-€4 mist-vital O h of fwW, e r Sci) 0 S
Location of Proposed Construction/Alteration:
Owner of Property: C-vce.1 # Aa(� /( C ice{ kO r
Owner Mailing Address: .� Q 13Mea ., Retf}j(M ore MO 2-1211
Owner Property Address: 7070 netitto kk 1414e, pe eo n i c
Name and phone number of contact person 1 (14 Si!M arks 7 3 Li-
`,
Tax Map No: Section �f Block Lot C�
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
frilUt-e-C
ASigna Applicant Date
Received by:
ESTHOLE PROPOSED POUR(4BEDROOM RESIDENCE i
IICDONALD GEOSCIENCE o — — 525 44 50 E 1006.55' — -
r HOLE DATA(4/10/08) h 3 V
TO SCALE PROPOSED NIELL—fit Q _
DE ELEVATION+72.0 FT. Zr '14 rb 7 "`"`ELL - _
ch t
BROWN SILTY SAND SM a? wN :t _______
z• PALE BROWN FINE TO U E ° z
0
MEDIUM SAND SP � � ,� ° Z w
T. Mks 11 OM MIMI 70";
NATER ENCOUNTERED P V81a isTkitiaideitim
. I U�S, ,� 47' 00 W 2 47' U a
PROP, �•
..'i� TOTAL SITE PLAN 7oview '
er —�-- - SCALE: N.T.S.to
SITE DATA — Z
Crii SERVICES
3UILDING WALL GRADE LINE ELEVATION +1- 22.0 FT'. �,�'`�' E� a
�4, a ORA SCTM# 1000-86-7-6 0
' , g ��, „--or-i10.11PROPERTY: 7070 INDIAN NECK LANE IN
51f Ji
CI-
r..-
ELEV +23.0 I' MIN. 2' MAX. stwFui" ' ,,np,,n"v L`•.• `'' Al,...-;s�r 1D ADDRESS PECONIC,NY
laU/�� f _ OWNER: GREGORY R.CUKOR
Pa �,a... _ �p,: 5913 MEADOW ROAD Ce
18"/PT FT'OP OF POOL 6`y`" BALTIMORE,MD 21212 3
SEPTIC LEAGHINfs 2O O FT. �-�� "`�� /�2-1 *^� SITE: 126,880 sf 2.913 ac o!1
O ZONING: R40 W IN
TANK POOL BOTTOM( OF R `�i" k'O. ``��j SURVEYOR: JOHN C.EHLERS z
+20.81 IE.+ 11.75 0 11_vi -/' game
8 EAST MAIN STREET g
20.254 IE.+ 19.f",? POOL 8.0 FT. j. c ,� RIVERHEAD,NY 11901 0 V
b i 111.4 I'1'-0' :::___C:s_______:777.:_ilitujm::ii:s7R000m11.1 .1x.mov,�� LICENSE# 50202mb fit. MIN. eft�• NO J_,`TER 5/16/06 zPTIC PROFILE P`- 1nA ` =GWA41 0 0_tr , ,,��? sr:L, tbein
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Abend ._ :.;�~i 4_•
Co nfo nee „i,I,d.3�• ;.v a.. _
PORI(
completed form\ �+`i - .� �,,�.
�� 1 W�: $Ii
s c N/F
,���y' tF s 5 phonic, 5. 4 Stephen 5. i shall 523 44' ��" E 1006.55' �SYSITEM I TAR I 1 a W. I s'
OM OM — — «• 8
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= 7, DRIVEWAY ("CATION1 , 4
o�'`` b
ir PROPOSED WELL -.\�% `% \ .r V I
FEST v 0 z
REGI 150 AGHI i& �[ ° � ' ;
' SpNiTAR 1-1-- N RADIUS EXISTING WELL TO 1'_ +21.0 a1 .. 1; N Ti0 I 1
NO �puND BE ABANDONED .1% '� �iJ
p00\--S PROPOSED FOUR (4) • 1 w �,� �_
: BEDROOM RESIDENCE li i o -v e
ATION MAPtu
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14
--,—OS ill +22.0 I' ; of b m UT
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GA 6E ._. . .. l
Is I O CHECKED BY:
INRp• US �f)
1 a� ; 1 DA7lE: 5/23/08
/
''''// /,;;%"/, 150 FE�❑�S FpUNfl KITH 1\ SCALE ._
i i� �, ,;0/.
11,011111
NO NE •1 50'
Or,,ice%❑''14 �❑i❑ -
/,// /i � / /❑❑ ' 1 SHEET TITLE:
❑❑❑❑ N23 41 �O W 542.4 1� 10 SCDHS
i'''%'% /EXIST! c- MU
❑ '%'' SITE
„ ,�. NEIGHBOR G WELL PLAN
;fi/�� �� �, ❑�
❑❑❑ ❑;,%� ❑❑ / SANITARY
'0 SYSTEM O
%���� i , ; sHEEr NO:/��-./i/ /iii/ %���� � 1 ' ��� -
// ,❑❑�% PROPOSED SEPTIC SY M ❑
,4,_,. %% % SITE PLAN (I) Ipoo GAL SEPTIC TANK (ST) SP
SCALE: 1"=50'-0"
PROJECT 51TE trIcIo 4 Robert RushIn (I) a FT. DIA. X 12 FT. HT. M) INS POOL $ DHS
(I) b FT DIA x b FT HT 4! EXPANSION POOL SUBMI -i ION
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