HomeMy WebLinkAboutFfolliott, Ann OFOLit
ELIZABETH A.NEVILLE,MMC ,r��r��® ���� Town Hall,53095 Main Road
TOWN CLERK j P.O.Box 1179
: 9 Southold,New York 11971
REGISTRAR OF VITAL STATISTICS Fax® ��� Fax(631)765-6145
MARRIAGE OFFICER 4'� fex.0 rrr Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER _ ® 1'7."
FREEDOM OF INFORMATION OFFICER www.southoldtownny.gov
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OFFICE OF THE TOWN CLERK p
TOWN OF SOUTHOLD MAY - 9 2016
TO: Southold Town Building Department BUILDING DEPT.
TOWN OF SOUTHOLD
FROM: Carol Hydell, Southold Town Clerk's Office
DATED: May 9, 2016
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4385 for a Cesspool/Septic Tank Construction
Permit submitted by:
Ann Ffolliott
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 i
Dated
ELIZABETH A. NEVILLE 44eG
�� l� ¢r �; � .Town Hall,63095 Main Roo:
TOWN CLERK ti P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �, �� Southold, New York 11971
MARRIAGE OFFICER :;®y �`�``'�1� Fax(631) 76b-6146
RECORDS MANAGEMENT OFFICER ; Ifo �� ii 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.
1-4,.›10_7
/�
— Permit No.
Applicant Name k/t9 / tf d )// 677—
Applicant Mailing Address a b 1g tsyc c _. b,r 17c-ti)7/ P7'
Septic Tank. I/or Cesspool ✓
Brief Description of Proposed Construction or Alteration e t.et 6i,
Location of Proposed Construction/Alteration:
Owner of Property: 'Fd £ ,1 -( Po )c)r °/./.P J.3-r
Owner Mailing Address: ,5v,rs`' CL Owner Property Address:
Name and phone number of contact person (..1/45.+e, - . /S0,13 S?� 63/ 51341 9)63
Tax Map No: Section a'�J Block / U Lot L
Cross Streetvext
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
�.►; � ..
Si:'a e of Applicant Date
Received liy: C
t
• ArmandLeGa&u,r
Q• Abandonment of existing s•: itary system must be in ARCHITEC -1
s -- '. Z ry ' comformance with departm nt requirement Submit
r
�=�'G:.K %:�tiR�lTYDs.i3A�Tt��il?�I" I={�t1;Li�; - ._'i VICE ' , Qicompleted form i��hllirl� 4 a proof°I'EnI1T �•OR APPROVAL OF CONSTRUCTfON �GA N/O/F IRENE TREIBER REVOCABLE LIVING TRUST N �,�y;1;1G • r -�qpA*®g�_ .-�.dE II.BE�gR®REVOGABLE LIVING TRUST f` e r 22n,:Scr«t,LJ p1,rAi411'. ASIDENCE O L�` E cAVA i�.��Vlltl���V 91111REt Jt • I T•_t 175r;°k�N`C�Y1�fiork 'biro'•
•
� l�1ITARY �,� RED EXISTING UTILITY POLE
T 1.:_41_2.72-116_, , /1210-�c s rip 1? �' HEALTH DEP'R-R "4-'.4q, RETAINING W=���
co
HEDGE ] i-�16 or EXISTING POWER
APPFOVE, _ _- - ES ABOVE
U� STOCKADE FENGE — ��— ��� �'�� LIN
FOR MAXIMUM OF gE�RQt IWI.
� rli S5N
=► V Ni
in
EXISTING UTILITY LINES
EXP RES THREE,YEARS !ROM z +� II1�� _ )--- / ABOVE TO BE BURIED
� ®pi tE E4� 4Rf �u �II I _.----
------=201":41 :,-=;: OR W _ .
�� "(11101p,...-7-.-•=--.---- 2 - ' EXISTING WELL TO BE
W U ..iL..IL..I�.II I D FLOOR ® lir, 111111 II; �♦ ABANDONED
V S1 4
� " :iii-' Ii"
Iliiiil1__—_,,q110,2,.._=.7iAl
_— �n
17' x 34' III ..�INO
.3
A PROVED IN ACCORDANCE WITr. Bs'i OF I (4) NEW .RYWELLS, I�, =IIIII III mr FRONT YA'D `TO q
+' ! VEGETABLE
RI VIEW DETERMINATION DATEDJ-U f� j,I b GARDEN w/5' 6 DIA., A DEEP
r
lli Illmmmn�-- SETBAG• STREFZ
Q � . FENGE PATIO � E 15 Z
I _ DECK.. = -- _ —
SEE ATTACKED SPECIAL CI-%1 .�` 1 \ REMOVED(DWS _:--u— _� _E=:_ ==� ° ) W �(�T�' ,`
_ IIIII IIII ` �J
. �sFiADII'�G PLAN ����,®R PLOT �� ,� � � � ,: � ==-°=� IIII � Q � �,
•. _. m i. BAR ARD �I - 11111 , 6A5-6.6 GA5 6A5 _ 6 - 6A5- Cr) l---1 I•�+
Z, SETB.: - . 15 IIII11111111 11111111111I - O o r �.
" I EXISTING GAS LINE W 2• 1 — — ��IIItI,I�III m oNEW SEPTIC TANK, �+ 1 (II ' I
q Iill III .,� I EINC POOLS ,.__.
III....II,..II.,.I... ( LINE OF EXISTING HOUSE x w
Y LEACH �� �-ro 20' MIN. D ,�
AND EXPANSION Irk
_ • U J TO BE REMOVED. STEPS, H Z
POOL _ _ -- ) `L - - MI5 cp DEC. 1 , A-K AND OUNDATION G z
e TEST HOLE w-----v...)
-- . ! 1 RE�' AR O Gfil
,I. t"' EL. 13.8 at LL.q 411710 14 istatistarp �� fril.,eG � r
c� 111in 4° Iq'00"W 5 <(/� � o F'- 1
CC '.�.1 • N6 17q.6 - PROPERTY I / 'a: _:!�*.t �-�
f. O
?;.� —14— LINE c� ,. ��..,)(,
ri cc �'` N/O/F REGINA ABERSMITH EMILY DEERKO� �'_...• ff01 jL
MU-41A AND LATERAL MUS1'BE I ''r . TEST HOLE DATA , FINAL SURVEY '9i. X18942 AO
EM
zd
�. 1-'-2_ McDONALD GEOSGIENGE
'1-`' 11/15/14
NOTES: OF NES
-.__x,.,,,, . L. 15.5'
DARK BROWN LOAM - OL I. SITE PLAN DEVELOPED FROM INFORMATION PROVIDED PROPERTY TAX # 1000-24-1-2
2'
ON SURVEY PREPARED ON 06-18-14 BY PECONIG ZONING GLASS =R-40
BROWN AND PALE BROWN SILT AND SANDY SILT SURVEYORS, PC. ELEVATIONS BASED ON Ig88 USGS DATUM. LOT AREA = 15,830 FT 2 (0.36 ACRE) 02/02/15 DOH APP
(VERY HEAVY GRAVEL FROM 7'-q') - ML 05/02/15 DOH REVISION
2. SCOPE OF WORK TO INCLUDE: REMOVAL OF EXISTING PROPOSED FIRST FLOOR AREA = 2,115 FT.2
q' BROWN AND PALE BROWN FINE TO COARSE I-1/2 STORY HOUSE, DEMOLITION OF EXISTING FOUNDATION, PROPOSED SECOND FLOOR AREA= 1,134 FT.2
SAND WITH 5-10% GRAVEL - SW STEPS AND DECK. EXISTING . SEWAGE SYSTEM TO BE
___ I2 7' REMOVED. EXISTING WELL TO BE ABANDONED. PROPOSED SEPTIC:
WATER IN PALE BROWN FINE TO COARSE SAND
WITH 5-10% GRAVEL - SW NEW BASEMENT AND I-I/2 STORY HOUSE PROPOSED. EXISTING NO. OF BEDROOMS: 4 N
17' GARAGE AND SHED TO REMAIN. NEW SEPTIC TANK, TANK CAPACITY: 1,000 GALLONS PROPOSED `-
LEACHING POOLS AND EXPANSION POOL TO BE INSTALLED IN [3] LEACHING POOLS: 8' DIA, 4' DEEP SITE PLAN
NOTE: WATER ENCOUNTERED 127' BELOW REAR YARD. NEW PRIVATE WELL TO BE LOCATED IN FRONT [I] EXPANSION POOL. S' DIA, 4' DEEP
SURFACE YARD.
1 A-001
7
1 J PROPOSED SITE PLAN „ SCALE: I" = 20'