HomeMy WebLinkAboutOlsson 0°0NSufFO(��®
ELIZABETH A.NEVILLE ��� � Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS 1 +.' Southold, New York 11971
MARRIAGE OFFICER Fax fir ..''y� l1,, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ; ®� d Etg 1� iii Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ,��� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2720 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : ZOUMAS CONTRACTING CORP
Address 1 : PO BOX 361
City St Zip ADING RIVER NY 11792
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 #R10-01-0249
Name Of Owner OLSSON, ROBERT
Mailing Address 1 1210 SANDPIPER STREET
City St Zip PALM DESERT CA 92250
Property Address 1 RAMBLER ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 88.00 block 5 lot 27.000
Cross Street MAIN BAYV I EW ROAD
Building Permit Number Cross Reference:
Issue Date: 1/11/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
• 0111 di vFO•
REGISTRAR OF VITAL STATISTICS - ? Southold, New York 11971
MARRIAGE OFFICER Fax.O ���� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER � ®g ED �� 1 011 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ���,�,Ssoutholdtown.northfork.net
OFFICE OF THE TOWN CLERK ,,� /a
TOWN OF SOUTHOLD ' Ccs
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TO: Southold Town Building Department .T �,
FROM: Linda J. Cooper, Southold Town Clerk's Office 0�r,
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DATED: January 3, 2002
Transmitted herewith is a copy of application No. 2815 for a Cesspool/Septic Tank
CONSTRUCTION/ALTERATION Permit submitted by:
Zoumas Contracting Corp for Robert Olsson
Please review the application and location map and advise if the project has received Suffolk County
Health Department approval and if this office may issue the permit.
Please complete the form below and return it to me.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: Maintain required setbacks from adjacent wells,buildings,property lines and water
Bodies. EXCAVATION INSPECTION RE•UIRED: I'
fire°6 t °14. ":4 2 ego,,f1 _
Signature
03 ® �
Dated
s 7 /C/3
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TOWN CLERK •
••. ����OCKQ�� z. Api? ,,
CE OF THE ' '
•` . ''r " ,Constr.uction___-
OF• FICE
� "t.,:,..!4".EfH A.1;EYULF.TOWN CLERK 4� :,.�q . ; ,
A :, ` Alteration
P.O.BOX 1179 ithi
�W YORK 11911 ra '1' +� ''t�
SOUTHOLD,NEW :� �I ft. r: ) / ,` . $10 00 . Residential
y0� "�""•'•• � �� esidential
Telephone -.�' �� � c �`•,•' •
$25.00 -Non-R
(516) 765-1801 �. ....� •
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
ACON
• for
CONSTRUCTION or ALTERATION PERMIT . _ :' -
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ a - '�. ;
DATE
APPLICANT NAME " }ttm::. 3 .P.O�TI . • , . . , - '; : ,x;,•
.'iBox 361
APPLICANT ADDRESS:_________ ,baaipg-Riye.• ,.
SEPTIC -CESSPOOL • .
OF PROPOSED CONSTRUCTION OR ALTERATION - .
DESCRIPTION ,
VA)e,if r
LOCATION MAP: Must be attached hereto before permit may, be Issued:
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION; • .', `.. . ` -- ;
OWNER OF PROPERTY• ri • DG-SSap-Sop
OWNER MAILING ADDRESS:
'L ' r , " , , 9.2.4"s---6
OWNER PROPERTY ADDRESS: Mk/ g -=�
/42-4,v f, . • al-e•up ...ill'ai.p.j. p4p.,,
., .
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•
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EPHONE NUMBER OF CONTACT PERSON: ��� Z
• TEL glocl< S Lot , . --. -^'-
TAX MAP NO. . Section! .
CROSS STREET
BUILDING PERMIT NUMBER CROSS ;REFERENCE: _
` _ ,..•, - � 1`• ,,•*.' ��,T• •Ii;•�•, -?^r;��i�`.? n f.. �� obi
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.4.4.?;;:
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•nature P,,,.;,
tit.`•may•- - _ - .- •,,!.r;,�� -+T
v;•k:.i RECEIVED BY:--------1-"vin Clerk's Office • _ .'';; ;' °'
DATE: ,,:4 - ` a•• ,F•
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LOTIAREA= 26,413 sq. ft.
' F.FL. ELEV.= 23,0 -
- R. ELEV.= 21.0 '
TEST HOLE .
by McDonald Geoscience
11-21-2001
dark brown sandy loam OL t`r
1 v
brown loamy sand SM
3' DWELLING — PUBLIC WATER " d
brown fine to coarse sand SW 3i
8' existl'nL water main \
pale brown fine to medium sand SP
13'
pale brown fine to coarse sand SW
17' (19.6) MAIN BAYVIEW ROAD (18.0)
18.0
S 68'00'30"E 163.10' .....est hole I (19.2)
R=20.00' I! 1111
_,.._ L=31.42'
o
woell - '4' I;
6 i (21.0) ) (21.0)
30.0
3 Cy prop. driveway garage I
z 45' 0 3 v
I:, a PROP. m m
Crl Lu DWELLING ` J a
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r. �+ v 36.0' ip z
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u (21.0) 0;
GI '1 (21.0) O
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(19.9) (20.4) "7-- _ NI
MON. Cleared — M
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o Z aE11rfOLIfCOLI IIDE,rP�t1:2'iit"�EN�"UrTikk '} �, p {6 ,79•
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cesspool
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NOTE: LOCATION OP`AQ-JOINERS–WATER"_SUPPLY--....-. W..---y...-.,.�,,...,,,,,.,.,.,�,,,.,.n,.
AND SANITARY SYSTEMS BY OTHERS AND
ARE NOT GUARANTEED. DATUM N.G.V.D.
THE OFFSETS (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TO THE
PROPERLY LUNES ARE FORA SPECIFIC PURPOSE AND USE AND THEREFORE ARE NOT JOB No. 01-543 FILE No. 779F
maxim TO GUIDE THE ERECTION OF FENCE, RETAINING WALLS. POOLS, PATIOS,
PLANTING AREAS. ADDmoN TO BUILDINGS OR ANY OTHER CONSTRUCTION. SURVEYED FOR
UNAUTHORIZED ALTERATION OR ADDFON TO THIS SURVEY IS A vlouinroN OF SECTION
7209 OF THE NEEM YORK STATE EDUCATION LAW.
GUARANTEES INDICATED HERON SHALL RUN ONLY TO THE PERSON FOR WHOM THE
SURVEY IS PREPARED. AND ON HIS BEHALF TO THE TITLE COMPANY. GOVERNMENTAL. SITUATED AT BAYVIEW
AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE
LENDING INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADDRIONN.ownrunONs TOWN OF SOUTHOLD – SUFFOLK COUNTY N.Y.
OR SUBSEQUENT OWNERS.
COMES OF THIS SURVEY MIP NOT BEARN 'S INKED THE LAND SURVEYORKED SEAL GR SCALE 1" = 40' DATE 11-15-2001
EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY.
FILED MAP No. DATE
CERTIFIED ONLY TO: TAX MAP No. (REF ONLY) 1000-88-5-27 DISK 500
HAROLD F. TRANCHON JR. P.C.
LAND SURVEYOR
I,„...As F-r;-,-- Q,._, 1866 WADING RIVER—MANOR RD. WADING RIVER,
NEW YORK, 11792
HAROLD F. TRANCHON JR. PENN. LIC.No. 21159E 631-929-4695