HomeMy WebLinkAboutBaker OFFOlir
LIZABETH A.NEVILLE Town Hall, 53095 Main Road
TOWN CLERK % o P.O.Box 1179
Southold,New York 11971
RE ISTRAR OF VITAL STATISTICS rri
MARRIAGE OFFICER `� ,y � ��� Fax(631) 765-6145
RE ORDS MANAGEMENT OFFICER
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lli Telephone(631) 765-1800
FRE DOM 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. 3092 R Residential x Non-Residential
F;e $ 10.00 Septic X Cesspool
P: RMIT ISSUED TO:
N.me : JAMES BAKER III
Atdress 1: PO BOX 9
C ty St ZipNEW SUFFOLK NY 11956
Descripton of Proposed Construction or Alteration
S''NITARY SYSTEM FOR ONE FAMILY DWELLING.
A°"PROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
O' HEALTH SERVICES. REF #R10-02-0238
N.me Of Owner BAKER, III JAMES
Meiling Address 1 PO BOX 9
C ty St Zip NEW SUFFOLK NY 11956
P operty Address 1 1600 GRATHWOHL ROAD
C ty St Zip NEW SUFFOLK NY 11956
7.x Map No. section 117.00 block 4 lot 4.000
C oss Street -GEORGE'S ROAD
B ilding Permit Number Cross Reference:
I sue Date: 10/20/03 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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,/�o,®�®guFFO`,tc 30`1
ELIZABETH A.NEVILLE 0,�`t` ®Gy` Town Hall, 53095 Main Road
TOWN CLERK % co - % P.O.Box 1179
- Southold New York 11971
REGISTRAR,OF VITAL STATISTICS % i, '
MARRIAGE OFFICER ,L
:1.46 yC �� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ”-t# a0./ Telephone(631) 765-1800
FREED 0 ,OF NFf'ORMATION OFFICER =,1 * ,/� southoldtown.northfork.net
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'J f% SEP 1 6 2003 ° i{OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
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_ TOV___l 1ti�;?-_y_i�(
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: September 16, 2003
Transmitted herewith is a copy of application No. 3226 for a Cesspool/Septic Tank Construction
Permit submitted by:
James A Baker III
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: 'I �''
7
- rfrtoce.... .fff‘e4-
Signature
,,,A4044%. to Aelcs3
Dated
•i UFFO(
ELIZABETH A.NEVILLE
Town Hall, 53095 Main Road
TOWN CLERK •
C7N� _ , P.O. Box 1179
2 , Southold, New York 11971
REGISTRAR OF VITAL STATISTICS W of
® � Fax(631) 765-6145 •
MARRIAGE OFFICER �
RECORDS MANAGEMENT OFFICER �f® aO i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER = ' 4/g �•1 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. 3.7.2-(e
Q Permit No.
Applicant Name _lbws 0k.,_t 1
Applicant Mailing Address PO
4dL1 MSC
%
Septic Tank A or Cesspool A
Brief Description of Proposed Construction or Alteration rvt,.i nJ.1 Cir ruestiA‘
Location of Proposed Construction/Alteration:
Owner of Property: lam A 6.Al2_,
. lU
- Owner Mailing Address: PO 7
(ttc " ) l(c 34
Owner Property Address: 6v&4 A.l R
f`L'A 1„1k l t195�
Name and phone number of contact person
Tax Map No: Section 11 Block — Lot 01-F-
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH E TH DEPARTMENT APPROVAL
Signature,of Applicant Date
Received by:
.S" 2.:;(2462 .
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
DWELLING PROPOSED GRADE N
PERMIT FOR APPROVAL OF CONSTRUCTION FOR A Lri
AUG• COVER 2'
z
INV. 67 2
DINGLE FAMILY RESIDENCE ONLY 1. PE
PIPE • T/POOL 6.7
U8"P
DATE / c/o1 3 HS REF.NO.e2/0— 0 3—c' 3g2 PITCH. 4"PIPE
SEPTIC TANK CESSPOOL B/POOL 4.2
APPROVED `_.' GROUND WATER ® 0.1
FOR MAXIMUM OF BEDROOMS PROPOSED SANITARY SYSTEM
CROSS—SECTION
EXPIRES THREE YEARS FR •
OM DATE OF APPROVAL (NOT TO SCALE)
Approved in a� w r*of&Mow •
.......
GEoRGE 'S RE)
S.C.D.H.S. ENDORSEMENTS
�c 0 ��h I H
,
�/ ',� �' ZONES I INACTIVE .
ZONE X °WELL IN
�(/ EL 8
�" 0 ® AREA OF 500
/, n �4j O I c YEAR FLOOD ZONE X
TIDAL WETLANDS , :N • = :• •• S3 °1V4i I OUTSIDE 500
BOUNDARY AS / /�� .D� `9 OS1 OO
I4440 ,, 70 pU YEAR FLOOD
FLAGGED BY • I
INC.,
EN-CONSULTANTS,
TANTS,02. 0� �� ti
� W W W W ,'G�`;l', �FNN�'`�OR,y/c �'�TE,Q I I V5 CONCRETE
O UL , \'-1 ..6.
� .C!a0 i,-cEN '`'�4/e4cs 4?pF 421 0 0 COVER
k ��_ 1, � �`''..' 14•.• U s'; �‘ SANITARY LOCATION
�'`�i IOD• cp \`� �( \W ` •. 7 J UNAVAILABLE WELL
14.1
I LAW AREA �'v loq• W � W\~� 2 6: 14o'f 10
lV MAINTA NED IN �� IN ply` B) h
o ASST CIATION �� ` .�I� �W W a/ W 3' O
WITH PUBLIC � 72' ' '` ,06
1GMWAY 0n'71 "� 2� X
.EXi , I PROP _ED - -3 rn
3' ti • I , I . 36 38' -- PROPOSE[ r\ W-!L 2
J-tom_ ' TWOe STORY4: DRY,VEL�- �pRlo• ,'� -- •
i h (`.,w - PROP WATER /N£ \ DW LLING `: P.) Bit12 ,. �; _ -_ �- -
O •
: 17't 2 tn ':*too2.- 1'• DECK DECK �DW II 11
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N PRO pE PROP,
• LV FEN• /''V/OUS DRIVE 2GA X•GE 32'
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® 'I 'GRAI/EL' pRIV : 'o O 1 k o
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LAND NOW OR FI I
Q GL4NDEORMERL Y OF W
k
°WELL IN HOUS
(ABANDONED I
PER OTHERS)
0 CONNEc PE To P TEST HOLE
/'' OTHERS C WATER CPO _1• TOPSOIL (EL. 7.1)
AREA: 12,525 S.F. (UPLAND PARCEL)
1,500 S.F. (WATERFRONT PARCEL) LOAM
•
ELEVATIONS ARE REFERENCED TO N.G.V.D. DATUM _3
SAND
e - DENOTES CONCRETE MONUMENT FOUND. PROPOSED SANITARY SYSTEM -7' (EL. 0.1)
(1) 1,000 GALLON SEPTIC TANK -1NA u. IN
LOCATIONS OF ADJACENT WELLS AND SANITARY SYSTEMS PER (5) 8' DIA. x 2' DEEP LEACHING POOLS ' -T;G'•It L (I')
OWNERS AND/OR OCCUPANTS AND ARE NOT GUARANTEED. ROOM FOR 50% EXPANSION C,�
SURVEY OF FILE NO. 1211 CERTIFIED TO: m-". �' r-w
PROPERTY REVISIONS: MARTHA BAKER :'t- :;�-;.
8/27/99 ADD TOPOGRAPHY JAMES BAKER - T:
PREPARED FOR 9/28/99 ADJACENT WELL & SAN. y •
01/26/2000 REV. PER SCDHSr�
MARTHA & JAMES BAKER 4/14/2000 REV `41
y
4/18/2000 REV ' !
SITUATE AT 6/01/2000 ADD DIM'sP, cn
10/17/2002 UPDATE �� T. ��� ^f\y�O
NEW SUFFOLK 10/28/2002 REV. {_
TOWN OF SOUTHOLD 12/12/2002 REV. l //`/�
12/31/2002 REV.
SUFFOLK COUNTY, NEW YORK 01/06/2003 REV. PROFESSIONAL LAND SURVEYOR, P.C.
„ , 01/10/2003 REV.
SCALE 1 = 40 MAY 20, 1998 0101/27/2003 STAKEOUT
2003 REV. PROP. SANITARY - SUCCESSOR TO —
S.C.T.M. DIST. 1000 SEC. 117 BLK. 01 LOT 12 06/25/2003 REV. PR. SAN. & HSE.
& S C.T.M. DIST. 1000 SEC. 117 BLK. 04 LOT 04 X. DONALD TASE, L.S.
RICHARD WILHELM AND ASSOCIATES
EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE 5l AT E OFPROFESSIONAL LAND SURVEYORS
NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF !y NORTHSTAR SURVEYING, P.C.
THE SURVEY. b,:(T.SF
GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON(S) FOR WHOM Q CC` PAUL T. CANALIZO, L.S., ROBERT A. KART, L.S.
THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, '-\ 9
GOVERNMENTAL AGENCY AND LENDING INSTITUTIONS LISTED HEREON, AND TO THE :t• .,. 74_,,, GOOD GROUND SURVEYORS, P.C.
ASSIGNEES OF THE LENDING INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO (7*
' t %^'.',,e.J 0
ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. THE OFFSETS (OR DIMENSIONS) /IA';� * 107-5 W. Montauk Highway 328A Main Street
SHOWN HEREON FROM /SPECIFIC PURPOSE ANDT USE AND THEREFORE ARE NOT INTENDED TO GUIDE THE HE STRUCTURES TO THE PROPERTY LINES ARE FOR A / ;� Hampton Bays, NY 11946 Center Moriches, NY 11934
ERECTION OF FENCES, RETAINING WALLS, POOLS, PATIOS, PLANTING AREAS, F 04 - • PHONE: (631) 728-5330 PHONE: (631) 878-0120
ADDITIONS TO BUILDINGS AND ANY OTHER CONSTRUCTION. �� 9Z87 0Q- FAX: (631) 728-6707 FAX: (631) 878-7190
UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF gNt)SUR N.Y.S. LIC. NO. 049287
SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY '
MAP NOT BEARING THE LAND SURVEYORS SIGNATURE AND RED INK OR EMBOSSED
S£.}L SHALL NOT BE CONSIDERED A TRUE VALID COPY. COPYRIGHT - 2002 PAT T. SECCAFICO P.L.S., P.C.