HomeMy WebLinkAboutBertani ELIZABETH A. NEVILLE may` ��G Town Hall, 53095 Main Roa,
TOWN CLERK � � P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ry Py
Southold, New York 11971
MARRIAGE OFFICE*'R � r `� Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER ��0� ��� Telephone (631)765-1800
FREEDOM OF 1NFOR.3AA^t ION OFFICER southoldtown.northfork.riet
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.
Permit No. ( _ ��
Applicant Name _)d tq Xj 13a)z 729
Applicant_Mailing Address 019Pe2d -..1)12- ,e
Septic Tank. or Cesspool
Brief Description of Proposed Construction or Alteration—,5/AK- e k,
Location of Proposed Cons
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�ruction/Alteration:
Owner of Property: IL I`l A-J C1 /11 CM 13 c-,- n
Owner Mailing Address:
Owner Property Address: e,,J6- tl�
Name and phone number of contact person �C �,��Aw G i ,.-76±5--15
Tax Map No: Section 6 3 Block 0 7
Lot t I
Cross Street 1-20
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NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION +QUME S SURVV Y WITH IIEAL.TH DE PARTMENT APPROVAL
Signat#of Applicant Date
Itcceived by:
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15 DRAINAGE SYSTEM CALCULATIONS
LOT DRIVEWAY AREA: 1,135 sq. ft.
1,135 sq. ft. X 0.17 = 193 cu.
ID*Ev\ v.IN 193 cu. ft. / 42.2 = 4.6 vertical
PV6�\G PROVIDE (1) 8' dia. X 5' high ST
vSE�' ROOF AREA: 3,025 sq. ft.
3,025 sq. ft. X 0.17 = 514 cu.
! 514 cu. ft. / 42.2 = 12.2 vertic,
PROVIDE (2) 8' dia. X 7' high ST
PROPOSED 8' DIA. X 7' DEEP DRYWE
PROPOSED 8' DIA. X 5' DEEP DRYWE