HomeMy WebLinkAboutMitchell ELIZABETH A. NEVILLE, MMC d Town Hall,53095 Main Road
TOWN CLERK" P.O.Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS i� Fax(631)765-6145
MARRIAGE OFFICERwb mu Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER " Y
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Sabrina Born, Southold Town Clerk's Office
DATED: March 16, 2018
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4588 for a Cesspool/Septic Tank Construction
Permit submitted by:
Charles Thomas for Andrew Mirehell.
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: l in tl royal re uh,ccl rtogi ll�c SttTo11( ±C"eogw_ Ilr�tWi De.artinem
Signature
Dated
ELIZABETH A.NEVILLE Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
Southold, New York 11971
REGISTRAR,OF VITAL STATISTICS Fax(631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER ' 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 � '
Permit No.
pP p ............
A licant Name •
Applicant Mailing Address 2 �
Septic Tank L-'-or Cesspool ti
p p
Brief Description of Proposed Construction or
Location of Proposed Construction/Alteration:
Owner of Property: A,a.... L_
Owner Mailing Address: 5-C L eQ!'n'l
Owner Property Address: �j_0_ Covn"ti WIA.—N
In I
Name and phone number of contact person
Tax Map No: Section �2� T Block ..0....� Lot � 22
Cross Street
NOTE: LOCATION MAP MUST BE StIRN1114 XV,JTH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WIT1 Il+ l: T EIIART1' ENTAPPROVAL
w
Signatcire of Applicant Date
Received b.
(1)U!'AUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW.(2)DISTANCES SHOWN HEREON FROM PROPERTY LINES TO EXISTING STRUCTURES ARE FOR A SPECIFIC R'+VIPPOSE AND ARE NOT TO BE USED TO ESTABLISH PROPERTY LINES OR FOR ERECTION Of FZPWtl 5,(3)CNM"rC OF THIS SURVEY MAP NOT BZARPRG THE LAND SURVEYORS INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. 4 CERTIFICATION
INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERNMENTAL AGENCY AND LENDING INSTITUTION US'1ED HEREON,AND TO THE ASSIGNEES OF THE LGNDING WSTTUTION.CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTION.:OIR UUB9&`..QUENT'00411S. (5)THE LOCATION OF WTAAS(W),SEPTIC TANKS(ST)k CESSPOOLS(CP)SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS.
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1 ,�y Thomas C,Wolloort,Professional Engineer
\,v% / g Adams,Profasssionoi Englnoor
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Robert G.Tast,Architect
CL 1` Robert Stromskl,Architect
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� -- SITE DATA
of a ,t SEWER PIPE 30 ELBOW D
ryAREA = 31,310 50. FT.
N y "SUBDIVISION- "LAUREL LINKS"FILED IN THE OFFICE OF THE
o / CLERK OF SUFFOLK COUNTY ON NOV.50,2001 AS FILE NO. 10712.
1 19 VERTICAL DATUM = N.A.V.DATUM(1988)
6R055 FLOOR AREA
FIRST FLOOR =2,530 50.FT.
60 WE SECOND FLOOR - 909 So.FT.
HEALTH DEPARTMENT USE
CLEANOUT DETAIL
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ANDW J. MITCHELL 4
MARY V. MITCHELL
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LOT 21, "LAUREL LINKS"
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7®"' "/ TE5T HOLE at Suffolk County, Neal York Id
FROM FILED MAP
t �' ' BUILDING PERMIT PLOT PLAN
EL=29.5 0.0" Count Tax MCI District 1000 Section
-4' / y 125 Block 04 Lot 24.22
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/ MAP PREPARED JUNE 50,201-7
(OL) Record of Revisions
EL=255 4,0' RECORD OF REVISIONS DATE
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SAND 3
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o FINISHED FLOORS ELEVATION TO BE VERIFIED // �.."' 50 O 25 SO 100
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EL=11.5 18.0'
IL �``�. '" .^'" Seale: I" = 50'
H16HEST EXPECTED JOB NO.2017-0128
DW6.2017_0128_bp I OF I
6ROUND WATER.EL-5.0
= MONUMENT SET = MONUMENT FOUND A= STAKE SET = STAKE FOUND