HomeMy WebLinkAboutMeskouris SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4415-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner JAMES MESKOURIS
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Mailing Address 1 1350 SOUND BEACH DRIVE
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Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 1350 SOUND BEACH DRIVE
Property Address 2
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City St Zip MATTITUCK NY 11952-0000
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Owner Telephone No. 631-298-2106
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Tax Map No. section 106.00 ' block 1 lot 36.000
------ --- ------
Cross Street INLET DRIVE
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Issue Date: 5/27/10 Elizabeth A. Neville
-------- Southold Town Clerk
(TOWN SEAL)
� OG
ELIZABETH A.NEVILLE �� Town Hall, 53095 Main Road
TOWN CLERK co C'* Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS O Southold, New York 11971
Fax
RECORDS RMANAGEMENT OFFICER yRIAGE OFFICER �0• �aO�� Tel phon54
Telephone( 63 31) 67651800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
OPERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10 or Non-Residential @ $25 Application No. Ji
Permit No.
Owner Name
Owner Mailing Address / .11,z_
Owner Propdrty Address r/,' / 2 4
02S 1F/
Owner Telephone No. &/3 /- 2-/-
Tax Map No: Section �G� Block D / Lot
Cross Street '-4
Please check each that applies: New Construction
Alteration to Existing System
Residential * --' Non-Residential
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. (Locate
building and system; give north arrow and approximate distance in feet from system to building /
and closest road. New construction may submit copy of survey with SCHD approval.) i
U
Signator f Applicant Date
1
Received by:
sl '
o�oSUFFot,��o
ELIZABETH A.NEVILLE �`� G.y Town Hall, 53095,Main Road
TOWN CLERK p P.O. Box 1179
H 2 Southold,New York 11971
REGISTRAR,OF VITAL STATISTICS th. �
MARRIAGE OFFICER G Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER �'� �a southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
a'l
SOUTHOL D WASTEWATER DISTRICT
—IJ
N
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$10 or n-Residential @$25 Application No.
Permit No. (�,
Applicant Name �✓�S Ale U d' f
Applicant Mailing Address /3S d Say,,j
fgTIK/ 7vC,/c //ff�Z
Septic Tank mor Cesspool
Brief Description of Proposed Construction or N teration 5
' /U as✓ � �° , coo S
Location of Proposed Construction/Alteration: ,
Owner of Property:
Owner Mailing Address:
i3r�T A,
Owner Property Address: Sri_
Name and phone number of contact person _Aq-4.
Tax Map No: Section 10Block 0 / Lot ? 6
Cross Street
NOTE: LOCATION MAP,MUST BE SUBMITTED WITH APPLICA ON. NEW
CONSTRUCTION REQUIRES SURVEY WIT-V HEALTH DEPARTMENT AP ROVAL
Si tore of li t Date
r
Received by: U
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SURVEY QF L O T 38_ ;
BLOCK 2 �
MAI? OF - Tesl Hole
9/22/08
CAPTAIN KI�OD.ESTA TFS o,,pIcDONALO GEOSC/EIVCE
MIXED SA AND ~�'L 9.7
FlLEDj ISG `19,_,1949 FILE NO. 1672 LOAM ND•
AT MA TTI TUCK INLET
5!9RADfiVG
ALE BROWN FWE
TO FWE TO
TO WN OF SOU THOL0 OARSE SAND.sP-sw
T.2 EL 2.5
*ATER /N PALE BROWN 1
FINE TO COARSE
K-COVN: T Y y -N / .' ! SAND SW
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'! 11000 - 10 - 01'-. 3V WATER IN BROWN
SALE: 1'"2D' ZD/7 e VE e/ 15 SILTY SAND
OCT 3, 200y 5l'
Sm
sIAN;;15,, 2008.laddtflonsl 1
A-PRlL` 28;'-2A008 (REVISION) i WA
TERT/BL
'AU�U$T,26, .2008 rB.0.H.1 ¢.a 5T
2008''p�s1. MOM BLLIDEW T/WX
rl DLr 2, 2oa�lrevis p^ o Et 9.5
OCT. 3/,,P0.08-IADDITIONSJ
`= NOV: l8,-20.08 Voidslonr!
;;, • r orenay
ANY A,'`
11 "- GTERA:T./ON_OR ADDITION•T,O TOS SURVEY/S A.;V/OLAT/ON Dv� SO
j�• OF:SECd70N;,T209.:`OE_, HE NCWYORK-STA'TE.EDUCATI,ON LAW.
P rEXCEPT AS?PER:SECT/ON-7209.=,=SUBD/V/S10N Z ALL CERTIFICATION
HEREON
'VA _T THIS:MAP AWD,COPIES THEREOF.ONLY!F _ new oa i- r }� �•r ,
SAID MAP'OR'COPIES BEAR THE/AIPRESSED SEAL ,OF THE SURVEYOR ve•� `;
IYHOSE':SIONATURE APPEARS HEREOF i.�� �� ( RAINq RUNOFF".2594 -s
.
aoa• 2594x0./7x/.11. 44/1
_
'AREA OF EXISTING HOUSE AND DECK = 2399 sq.ft. ,y 441142.2'—10.5 �
iy AREA AT COMPLETION'OF CONSTRUCTION = p " ° N PROVIDE 2'DRY WELLS
2594 8' x 6' DEEP
1 STY FR v r s1LPs
HSE G , o ® = DRY WELL
LOT COVERAGE AT COW..LETION OF
r 'CONSTRUCTION TO MHWM 1
•2594 Sq.1L/13847sq.1t, a 19% FX FM EL 121
TO COASTAL,EROSION HAZARb UNE
2594sq.11./6/25 Sq.fl a•42%' p I b
TO •WQ0D BULKHEAD
•2594 sgjY-'71'00 s .(I - 37% .vc uwr ' ITI
q -
EX/STIM LOT COVERAGE- TO MHWM=
1 """ �I '
2399//3847 = 7.3% Ill'
T.0 COASTAL- EROSIdN-CINE. L' 3OE' s.
2399/6/25 = 39,te% ` i Posr ,
;':TO•WOOD BULKHEAD ib
Ile
2399/7100.= 33, o = r •
- � 8� ;• � � � Foy- ��y �.� �,ll •
b � y o
TQk
he locations o% wel%s and cesspools �'� 37 �'"� h j` coyer,.edc. ��D 4„
shown hereon are from lie/d observations' I -i
,and or from dala ohrihft from olh24•7' 's'M d`
3 Y' P
;l AREA, = 13,847 s .Et a ` ` "� ;� Lu
101
om 1 y E P pEL a s
am /am/Uor with 01
/he S.TANDARDS•FOR APPROVAL i¢ �•,M s.Muv �, s��
T. O�
;i AIYD' ONSTRUCT/ON OF SUBSURFACE SERFAGE rebct r 1 3` � 'L�i
DlSPO$AL, SYSTEMS FOR SINGLE FAM/L Y'RESIDENCES Set 7.30'0 1y
50-23
`and w abide by the con lions se! /or/h lhereln'ond on themom ` ;Qz?
pit*Aa Construct •; s e f 3^ ,
LIC: IVO. 496/8
i SOU a ao G�LEsrOW APRONEL eq (631 R Y.
j fPUBL/C WA TER /N S7•,gEETI SEA Cly DRIVE r63/J 765 1797
P. O. ' I
"ELEVA TIONS ARE ,REFERENCED To N.G.V.D. 1230 TRA R STREET R
VACANT SOUTHOLD, N.Y. 1197/
1
89-188