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Home My WebLink AboutMott `��x g�1ff0[�►c ELIZABETH A. NEVILLE,MMC O� Town Hall,53095 Main Road TOWN CLERK P.O.Box 1179 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS GO (631)765-6145 MARRIAGE OFFICER Irk,j► Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER ��l �v www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD D Mc�uv[E DD TO: Southold Town Building Department JAN 2 2018 FROM: Sabrina Born, Southold Town Clerk's Office BUILDING DEPT. TOWN OF SOUTHOLD DATED: December 29, 2017 RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4551 & 4552 for a Cesspool/Septic Tank Construction Permit submitted by: Michele Wagner-Nebbia for Wayne Mott 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: Final Uproval required from the Suffolk County Health Department Signature i3 08X 3 Dated SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @ $10 or ❑ Non-Residential @ $25 Septic Tank Xor Cesspool ❑ Application No. Permit No. Applicant Name: _M k(-tk" w¢&Nk-V.- N'0 6I Q, Applicant Mailing Address: �7 � t t,5�ToNE �a UJ 1 1-7 9 � Brief description of Propsed Construction or Alteration: F"p o 5 W DV6 L-VI nl G Location of Proposed Construction/AIteration: Owner of Property: _ (klA�jN6 m,o`rT ----- - - - — ---- Owner Mailing Address: L,4 CU-10,1 ----- ----Pro e---Address: -- -- ----r—------- ------ Property 7 5� S 1n1 I,<- LAI Cil/`►"0 O G Vc /J y - l 01 3 S , Name and Telephone No. of Contact Person: M(CLI-6'1,4 (AJ46W-V_-W6Pj I A 631-5(.3 -22 83 Tax Map No.: Section: 9 -1 Block: 4 Lot: g Nearest Cross Street: LESLIE'S CANE - NOTE: LOCATION MAP MUST B BMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SU VEY H HEALTH DEPARTMENT APPROVAL. Received by: - Si an f Applicant Date i I i 7 o ?ST HOLE BY: c a 1ALD GEOSCIENCE d o w x OCTOBER 4, 2017 o o� Or �tp � 1 110 X25 LJ e .ICt l� LOAN. �` P. w o.o o'• SAND. � 0 C. ca . P o c7 a w FINE SAND. a s 3 - O" �r Q7,3 _ 3 BROWN FINE SAND: - 3 v_ w 10 to .z Its /� do x ;Q 195.0 t� z� 4.7' OFWpN z • a.� ii aV]Rw< a r, 10.0 W� Bpm 199.6 z p1 01x a cn �; A-1 cam- ------- co t --- -- ------------------------------------------ - ------------------------------------ --------------- ----- ------ � o s +0. 0 z 213-�-$ ro� o.gS OAS 's, ��I 0 ar o o a >�F 0 (l, .6En p+a'� -+ A o 1 IITARY DESIGN: ME-FOUR BEDROOM SYSTEM), 100 GALLON SEPTIC TANK. ' 8'0"DIAMETER X 6'0"DEEP LEACHING POOLS. JITARY DESIGN: I FRAME BARN) = GM-100.-SEPTIC TANK. 8'0"DIAMETER X 6'0-DEEP LEACHING POOLS. LEGEND: PROPERTY INFORMATION: 'ES: RCEL IS CURRENTLY VACANT. (NO RESIDENCE). FF = FIRST FLOOR AREA:. 130,6.83.29 Sq.Ft.. = 3.00.0.0 ACRES [STING VINYL SHED, FRAME COOP & FRAME SHEDS TO BE GF = GARAGE FLOOR ZONED "AC" AGRICULTURAL CONSERVATION ROVED IN THEIR ENTIRETIES. RG = RIDGE HEIGHT ELEVATIONS IN NAVD88 DATUM [STING WELL HEADS ARE TO BE PROPERLY ABANDONED. ST = SEPTIC TANK SURROUNDING DWELLINGS WITHIN 150.Oft. HAVE PUBLIC WATER. LP = LEACHING POOL ALT: ARE- NO•WELLS WITH TE EK=Xft. OF-T -SUBJECT-PROPERTY., EP = EXPANSION-'PUOI: G TREES.THAT ARE-.IK HEALTHY CONHITIlII�TQ-B9.PRESERVED_ TW._ = TOP OF WALL MICHEI:g WAGNER-NEBBIA TB MAXII�IIM EXTENT POSSIBLE. BW = BOTTOM OF WALL 57 ROLLSTONE AVENUE, WEST SAYVILLE, NY 1. RK-N79 NOT DONE AT THIS TIME. SURVEYOR IS NOT RESPONSIBLE DW = DRYwELL PHONE: (631)-563-2283 R T1Aii1F�f.tGROUND UTILITIES OR STRUCTURES. -- _.� .=Eq.VWUIM OF s ox 7M or TBI un 446'15 0 dp 40. vi - d ` 11 L/] N •m O , CO V O of l i `ll°o O oa o \` `\' �v�(Jw' ° Jnr r m, ^✓ I N 1 Cn Lo I V 408.1 c V/V��rI�V r O I I Cn r r I r / r r ' 1 I ' , r I I 0 r r r � r � i r r � ' 46 15 4 J MAp 04 oY 0 16y, $ � 'SNo:9192 r�� Ul1t4 �3,,X992 w o W a SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES 7- PERMIT FOR Ar-PFOVAL OF CONSTRUCTION FOR A SIN ^L1::f AM!LV Rrr.titDENICE/\ND cs � DATE � r�Z I APPROVED TOTAL MA)C tUM BEDROOMS:21 Water Line(s) ft l 1'7 ^ca. 6s�5r�c�cteci By The EXPIRESS THREE YEARS FRe' rt DATE F APPROVAL Suffolk County +.')-p... :;)r Health S-ervices. Call 852µ5700, AW Hours In Advance, To Schedule inspection(s). Revised Plan Approved Z ZZ �p Q m ✓1 r h U vn, Expires - { I i DRAWING INFORMATION: o- NEW roR SCALE: V=40.' '� G-"`P`'j� LISA McQUIIMN DRAWN BY: R.K.H. + LAND SURMI NG + SURVEY OF FILE No.: Q440-17T DESCRIBED PROPER? DATE: OCTOBER 25, 2017 Uj AT CUTCHOGUE, TOWN OF SOUTH( ADDITIONAL.MAPPING: DECEMBER 18, 20L7 274 EAST MAIN. STREET SUFFOLK COUNTY, NEW YORK a EAST ISLIP,, N.Y.. 11730 r o 05otiti J�J`` TEL: '6M- 77-3605 SCTm- 1 't.0(I-(?4:x:4 cF Seo LA�pS FAX: 631-277-3906 IL I S WMATION LAM.09113 m TBS SOW YAP NOT BIASING TBI LAND SDBTSM D®OR SYBOSM ML W NOT CONSD=TO RS 1 TM VALID COR.MWCIS SHOiM TROY PR Uff LOW TO COSMIC SISOf.MM ARS POR A SPXMC PORPOSR AND DSS,AND ARE NOT HIMEDm To COD)I DI RUN ONLT TO TIM Pam TOR RHOY TBI SDRTR 6 PtQ am AND ON BS RSRALP.TO TBS COYPANT OR Aman LEM Bm6ON AND TO TBI ASSICNZ<4 OT 7BS LRNDQIC Db'14QIfON.CtQMCATlON3 ARS NOT tStANS►ttASIM 70 ADDTf10NAL DUMMONS OR SUBSLQOm 01mm. ! 1765 SKUNK LANE, CUTCHOGUE X440 - ^ X OFFOLAr. ELIZABETH A. NEVILLE,MMC O� CQ Town Hall,53095 Main Road TOWN CLERK � P.O.Box 1179 Southold,New York 11971 coo REGISTRAR OF VITAL STATISTICS Fax(631)765-6145 MARRIAGE OFFICER Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER ��,� ��O www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD nf`�C[ED'YR DD TO: Southold Town Building Department JAN 2 2018 FROM: Sabrina Born, Southold Town Clerk's Office BUILDING DEPT. TOWN OF SOUTHOLD DATED: December 29, 2017 RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4551 & 4552 for a Cesspool/Septic Tank Construction Permit submitted by: Michele Wagner-Nebbia for Wayne Mott 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: Final approval required from the Suffolk County Health Department AI Signature 6) Dated SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK XResidential @ $10 or ❑ Non-Residential @$25 Septic Tankor Cesspool ❑ Application No. Permit No. A5S Applicant Name: Applicant Mailing Address: Brief description of Propsed Construction or Alteration: PA,P o 5 `p 6-AN Location of Proposed Construction/Alteration: Owner of Property: UjA� Owner Mailing Address: l 2. S "Nk— (,AC Q-rgk) 6 Property Address: ;5"/'JV LAw T CJ10 G 0 3 Name and Telephone No. of Contact Person:t(-A W h&/U�-)2-— , Tax Map No.: Section: Block: Lot: Nearest Cross Street: L/6w C5 LA _ - NOTE: LOCATION MAP MUST TTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURNTy WIHEALTH DEPARTMENT APPROVAL. )x- Received by: Siga tur plicant Date r. o .� QST HOLE BY: o � 1ALD GEOSCIEj b o w OCTOBER 4, 2o o O» n ' 1 18.3 �� ARK BROWN LOAN. �� Z `n 15.3 A o+ o BORN SILTY SAND. Q(� L. 13.3 A a o�l la6.13 ALE BROWN FINE SAN ° �i F _ - d 3 L 1.6 - '%T LN PAIR BROWN F - & ' — 3— v/ 6 -0.7 — 3— a---- 0 — 3— L — r Ps C4 y -'---' k'-' Gt �� ]gypto 7 195.0 �X34:7 4.9/ �1H1zQN a� OVww 0.W Z ` .: a�av U „00 e.o ; 7 10.0 I i N• a 0-4 W 30.0 - - - w 199.6 ox a I � o wr�1' 2 O IV oto x a 9 pa 4 En d ------------------------------ ------------A------------------------ O Baa C) C) s +� z 213.7.5 r� I� > ° Ols ,4 VE RTARY .DESIGN: tEE-FOUR BEDROOM SYSTEM), ►00 GALLON SEPTIC TANK. ' 6'0"DIAMETER X 6'0"DEEP LEACHING POOLS. 1ITARY DESIGN: 1 FRAME BARN). = G;AMN-SEPTIC TANK 8'0"DIAMETER X 6'O-DEEP LEACHING POOLS. LEGEND: PROPERTY INFORMATION: 'ES: RCEL IS CURRENTLY VACANT. (NO RESIDENCE). FF = FIRST FLOOR AREA:. 130,6.83.29. Sq.FL. = 3.00.0.0 ACRES. (STING VINYL SHED, FRAME COOP & FRAME SHEDS TO BE GF = GARAGE FLOOR ZONED "AC" AGRICULTURAL CONSERVATION MOVED IN THEIR ENTIRETIES. RG = RIDGE HEIGHT ELEVATIONS IN NAVD88 DATUM [STING WELL HEADS ARE TO BE PROPERLY ABANDONED. ST = SEPTIC TANK ij SURROUNDING DWELLINGS WITHIN 150.Oft. HAVE PUBLIC NATER. LP = LEACHING POOL APPLICANT: ERE-ARR NT WELLS- PITH--f50:0ft. OF,TIS SUBJKCT--PROPERTY. ["TW EP = WANSWN_PUM TREES.TRAT AR&lK HEALTHY CMMM.TO- BE = TOP OF WALL MICA ME A NEBBIA M�jM ff POOLE. BW = BOTTOM OF (PALL 57 ROLLSTONE AVENUI T SAYVM, �Y 1 Rg—D NOT DI T THIS TIME. SURVEYOR IS NOT RESPONSIBLE Def = DRYWELL PHONE: (631)-563-2 R UND . GROUND UTILITIES OR STRUCTURES. 1 \ 446'15 P 1. �s� °'• y � O =' o % _ ------- -A --- -- Z o y o0 in �/ \\ Cut 1 � O o v� E- r itr o r L!1 I � \ I / I / ' 446,15 �p 04 �OAg4 1g. 1992 " SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES 'Y'Yll PERMIT Fm APPROVAL OF CONSTRUCTION FOR A c sSIN -LE:FAN":LY RE-SiDENCE AND co DATE 441(-�.5. 'i . ;N0.a: 0z 1 APPROVED TOTAL I'J AMMUM BEDROOMS Ll Water Line(s) MQ570,e Inspected By The EXPIRES THREE YEARS FRC:1 OATEF APPROVAL Suffolk County Oep . "O Health Services. Call 852.5700, 4.8 Flours In Advance, To Schedule inspection(s). Revised Plan Approved r dep� m-.✓1 I /h U M. DRAWING INFORMATION: of NEW )'0 SCALE: 1"=40.' ��N`G."`Q�li LISA McQUMN SURVEY of DRAWN BY: R.K.H. Q LAND SURVEYING FILE No.: Q440-17 J 4� DESCRIBED PROPER? DATE: OCTOBER 25, 2017 W TOWN OF SOUTH( ADDITIONAIL MAPPING: DECEMBER 18, 2007 � 274 EAST MAIN BEET AT CUTCHOGUE, EAST ISIJP,: ZL.Y- 11730 SUFFOLK COUNTY, NEW•-YORK r 0 ost JQ,� TEI:: 631-27T 3605 SCTI�: 1Ef� .0E1�04: :Ef CF SED LANDS FAX: 631-277-3906 MOCAM N IAT.Cww OP Tm SOYTYT WP NOT NMC TU Um SUMTM DCS aImmme ML YR NOT mm=TO S,TYOY vAm COR.Zmess 6006 mm mrwff Lm TO c�(G S740G7T m An Poi A,R=C POOH AD OSR AND W NOT OTI==TO G=Z IN `YON OnT TO To nwml1M IM To SORTS 6 PWaM WD ON=UW,TO=CWNY OR AM=W=MM N AM TO=I.SSIOM OF W I1 MM OS MUM.CYYfti1UDONS AIDC NOT nANSMUU TO/DDMWAL U==On OR SOBMMW OMM' • 1765 SKUNK LANE, CUTCHOGUE Q440 - I �r _