HomeMy WebLinkAboutZatcoff r
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ELIZABETH A.NEVILLE,MMC �.ZO r/y Town Hall,53095 Main Road
TOWN CLERK P.O.Box 1179
CIO Z Southold,New York 11971
REGISTRAR OF VITAL STATISTICS - ® .� Fax(631)765-6145
MARRIAGE OFFICER aQ�' Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department D [ECEgV L� DD -
FROM: Sabrina Born, Southold Town Clerk's Office MAR 2 9 2015
DATED: March 29, 2018 BU��ING DEPT.
TOWN OF SOUTHOLD
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4592 for a Cesspool/Septic Tank Construction,
Permit submitted by:
Edward Tenety for Adam Zateoff.
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_
Signature
Dated
ELIZABETH A. NEVILLE �`�`� � Town Hall, 63096 Main Roa.
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS
Southold, New York 11971
MARRIAGE OFFICER o Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER ��Q� y s`b��` Telephone(631)765-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.nef
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 Ap1?lication No. -
Permit No.
Applicant Name M AI /V �
Applicant Mailing Address
Septic Tank. or Cesspool
Brief Description of Proposed Construction or Alteration
Location of Proposed Construction/Alteration:
Owner Of Property: //Ucf1%!'I z/1i71-0�
Owner Mailing Address: d C — 1W &AMMW
Owner Property Address: y-5 06
Name and phone number of contact person
Tax Map No:/060 Section Block Lot 3=38
Cross Street
NOTE: LOCATION MAP MUST-BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
Signature o icant D to
Received by:
FOR SCDHS USE: PROFILE (NOT TO SCALE) PARCEL AREA:45,661 SF or1.D5Ar-
GARAGE AREA-543 SQ.FT.
1 ST FLOOR AREA=1725 SQ.Fr.
FINISHED FLOOR 16.5 0=10 INV=13.4 2ND FLOOR AREA 1653 Su.FT.
FIN. GRADE 15.5 FIN. GRADE 15.0 TESTHOLE #2
- SUFFOLK COUNTY DEPARTMENT ENT OFr HEAL:rH SER'VIC BOTTOM OF CRAWL SPACE 11.0 �" r SEPTIC 7LEACH.
PERMIT ,R APPRC'!,,.L OF CoNs'"RUCTION FOR A
TANK POOL
G N G L E F A M i LY Rn-SIolPNI"E 0 N I INV=13.6 INV=13.2 3' MINIMUM
GROUNDWATER 5.0
JAN 0 ! p
SATE i�:�, o
APPROVE` OZ
I OI r rin tGM Cfr' BEDROOMS
HRE
EE YEARS FROM DATE OF APPROVAL.
7-4 OP ro l IV 04
a 61x 9.6 91,3' r/?
z x 9.7 `* '91J op o°j,o
x 1114 10.0 4 � WA 7-"
x10.1r .
1a2 x9.7 x10.2
x 11.37 44p) C
X0.8 11. 0 Ipi % �
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0.7 M 11.0 ®
TEST HOLE INFORMATION: x "�r a 13.4 �`"
ge 11.0 122 ;ee6'.° 4O,w 13.2
x x ix J� LAND NOW OR FORMERLY
' ?* r x 13.6 O OF CASTLENUOVO
TESTHOLE #2 MAP OF ANGEL 0 � CO � 121 rcyT � �mop.Aq 13.4 1. �I �O RESIDENCE-PUBLIC WATER
SHORES MAP # 9729, 8/23/95 , z x PROPOSED c KCO
�r STORMWATER ST LP TC-13.33
X1.7 DRYWELL (TYP.) ,LP BC-13.07
0p 16 13.20
' R--
50.0 713 y� m.
L.P
o PROPOSEDWATER SERVICEPROPOSED BC=IZ88
L=108.26'
BC=13.16
11.7 11.7 12It 129 1 U.G.. UTILI'nES wl
13.5 1 4 1386 F'�13 ISI - )
LOAM FE sTAK'E BC°129�'�ALu ,3 (DUSTING s WATER MAIN
4i
OIL
o.5'N 1 '03'52" IN 265.82' C=13.9 FOU WINDS COU 1
S 5
LAND NOW OR FORMERLY OF ROGAN
RESIDENCE-UNDER CONSTRUCTION
PUBLIC WATER
-5, ® SITE PLAN
SITUATED IN ' Til
SOUTHOLD
SAND NOTES:THE PROPOSED RESIDENCE IS TO CONTAIN 5 BEDROOMS. TOWN OF SOUTHOLD,COUNTY OF SUFFOLK,STATE OF NEW YORK S "
II
efil
Uj
AND & 4'E.D.X 8'DIA. LEACHING POOLS "'
RY TOCONSIST OF. 1500 GAL.SEPTIC TANK 5
PROPOS
ED SANITA
ELEVATIONS ARE NAVD 1988 O'Connor - etit0 .C '
THERE ARE NO SURFACE WATERSNVETLANDS WITHIN 300 OF PROPERTY AS DEPICTED Land Surveying 27 Forest Avenue ze
0
'UNNAMRIZED ALTERATION OR ADDITION TO A SURVEY MAP PREPARED AND SEALED 13Y A LICENSED LAND Locust Valley,NY 115f S
SURVEYOR IS A VIOLATION OF SECTION 7208 OF THE NEW YORK STATE EDUCATION LAW.' Civil Engineering (516)676-3260 /
-10' NOT MARKED WITH AN ORIGINAL OF THE LAND SURWMR'S
GR INKED Ti FROM TME , OF THIS SURVEY MAP " MAP ANGEL SHORES,MAP No.9729,8/23/1995 DIST.1000 SEC. 88 BLK.6 LOT 13.38
GROUND WATER INKED SF�IL OR Elas ED SEAL SHALL.NOT 9E CD1�sIDERET�A VALID TRUE CGPY. CERTIFICATION
INDICATED HEREON SIZNIFY THAT THIS SURVEY WAS PREPARED IN ACCORDANCE'WT H THE EXISMNO CODE OF
PRACTICE FOR LAID SURVEYS ADOPTS BY THE NEW YORK STATE ASSOCIATION OF PROFESSIONAL LAND
SURVEYORS. SAID CERITFICATIONS SHALL RUN ONLY TD THE PERSON FOR WHOM THE SURVEY IS PREPARED'. DATE: DECEMBER 3,2017 REVISED: SCALE: 1"=50' SHEET: 1 OF 1