HomeMy WebLinkAboutBurns ' ��gUFFO[�co
ELIZABETH A. NEVILLE,MMC O G Town Hall,53095 Main Road
TOWN CLERK �� y� P.O.Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS � Fax(631)765-6145
MARRIAGE OFFICER ,f. Off. Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER O,( �`1 www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department D [ECROV[E DD
FROM: Sabrina Born, Southold Town Clerk's Office JUL - 2 2018
DATED: June 28, 2018 BUILDINGDEPT.
TOWN OF SOU HOLD
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4621 for a Cesspool/Septic Tank Construction
Permit submitted by:
Krzysztof Zebrowski for Patricia Burns.
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
07//7//,g
Dated
r J�
r
ELIZABETH A.NEVILLE p�� k Town Hall, 53095 Main Poad
TOWN CLERK P.O. Box 1179
C40 Southold,New York 11971
REGISTRAR OF VITAL STATISTICS w
MARRIAGE OFFICER ® Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER .fa ,.dam 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 V or Non-Residential @$25 Application No.
Permit No.
Applicant Name YAW �M V Q tNWMW
Applicant Mailing Address �i,1/& (y
Septic Tank or Cesspool
Brief Description of Proposed Construction or Alteration nw a ci ult
Location of Proposed Construction/Alteration:
Owner of Property: VV1 9� p�A- G. PDO MS
Owner Mailing Address: W b �f�cMIN 90
MTiITV C9f V�
Owner Property Address: �� i-I N VfU
Name and phone number of contact person K&Ubm F
Tax Map No: Section Block Lot
Cross Street MAI - 0
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
Signure of Applicant Date
Received bY
10 `
S.C.T.M. NO. DISTRICT: 1000 SECTION: 109 BLOCK: 1 LOT(S):21
#R10-17-0199
J MON
C1 EL 42.5 _ _ — ,. ..•,
e p\ SUN°FOLK. CO1.UNP E,PA.RwTM6.NT O "TII FROCES I'° I� 1»
Oa
°h..»RIAr F�,�� � �I � OV� LOr ODS TRUC1I
O
N FOR A
VACANT LAND
150" SINLLIZ, FA „s ONLY
/ �`
o u RI
EL(47.5) Vd '�
MON. ERM. SHED �.) �T r, C k;I» G` dJ»
EL 39.3 O TO BE REMOVED —
/ •. O.. �L EL 48°5 PROPOSED 3-4 BEDROOM —wp
SANITARY SYSTEM », I�a
SEL 4f1,fF} ,� �° i�'»v U'4""']' M
..:.., .....,..,°. � Ori. fl,'U
1 000 GAL S.T. .._....._ ...._..•.�»�,,
ELEV. 47.3 /// twa r4 { 0 1 8'X12'DEEP L.P. •,
DR BROWN
L PgRF )iR� I �� RP ':�. KR DATA ) k �' ' O�� .1
�81,
OL LOAM 1.0 EL(47.0) WE,
_ �� TO BE "
'r d
BROWN ciO O DONE
ML LOAMY SAND 2.5 Ol Cr EL ,50.0
r gyyC \
EL 44.5 d p \ WELL
TO BE 't
0) b 7 •and ` ABANDONED
SP PALE BROWN `I 48.0 h a 49.5
FINE ow
SAND , TYPICAL CLEAN OUT / C
1,1'W
13.5 / \F DWELLING W PUBLIC
0
SLATE OR � 0 \ WATER 150'
SUITABLE COVER 0 a 4e.3 1,7,W \
STOPPER END 0 3
OR PLUG 00
0 hod O n n (.,"�». .
r k conformance with � ��d 1 T11Usk �a 1
o , I a 1 711 T1�1� exist 11 ��11II
Submit
NO WATER 30' ELBOW . ^I B,W
1
60' WYE \ CJ 1"W I ! ' " Of.
.,.,—
06-23-2017 �/fi,, EL 50.2 N " 11, O v� '< 4'O \
McDONALD GEOSCIENCE FLOW yE1 o, 0"ti 4'\
1<1
NON—CONFORMING LOT
FRONT: 40' MIN . \ $
SIDE: 15' MIN, 35' TOTAL DWELLING W/WELL
REAR: 50' MIN
THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL \ �� , a
EXISTING SANITARY EL 50.5 � ��d y, �7
LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS \ TO BE ABANDONED F .•
AND OR DATA OBTAINED FROM OTHERS. AND WITH CLEAN LCOARS 0 > -
SAND w r `. EL 50.,
AREA: 27,138.57 SQ.FT. or 0.62 ACRES ELEVAnON DAnJM; ASSUMED
UNAUTHORIZED AL7ERA77ON OR ADDITON TO THIS SURVEY IS A VIOLA TON OF SEC71ON 7209 OF THE NEW YORK STA 7E EDUCATON LAW. COPIES OF THIS SURVEY
MAP NOT BEARING 7HE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID 7RUE COPY. GUARANTEES INDICATED HEREON SHALL RUN G.V.
ONLY TO THE PERSON FOR WHOM 7HE SURVEY IS PREPARED AND ON HIS BEHALF TO THE 777LE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTYUTOW
LISTED HEREON, AND TO 7HE ASSIGNEES OF 7HE LENDING INSTTUTON, GUARANTEES ARE NOT 7RANSFERABLE. EL W.6a00
714£ OFFSE7S OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE 7HEY ARE WELL �0
NOT IN7ENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE 714E EREC77ON OF FENCES, ADD/TONAL S7RUCTURES OR AND 07HER IMPROVEMENTS EASEMEN7S Cj
AND/A4 SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT 7HE TME OF SURVEY
/ "U.P. r
SURVEY OF: DESCRIBED PROPERTY CERTIFIED TO: WILLIAM BURNS; /
MAP OF: / .•
FILED: - w---
O
-UATED AT: CUTCHOGUE -- —"
.OWN OF: SOUTHOLD KENNE'T'H M WOY•CH I,AND SURVE) [N , PLLC
SUFFOLK COUNTY, NEW YORK Professional Land Surveying and Design
P.O. Boa 153 Aquebogue, New York 11931 REVISED 01-18-17
PHONE (831)298-1696 FAX (631) 898-1566
FILE � 17-127 SCALE: 1 '=40' DATE: SEPT. 3, 2017 f � � REVISED 10-24-17
N.Y.S. LISC. NO. 050882 maintaining the recordm of Robert J. Hennessy b Kenneth M. Toyebuk