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Home Rescue Solutions
SUFFOL�- ELIZABETH A.NEVILLE,MMC O� CSG Town Hall,53095 Main Road �� y� P.O.Box 1179 TOWN CLERK Southold,New York 11971 REGISTRAR OF VITAL STATISTICS _ Fax(631)765-6145 MARRIAGE OFFICER ,f. Off. Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER �!!,( �`1 www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD o [EC740'V[E D TO: Southold Town Building Department SEP 2 1 2018 FROM: Sabrina Born, Southold Town Clerk's Office BUILDING DEPT. DATED: September 21, 2018 TOWN OF SOUTHOLD RE: Cesspool Construction Application Transmitted herewith is a copy of application No. C4654 for a Cesspool/Septic Tank Construction Permit submitted by: John Bertani for-Home Rescue Solutions LLC. 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 O ELIZABETH A.NEVILLE §`Z`O G•y Town Hall, 53095 Main Road TOWN CLERK ® P.O. Box 1179 y 2 Southold, New York 11971 REGISTRAR,OF VITAL STATISTICS • Fax(631) 765-6145 MARRIAGE OFFICER A �� Telephone (631) 765-1800 RECORDS MANAGEMENT OFFICER ��1 �a 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 @$25 V ApplicationNo.q.l 5q Permit No. ` Applicant Name V OeAP'�'G� Applicant Mailing Address 13 n 061,"- do '� l SoL. - 'ol Septic Tank or Cesspool Brief Description of Proposed Construction or Alteration ©•-��-�n S. 1-�c� roa „n ct-A& Location of Proposed Construction/Alteration: Owner of Property: ge-scue- Owner Mailing Address: S-q-7-K-6 0-. Z `iF(�/ Owner Property Address: 9,6.cy�'— Name and phone number of contact person Tax Map No: Section A (oq Block 3 Lot '3 Cross Street ND,V L- �l�cA.cli NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HE TH DEPARTMENT APPROVAL la- 9 I P/.&,& Sijure of Applicant at Received by: THUJA NI GRA (PYRAM I1?AL- ArRBOR) 6-1 HIGH =i PROVIDE YVOOD CHIP5 AROUND ALL 5i 1rW5e A,N.*.7 TREES %RVIVORShiIP SHALL BE MAINTAINED POR FIVE ($) YEAR5. ANY PLANTS WHICH DIE OR BECOME DISEASED DURING THAT TIME SHALL BE REPLACED BY APPLICANT. i - Suffolk County Department of Health Services Approval for Construction-Other Than Single Family Reference No-ICIO-/8-OW Design Flow Use(s) 610' W4tf, / "k OAt sS !C' —� These plans have been reviewed for genEra'l conformance w hSuffolk County Department of Health Services standards, relating to water supply and sewage disposal. Regardless of any omissions, inconsistencies or lack of detail, construction is required to be in accordance with the attached permit conditions and applicable standards,unless specifically,waived by the Department.This approval expires 3 years from the approval date ss extended o new t X01$ Approval Date llevi6ver APPLICANTS NAME: HOME R 5GUE SOL UTION5, U.—C, R� ,c/o 5PARKLIN0 POINTE, LLG ADDRESS: 5ci"150 GR 45, 5OUTHOLO, NY i! ��u -�- PHONE #: 651-165-0200 do ARC PROPOSED {���R�HOUS� �UILI7�INa may✓ ��� �L� I�?i GOt�t(T t:UAD 4a I ��....�. �.'iJTiIUCD,NY O� SCALE A5 NOT'--P APPF OVED 9Y: (, .i.TUf?NER { DAT- i2/2I/I 1 I Kc-VIESI?BY=t7 BY , . d5� Robert J. C-�r ubor - JAr chitoct 476 Express;roy Drive So. Medford, N.Y. 11763 (�31) 654=4949 pF �'� �I -11-E- ���� DRAWING NUMBER: 5P-1 Or- I JOB#: I?-125 IT ZNJ \ O e ,��'Oi"` / G , —�Oy ro _SPA o u +�tiHAI'10 -,Nr, FENCE �° �e O? EXT'G SEi-WIG1 EXT'G WATE - ryo4 f, O�A�� — G WATER - N-- � Z ,1 o Z -- — C-4 0 try X - - rw ts) , � SSPEITK E N1c1 o 9 4! v -X00 {OUSON GR o20.MI teSTORY 3 Lu EL.21.0' MIN. MEN ------ ---------- 0 —A---- --- , 'l ^ 7 ----------- ------'tf-7 �--------------- \ PST ---- --- -- ''°� 9• Rw'�CE .t)'_�o _ ,�- -- '= ySJ�.` - - ITgRY Pl I/4•/FT 10k z __ z I WOOD PADDOCK FENCE .IG L N N E STAKE— 2 un�elo 0 FrRR J e (TYPjsEttzkit R t 0 0Vol v 0 -Z) NOW Oil Oi�M �-X lG�s DOfiz05K1 0 STFFHEN J. pO OSKI 0 S x/ i F,-'( LANE) 30 (oGo��� o G Q�5 ,c��C�GP