HomeMy WebLinkAboutMorton ELIZABETH A.NEVILLE,MMC i '�" Town Hall, 53095 Main Road
TOWN CLERK P.O.Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICSFax(631)765-6145
MARRIAGE OFFICER 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
FROM: Southold Town Clerk's Office
DATED: October 22, 2018
RE: Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 4667 for a Cesspool/Septic Tank Construction
Permit submitted by:
Keith Scott Morton
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:
Signature
Dated
ELIZABETH A.NEVILLE Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
C4 � Southold, New York 11971
REGISTRAR,OF VITAL STATISTICS Fax (631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER .+ 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 or Non-Residential @ $25 Application No.
Permit No.
Applicant Name�_�,,, _ . .. .,........_.. __.._
Applicant Mailing Address � �
Brief Description noof Proposed Co ,
Septic p
B
. 'p p Construction or A1ter�Ition�
Location of Proposed Construction/Alteration:
Owner of Property: __(�! ` p
� ._.
Owner Mailing Address: PGm,.._4r!a 13C-/
...... �I -.
Owner Property Address:,,, Z-Z �"�
/ mc� � �." .IT
Name and phone number of contact person /C E: ._ � �a 1 yZ L1
01
Tax Map No: Section �_ Block Lot /.its
Cross Street...� ... _ _ .••_ _ ..... ...... ..•• •
NOTE: LOCATION MAP MUST BE SUBMITTED T APPLICATION. NEW
CONSTRUCTION UI S SURVEY WITH HEALTHDEPARTMENT APPROVAL
a
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Signature opplicant Date
Received by: ....._.
Town of Southold
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Date: 10/22/18 Receipt#: 249221
Quantity Transactions Reference Subtotal
1 Septic Permit- Construct- Resid. 4667 $10.00
Total Paid: $10.00
Notes:
Payment Type. Amount Paid By
CASH $10.00 Morton, Keith & Christine
Southold Town Clerk's Office
53095 Main Road, PO Box 1179
Southold, NY 11971
Name: Morton, Keith & Christine
1220 Old Farm Rd
Orient, NY 11957
Clerk ID: JENNIFER Internal ID:4667
SURVEY OF PROPERTY
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TO WN OF SOU DOF CO. �,. H SERA
SUFFOLK CO UNT Y, N. Y. � .�..
11111EWATER MGT.
1000-25-04-11.10 LOTT
SCALE: 1'=40-1 VACANT
MAY 11 , 2016
JUNE 27, 2016 (REVISIONS)
MAY 14, 2018 (PROPOSED HOUSE)
MA Y 25, 2018 (WELL LOCA TED)
JUNE 5, 2018 (CO DETAIL)
JULY 26, 2018 (SCDHS COMMEN TS)
AUGUST 9, 2018, (REVISIONS) N87'40'40"E(REVISIONS) 173.66
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(2) 8' DIA. x 6' DEEP LEACHING POOL (LP)
(1) 8' DIA. x 6' DEEP EXPANSION POOL (EP) OO
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VACANT �
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= HYDRANT
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PERMIT FOR APPROVAL OF CONSTRUCTION FOR
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/LST HOLE DATA
ATS � � U �S.!?,_ . 7�
McDONALO GEOSCIENCE `^-��,.,,,,
03-09-16 APPROVED Z'��,.
16.0'
DARK BROWN LOAM OL '
0.5'
TOTAL MAXIMUrA BEDROOMS
BROWN SILT ML
EXPIRES THREE YEARS FROM DATE61F APPROVAL..
3'
BROWN FINE TO COARSE SAND SW
10'
PALE BROWN FINE MEDIUM SAND SP
14.4'
Water ,i e( ST Be Ined' The-
WATER IN PALE BROWN FINE MEDIUM SAND SP Suffolk County Dept. Of Hea1,1hS-enAv5&
17' Ca-11 852-5700, 48 Flours in Advance, 1
NOTE.- WATER ENCOUNTERED 14.4' BELOW SURFACE TO Schedule InSpecfion(S). ® a.
f- NEW
LOT NUMBERS REFER TO "MAP OF ORCHARD STREET FARM
FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE
ELEVA77ONS & CONTOUR LINES ARE REFERENCED TO NAVD 88 ON FEB. 23, 2007. AS FILE N0. 11498.
ANY AL7ERA7701V OR ADD177ON TO THIS SURVEY/S A VIOLATION
OF SECTION 7209OF THE NEW YORK STATE EDUCATION LAW. I�
LIC. NO. 49618
EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CER77FlCA77ONS
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IFPECONIC SURVEYORS, P.C.
SAID MAP OR COPIES BEAR 7HE IMPRESSED SEAL OF THE SURVEYOR ' (631) 765-5020 FAX (631) 765-1797
WHOSE SIGNATURE APPEARS HEREON. P.O. BOX 909
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