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ELIZABETH A.NEVILLE,MMC � � �� ,
°� � � Town Hall, 53095 Main Road
TOWN CLERK "= P.O. Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS4�° Fax(631)765-6145
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MARRIAGE OFFICER �+� � �' ,� Telephone(631) 765-1800
RECORDS MANAGEMENT OFFICER r
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FREEDOM OF INFORMATION OFFICER { www•southoldtownny.gov
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Southold Town Clerk's Office
DATED: September 18, 2019
RE: Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 4785 for a Cesspool/Septic Tank Construction
Permit submitted by:
Meryl Kramer Architect for Andrew Fohrkolb
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.NEVILLEp,„� ""� Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER Fax(631) 765-6145
RECORDS MANAGEMENT OFFICERTelephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER JO "� 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 Nanic
Applicant Mailing Address
Septic Tank X or Cesspool
Brief Description of Proposed Construction or Alteration
Location of Proposed Construction/Alteration:
Owner of Property:
Owner Mailing Address:
Owner Property Address:
Name and phone number of contact person
Tax Map No: Section Sol , Block Lot SO
Cross Street
NOTE
LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
®CONSTRUCTIONS II ,Y WIT IDEPARTMENT APPROVAL
a
)
Signatur o Applicant Date
Received by:
h
S.C.T.M. NO. DISTRICT: 1000 SECTION:137 BLOCK: 4 LOT(S):30 -
s _
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eXOUNLI4RY€. EL€V:28.9
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a OL 0LOAM
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taU� `3 g "' ° 5 BROWN
M SILTY SAND 4.0'
-IIS, > s
r
TYPICAL SILT _--i11810 E la P \` �2X PALE
cT'R N S TION $ \ �'
4 For 'j \ 1 F BROWN
ForFINE
CEUTEx FABRIC 1 3 ~
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41L
WOOD > 1, :;r 'a ,.-E,=FROM r _ \ MEDIUM
WDDD OR AL Pd" -.\`l\ > ') SAND
FLOW DIRECDONMMIM&RUL 3an lls�
NO / ar A oT JID'
EXCAVATED AND i
To
AT A#SEI OF SC AL3}M Bi a
eACImuED TRENCHI-T�'.= t €USMNG ISTY FRN.
Exlmrw GROUND `;=« g i BLDG. aE i
iT ` f a PROPOSED \\ No WATER
t+1IFI�III� 1� II f 10'ROE03-26-1817'
EL�Tav"I { NOu-nrRF BUFFER \ S ci
,§ MCDOWdD GEOSCIENCE
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: f
mengs
a ) PROPOBEO
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P OPOSEP '
pwm sum moo �g° 'a PR r f +7 . DRAINAGE CALCULATIONS:
a$' pRo E 1,- T rI Afl r f MCN A) PROP. HOUSE W/COVERED PORCHES,
CELLAR ENL, SHOWER AND STORAGE: 2635 S.F.
2635 x 0.166= 438cf REQUIRED
329•E (2) 8'DIA x 5' DEEP DRYWELLS=442cf PROVIDED
} oR sT y OS as _ Eos M SANRARr To BE
ABANDONED AND BACKFILLED tB .
WITH CLEAN COARSE SAND. ) PROPOSED GARAGE: 363 S.F.
363 x 0.166= 61cf
f a.
\ cV s ,y; -- �B _. _` TYPICAL CLEAN our C) PROP. DRIVEWAY: 1470 S.F.
`rT
\ "0 1 4 'F SLATE OR 1470 x 0.166= 244cf REQ.
€f ` tr eulsT. WA'f MBFR SUITABLE COV OR P�END TOTAL = 305cf REQ.
m 41r To BE Rpavm (1) B'DIA x 7' DEEP DRYWELL= 310cf PROVIDED
aet ✓ a,'i0 THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL
m 5'I 30'ELBOW LOCA77ONS SHOWN ARE FROM HELD OBSERVATIONS
Sc1ELfIODo-LJs s ePROPOSED 80'WYEAND OR DATA OBTAINED FROM OTHERS,
MUM 26.7 5 BEDROOM
WtaL WHIR 1556 t,_ M F.1- SANITARY SYSTEM FLOW-0 NSIA'y ' t 1500 GAL S.T. AREA: 21,255.21 SQ.FT. or 0.49 ACRES ELEVATION DATUM: _
�L O nsuw WM �E�O D s {1)8'0X16' DEEP L.P. UNAUTHORIZED ALTERATION OR ADOI7TON 717 THIS SURVEY 15 A WOLA77ON OF SEC77ON 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY
ISR ,S{OH MAP NOT BEARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VAUD TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
Wa �.yL CPN• DAILY TO THE'PERSON FOR WHOM THE SURVEYS PREPARED AND ON HIS BEHALF TO THE RILE COMPANY, GOIERNMENTAL AGENCY AND LENDING INSTITUTION
0 V TOWN OF SOUTHOLD LOT COVERAGE LISTED HEREON,AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE
BASED ON UPLAND ARTA LANDWARD OF THE OFFSETS OR DIMENSIONS SHOW HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
CREST OF BLUFF,14,570 S.F. NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE EREC77ON OF FENCES,ADD177ONAL STRUCTURES OR AND 07HER IMPROVEMENTS. EASEMENTS
[ I EXISTING LOT COVERAGE AND OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY
I BLDG.W/SHOWER:356 S.F.
V SHED:98 S.F.
U.P. SURVEY OF:DESCRIBED PROPERTY CERTIFIED T0: ANDREW F
T i Si
TOTAL-454 S.F.or 3.iM I• ®HRKL7L8,
€ MAP OF: SHARON TUTHILL;
-,-ED LOT COVERAGE
G ` 356 PROPOSED HOUSE W/GARAGE,POU,000R SHOWER SITUATED AT:C
SHED:-98 S.F..F.(70O BE REMOVED)8E DEMOLISHED) 1
UTCHOGUE . I
&COVERED PORCHES:2824 S.F. I --}
Nam � TOTAL:2824 S.F.or-19.4/6 TOWN OF.SOUTHOLD KENNETH Td 'Wi3YCHLJK LLND SURYEYINO, PUC
REVISED MAR.18, 2019 WA's ram SUFFOLK COUNTY, NEW YORK r Professional Lend Surveying and Design
REVISED FEB. 21, 2019 too P.O. Be. 163 Aquehogue, New York 11931
REVISED JAN 31, 2019 Y ' PHONE(691)E99-1688 FAT[(891}E98-1588
REVISED DEC. 10, 2018 FILE N 18-36 SCALE:1"=30' DATE:APRIL=21118 --IV.YS. LISC. NO. 050882 mc/nftlWoB the reoordo of FlOnt J.Ban-7 k Kenneth M.Wopchok