HomeMy WebLinkAboutAriizumi (2) ELIZABETH A.NEVILLE,MMC �_ Town Hall,53095 Main Road
ny
TOWN CLERK P.O.Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS Fax(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: Sabrina Born,Southold Town Clerk's Office
DATED: November 7,2019
RE: Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 4812 for a Cesspool/Septic Tank
Construction Permit submitted by:
Hideaki Ariizumi
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
REGTSTRA-R OF VITAL STATISTIC Southold,New York 11971
MARRIAGE OFFICER 'F Fax(631)765-6145
RECORDS MANAGEMENT OFFICER Telephone(631)765-1800
FREEDOM OF INFORMATION OFFICER soutboldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$101 or Non-Residential @$25 Application No. J0
Permit No.
jj
Applicant Name dl 0 6d C e- '2- 1 1 1
Applicant Mailing Address F C) X 4-
-7
r) L
Septic Tank or Cesspool
Brief Description of Proposed Construction or Alteration - P,,c't-i"t, e7
Location of Proposed Construction/Alteration:
Owner ofPrope-rty:-,- 11-3o 10-,�`rva-'_.
Owner Mailing Address:
Owner Property Address
Name and phone number of contact person
Tax Map No: �Do o Section
t Block Let
Cross Street I A
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION RE-QUIRES SURVEYWITH HEALTH DEPARTMENT APPROVAL
-7( '7,o(T3
Signaturbof Applicant Date
Received by:
GREYWATER OVERFLOW PIPE FROM
LINE FROM
4"WASTE BLACK WATER SEPTIC TANK GREYWATER SEPTIC ABBREVIATIONS: :3
114"PER 12" TO GREYWATER SEPTIC TANK PROPERTY TAX MAP#:1000-31-12-9
0
SLOPE MIN. TANK TO LEACHING PIT PROPERTY OWNER:
LYNS BERRY,
BLACK
d"WASTE 4 @ AT�'WASTE & AND NAME: EDTH BERRY,G
AND HIDEAKI ARIIZUMI
C9
WATER 1/8"PER 12"SLOPE MIN. 1/8'PER 12"SLOPE BW BLACK WATER PHONE: 631 323
4"WASTE MIN. CONC. 6
STI ST2 •
LP CONCRETE E-MAIL glynis@studioalb'architects E
114"PER 12" BLACK WATER G.O. CLEAN OUT 0
SLOPE MIN. GREYWATER B'DIA.X 12'DEEP STREET ADDRESS:
SEPTIC TANK SEPTIC TANK E or ELEC. ELECTRIC 1330 TRUMANs PATH
ELEV.or EL. ELEVATION
10.0.+1 GW EAST MARION,NY 11939 U)
FL LEVEL+22.9 GREYWATERwl
10-0'*/ 10.61
zo GRADE ELEV. HOPE HIGH-DENSITY LOT AREA: 6,812 SF,0.16 ACRE
_r:r,016 1
iv 20.0' POLYETHYLENE ca
C�
ni LP LEACHING POOL OR PIT SANITARY SYSTEM DESIGN: <
MAX. MAXIMUM
MIN. MINIMUM
HOUSE TRAPS—1' #OF BEDROOM: I
N.T.S. NOT TO SCALE SEPTIC TANK CAPACITY: U)
FOR EACH GRAY AND REQ. REQUIRED
A GREYWATER AND BLACK WATER
BLACK WATER LINES
SCDHS SUFFOLK COUNTY
1,000 GAL.EACH
DEPARTMENT OF LEACHING POOL:
LEACHING
HEALTH SERVICES (1)-8'DIA.X 12 FT
PIT ST SEPTIC TANK
zotV W WATER
c6
FFOLK COUNTY__DVWEFARTMZN1 F r—A -1 H TsFRVICET
UU W> <
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Z� Z� >' TEST HOLE DATA
LU z
w LU LU LU SM;LE FAwuf 111-:51DENCE ONLY
Sanity S stem Section Dia ram g � by McDonald Geoscience
date:Jan.2,2017
El j"
j
SITE .Dark Brown loam OL
S BEDROOMSFOR Maxyl. of Brown silt ML L.C" 46,
S! OF DATE Of APPROVALFINGERS \ $'
BASED LK ON (PUBLIC ER) —
GRAVEL DRIVEWAY OF
SUFFO7
COUNTY
N®4 0S 40' VICKY PAPSON Pale Brown fine to
IS DATA / -
REVOCABLE
G Coarse sand SW
(PUBTRUST
3.0 TER I - '_'-' _: .'
FLELEV. LIC WATEtA)
WATER_1z:_r)WMA N
6
N
/F
F, 110
LAND P0 Lj
aaaEt( ELEV. EXISTING EE
OF 1FL, 4r 17'
GW RA -10.01
FINGLAS tj STORA /YC4 Olt com is No water countered a 2
2STORY C�7 f';
(PUBLIC WATER) 'U BLACK
FRAMED H2O HEAVY DU
HOUSE GAL Hole ata
LP 60%EXTENSION
10.01 V
M-ATOMARIONWHEN EXTENSION IS NEEDED
LAKE _� 0
ti 4
ROPOSED N TREE NEEDS TO BE CUT
To
.WATER U
DRY'Al-LO.
-81 GREYWATER ST
3: ENTRY PORCH S H2O HEAVY DUTY 1000 GAL
LAND NIF
4360LP 8'DIA.X DEEP
211 (D
OF
EDITH BERRY,
L)
GLYNIS BERRY,AND 8
HIDEAKI ARIIZUMI �L2� I RE f, Fs
S 64'05'40'W 117-SU
(PUBLIC WATER) i -
L11 L)
LAND N/F TEST HO L MAY 3 0 2017
OF GRAVEL
REINHARDT DRIVEWAY E& SERWCES
ODICbr
(PUBLIC WATER) To
Sanitary System Layout 0