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ELIZABETH A. NEVILLE MMC Town Hall 53095 Main Road
TOWN CLERK �` kx P.O.Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS a P ���
, � ��" Fax(631)765-6145
MARRIAGE OFFICER araw`
RECORDS MANAGEMENT OFFICER ' u "� Telephone(631)765-1800
FREEDOM OF INFORMATION OFFICER zl� r" www.southoldtownny.gov
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Southold Town Clerk's Office
DATED: January 6, 2021
RE: Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 4932 for a Cesspool/Septic Tank Construction
Permit submitted by:
Ioannis J. Zoumas
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. ox 1179
". Southold, New York 11971
REGISTRAR OF VITAL STATISTICS tv Fax(631) 765-6145
MARRIAGE OFFICER
CORDS AGE T OFFICER Telephone (631) 765-1800
F INFORMATION OFFICER sotolto . ortfor . et
<y
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION
r ALTERATION PERMIT
CESSPOOL r SEPTIC TANK
esietil /or Non- si etilApplication .
132-
Permit .
. . !.. ,.r"_�.m.. .......
Applicant Mailing ddres _ a_,R " _.._.�J _. "
Septic Tank—.",-or Cesspool
t ..... ........ —. _ � at� ��
Proposed Construction r
� �
Brief L�escrM �tw �.. +; _� .:m. �__ �.�� . ... ��� w .... ..........
ono ro
Location of Proposed Construction/Alteration:
Owner of property: .�..� . �� .._...... ........._..
Owner Mailing Address:. __.. _ �, �� �m . ......��... ...
Owner Property .ddress:__ _ .. _ � M . ..( .. - .... ..__..
....
Name pone number of contact ..�...�. ��
person ... �. �. . _..m... � " . ...
Tax Map No: Section ...... .. .. Block _ :Lot
Cross Street _- ���"�_ "��r- - .........__ ......
NOTE. LOCATION MAP MUS"I. BE SUBMITTED u11 APPLICATION. NEW
CONSTRUCTIONAFI ,S SI. RVR ' ITIS I1 Al EPARTMENT APP O"P"AL
ignature of Applin r . a�
.eceived. by.
Town of Southold
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Date: 01/06/21 Receipt#: 277176
Quantity Transactions Reference Subtotal
932 $10.00
1 Septic Permit-Construct- Resid
_ Total Paid: $10.
00
Notes:
Payment Type Amount Paid By
CK#1201 $10.00 Zoumas, loannis
Southold Town Clerk's Office
53095 Main Road, PO Box 1179
Southold, NY 11971
Name: Zoumas, loannis
2050 N Country Road
Wading River, NY 11792
Clerk ID: JENNIFER Internal ID:4932
EXISTING LEGEND
GRADE
9.0T:TOPSOIL E-1 PROPOSED BUILDING
Ld Dwaqllll 1111 ulrc��aurlwl',cvlltlflln�I Requilo ed
LOAM PROPERTY LINE 0 1! 1 SNlhiiinH 111,11 oI 114 A Cui 11 1 w,fll imiiii 11 oii
8.57 PROPOSED—HALT L, ........................ ............................................----------— ----------------------
15 6.57'SAND PROPOSED CONTOUR 111w In"I'dl;Rionalli9 r lmt�11,t1cm ell'11i �wvlaI7,1,Dkjpmal Sy^,tvlll
3.5 5.57' —11,0—EXISTING CONTOUR N _0 3� I ho I ol I I I wwlM 0�l
PROPOSED i ---------- -------------—-—------------...----------
P� wPROPOSED HYDRO-,ACTION I/A OWTS MODEL AN-5DD 0 o
SANDY CLAY U'G........ t a-
ii PROPOSED SANITARY LEACHING POOL ELECTRIC
4.07' PROPOSED SAMPLING/DISTRIBUTION MANHOLE SERVICE SUIll �OLK CCAPM( 1)11[��PA�RlMll[�A411 0111 �`ill[��ALHH SC�11:hhrll��S
PROPOSED FUTURE EXPANSION SANITARY LEACHING POOL
SAND F�'[�RN 11 �Fo�:� A�:� OVAII O� COINSTFU I A
—S—PROPOSED SANITARY PIPE
PROPOSED 8'ADS ROOF DRAINAGE PIPE kj y
7' 2.07' SHV31-11: Y III �Rll SUll M IF 0II
PROPOSED 10-0 DRAINAGE STRUCTURE(SOLID COVER)
PROPOSED WATER SERVICE
SAND, GRAVEL
9 TEST HOLE LOCATION 4v 12/ 2020
EX UNDERGROUND WATER ,' , -), R-20-1567
DA 1`1 S� F?Er M
91 0.07-(WATER ENCOUNTERED)
C'�
Appp
1.2' (HIGHEST EXPECTED GROUNDWATER F 0 R r"Al I I �'v'l 5 Bt ii)ii�cN,)iiviis
AS PER WELL 547234.1)
TEST HOLE ll--M�'IRE" u u NII II IIYEAll�R :lIII_R0lM IATE OF AI:1-)IRO'VM
N.T.S.
.................................- .............
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
BUILDINGS:
PROPOSED 2 STORY RES DENCE
4 BEDROOM
ZONING
R-40 (RESIDENTIAL)
SrrE DATA*
k SCTM#: 1000-090-04-03
� � e ���� ,���
� » _ g SITE ARA 0.666 ACRE
GENERAL NOTES:
I, THERE ARE NO KNOWN WELLS'DEEP OR SHALLOW)WITHIN 150'OF PROPOSED SANITARY STRUCTURES-
2 THERE ARE NO OWSTORM DRAINS WITHIN 20 1 OF PROPOSED CESSPOOLS.
3: THERE ISA WATER MAIN AVAILABLE ON OAKWOOD DRIVE
4. PROPOSED rAIS DESIGNED FORA TOTAL OF 5 BEDROOMS,
GARAGE 5. TEST HOLE SPAE` Fy
RFR?MED`SlTE` IS
TUYL ROOSUCK,P.C.ON 7-27-1981.
F.F.E.=l 1.6' SURVEY NOTES:
1. MEASUREMENTS ARE IN ACCORDANCE WITH S.STANDARDS.
// 2- BEARINGS SHOWN ARE IN NEW YORK STATE PLAN COORDINATE SYSTEM,LONG ISLAND ZONE_
/��, / ��
3. ELEVATIONS SHOWN HERE ON REFERENCE NAVE)4. TOPOGRAPHICAL SURVEY PERFORMED BY LKMA ON 9/30/2020
5. PROPERTY SURVEY PERFORMED BY VAN TUYL RODERICK,P.C.ON 7-27-1981
PROPLED 2 STY w ... ......... ......................................................................... -------
R[SIDENCE
00 5 BE!DROOMS W/
UNFINPRO
PROlICT 1JDCAlIJDN
POSED
F.
BASEMENT WATER
E. 13.6' N SERVICE
10"IfUt 10, IN.. 0
0
0
FrII0
0 - 01
i 0.
CL
0 1 ST Fri
—3.MIN
7%
10 Ds
a
2
0- LP
PROPOSED
SANITARY ALARM 5'
CONTROL PANEL NN
-4 P LP MIN-
—---- ------ ..............
L P LP LOCATION MAP
ELECTRIC FOR SCALE: 1 =±1,000'
PROPOSED U.G.
E =Aam —;;�, 4Z- FE
HYDRO-ACTION
0 SEPTIC TANK LP
F
I - 10/26/20
FE 0, DATE MF UPDATED FLOOR PLAN CFD BY
ave � 4 G
REVISIONS
......................................... ... ............... --------------------
505 LAKESIDE DR. N.
Exr)�\o�i iai+� ii,Nsllll rHON ?,Ff,,4.RI1RLlD 5MIIjQJmQ_NY_J 1971
E 0 Fu� �3AI,�HARY SYSN M
PROPOSED RESIDENCE
BY �FAI i� Di PANUkll N1
%
0- N, PROPOSED SANITARY PLAN
. ....•
..................... .................................
0 ........ -. ......
0
CII 0 L. K. McLEAN ASSOCIATES, P.C.
0 0 CONSULnNG ENGINEERS 437 SOUTH COUNFRY RD-BRODIGIAVEK.NEW YORK 11712
clj c� Z S61* 15'� 50"W D.e.sig.nod%r.
c� MF/CFD swe: AS NOTED
0 N60' 201 30"W PLAN
' SITE P 170.14' PAUL GILWIN 0—W. MF Dte: OCTOBR 2020
0 SCALE: 1"=20' DEVELOPED s 1
PUSUC WATER App—d Ebr. RGD Rl.N.. 20102.E 000
a_ 1 5MI