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ELIZABETH A.NEVILLE,MMC 11
�a Town Hall,53095 Main Road
00
TOWN CLERK P.O.Box 1179
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V P 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 �'� 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: February 23, 2021
RE. Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 4943 for a Cesspool/Septic Tank Construction
Permit submitted by:
Kim Sperling for Do an & Karen Baruh
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. VIL Town Hall, 53095 Main Road
TOWN CLERK . P.O. Box 1179
REGIST OF VITAL STATISTICS Southold,New York 11971
GE OFFICER Fax(631) 765-6145
RECORDS AGEMENT OFFICER Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
OFFICE OF TIRE TOWN CILERK
TOWN OSOUTOL
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$10_X or Non-Residential @ 25 Application No.
Permit No.
Applicant N e ' Lrn1G-
Applicant Mailing Address 26C J?
._.........
Septic T or Cesspool
Brief Description of Proposed Construction or Alteration q �_.
Location of Proposed Construction/Alteration:
Owner of Propeity: ( _ I _.. IeA.��..... „_.
Owner Mailing Address:_ _ i _ ............
� N .........ilzol..... _._.....__..... ..... ..._.
Owner Property Address:__"o ............ ..........
Name and phone number of contact person k 5 w 06-
� 1
Tax Map No: j000 Section J'9 Block Lot�IT
Cross Street Ma.)
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SUR17EY WITH HEALTH P TME 'T APPROVAL
Signature of Applic t Date
Received by: ___
Town of Southold
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Date: 02/23/21 Receipt#: 278092
Quantity Transactions Reference Subtotal
1 Septic Permit-Construct- Resid. 4943 $10.00
Total Paid; $10.00
Notes: 400 Youngs Rd, Orient, NY 11957
18.-2-19
Payment Type Amount Paid By
CK#12683 $10.00 JNS Contracting
Southold Town Clerk's Office
53095 Main Road, PO Box 1179
Southold, NY 11971
Name: Sperling, Kim
256 Route 25 A
Wading River, NY 11792
Clerk ID: JENNIFER Internal ID:4943
S.C.T.M.# DISTRICT 1000 SECTION 18 BLOCK 2 LOT 19
S U F FLK E0UI� E"—PA R"T—Al E"3„, OF �"A&,.Tli SERMs
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EXPIRES THREE E Yk A FROM DATE OF APPROVAL \ /
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DWELLING
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�L WATM
DWEUJW / / WELL OVER 150'
.�... .. . . . .W . ... , rAML WATM
LP OWELL
/
WELL
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/ LAND N/F OF
/ 2a-® ANN SOITO
DWEUJNG DWELLNGLP
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aa� 1 L X25.0 /
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\ \ ' �' E EL 23.5
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\ Q425.0) 1 h 10'Ox13'DEEP L.P.
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\ EL(25.0) LP *%* ti
\ EL 26.2 h 10 2 3 EL 4.0) Exp
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EL 25.0 '2 STY
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PROP. ' �E 22.5
LIQ ® WELL 4WaTl:R U E ' 1:7O° LAND N F OF
EL 5.0) r .a m '
/ 1 w. � OYSTERPONDS UNION
WELL
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WELL
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Et 28.0 ANN SOITO
WAVELL WATER
DWELUNG PIPE
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Et 24.2 92 WELL LOCATED ON FARSIDE
2'
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MON. OF SCHOOL OVER 150'\ 2«�
\ 1 SJL7'�aWYOE NIW PROPOSED
srosPEE AM �
4
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� I � � 1,9,3. EL 22.5
\ I ~
MON.
LP I WELL I
\L OWAUU WATER WAVELL WATER
DNOREGATFOM CHURCH
WAVEU WATER
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I ®” SEPTIC OVER 150' F --
LP
o wElL DWELLINGI
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WAVELL WATER WAVELL WATER
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SEPTIC OVER 150'
I Id
/ .._._... ......... .� .-._._, ,..�... ,.�.� ,..� -. .._ ..�. ...�.. -�._. .. � 180' `— —
i
CWEIL / o
LP
ELEV. 25.0
MAIN ROAD OL MIX
30'MK
SUFRCIENT TO KEEP
SC LAYEY SAN BROWN SEDIMENT ON FATE
BAI
DRAINAGE CALCULATIONS: 5' ,'SILT FEN`CI c°�°R
TYPI6IL SILT A) FOOTPRINT W/COVERED PORCHES= 2,301 SQ.FT. PALE "
2.301 x 0.166=382cf REQUIRED SP FINE
SAND
cEDTEKr�E vABRIC�-. (2) 8'DLA x 5 DEEP DRYWELL 442cf PROVIDED b
"—
WOW OR WErAL B) GARAGE= 576 SQ.FT. 9.5
576 x 0.166= 96cf REQUIRED PALE
(1) 8'DIA x 4 DEEP ORYWELL=177cf PROVIDED Sw MED c ra TR'ICTON MmT, �f 0
EIfGYATm AND
BACKRLLFII TRENCH�. OVERSIZED FOR POOL WASTE WATER STONE BLEND OR R.CA,.
TO SAND COARSE Fri TO 18" (Wnj �, EVSTINO GRADE , � bft ADE;
C) DRIVEWAY = 2,430 SQ.FT. �� ""
2,430 x 0.166=404cf REQUIRED ILE & GRAVEL
2021
(1) 8'DIA x 10' DEEP DRYWELL=442cf PROVIDED
xi a
ZONED R-40
NON—CONFORMING LOT e
FRONT YARD: 40' MIN THE WATER SUP "T; I fiaa„'(JRYJiLL A iO ��Otx
SIDE YARD. 15-MIN (35' TOTAL) LOCATIONS SHOWN ARE FROM RELD OBSERVA77ONS
REAR YARD: 50' MIN 7' AND OR DA TA OBTAINED FROM OTHERS.
TYPICAL ORYWEU_ CROSS SECTION
(om, PRECAST COMPONENTS) K.WOYCHUK AUG 5, 2020 EIEVA77ON DATUM: NAVD58
ESM AREA: 23,902.56 SQ.FT. 0.55 ACRES
TYPICAL CLEAN OUT �'U° + c :a L,,,,,U eft UNAUTHORIZED ALTERA770N OR A00177ON TO THIS SURVEY IS A VIOLATION OF SEC7701V 7209 OF 7HE NEW YORK STATE EDUCA77ON LAW. COPIES OF THIS SURVEY
WL,e ok ,� a MAP NOT BEARING 7HE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
Baa wrE CABG a�� Nr�
mw m11r1l alCm+ /+' ONLY 70 THE PERSON FOR WHOM 714E SURVEY IS PREPARED AND ON HIS BEHALF TO THE 777LE COMPANY, GOVERNMENTAL AGENCY AND LENDING INS17TUT70N
SLATE OR STOPPER END LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INS71TU710N, GUARANTEES ARE NOT 7RANSFE'RABLE..
SUITABLE COVER OR PLUG ® � 7HE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
Q 0 0 0 NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE EREC77ON OF FENCES, AD017IONAL STRUCTURES OR AND 07HER IMPROVEMENTS EASEMENTS
AND OR SUBSURFACE STRUC7URES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHY57CALLY EVIDENT ON THE
/ PREMISES AT 714E 71ME OF SURVEY
SURVEY OF:DESCRIBED PROPERTY CERTIFIED TO: McCARTHY MANAGEMENT INC.;
30' ELBOW MAP DOGAN BARUH; KAREN BARUH;
60' WYE FILED:
SITUATED AT:ORIENT
X Md g ��
FLOW CLW Sura AM GRAVEL SUFFOLK COUNTY NEW YORK KENNETH M WDYCHU ILD SUR YI IPLLC
BACK FU 4ATERaAL TO BE TOWN OF: SOUTHOLD
Professional Design
REVISED 01 -15-21X.& 153 Aquebogue, New York 11931
REVISED 10-26-20 FILE /220-81 SCALE:1"=30' DATE: AUG. 5, 2020 PHONE (631)298-1588 FAX ( 1) 290-1568
N.YS, LISC. NO. 050682