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Home My WebLink AboutGibbons ELIZABETH A.NEVILLE,MMC ;Hyp Town Hall, 53095 Main Road TOWN CLERK J ��u �� P.O. Box 1179 Southold,New York 11971 REGISTRAR OF VITAL STATISTICSu �� Fax(631)765-6145 MARRIAGE OFFICER �i3"w Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER �u4 �l � �' � www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER ' r ° OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Sabrina Born, Southold Town Clerk's Office DATED: April 28, 2021 RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4981 for a Cesspool/Septic Tank Construction Permit submitted by: Melissa Butler for Casey & Marissa Gibbons. 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: Fipal approval required from the S Liffolkm Count Health Department __........... Signature .a._...__...�.... Dated ELIZABETH A.NEVILLETown Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 02 Southold,New York 11971 REGISTRAR,OF VITAL STATISTICS 0-0 MARRIAGE OFFICER Fax(631) 765-6145 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---Z' or Non-Residential @$25 Application No. Permit No. 'EA Applicant Name, ...... Applicant Mailing Address s Brief lies tion of Pro Deed Construction or 1 t a akic Septic p Location of Proposed Construction/Alteration: Owner of Property: CAmm� � � S Owner Mailing Address: .. . . .. Owner Property Address: AAJd Name and phone number of contact person --A 6QTZ,��- ) Tax Map No: Section ._. -f3 _Block_ �.._�.. Lotj. ..�....� Cross Street _ NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY PARTMENT APPROVAL 6 Signature of Applicant Date Received by: ,,, COUNTY OF L STEVEN BELLONE SUFFOLK COUNTY EXECUTIVE DEPARTMENT OF HEALTH SERVICES GREGSON H. PIGOTT, Commissioner PERMIT CONDITIONS Project Name: 1380 Orchard Street Health Services Reference#: R-20-1998 SCTM #: 1000025000400011001 Revision #: 1 The attached plan, when duly signed by a representative of the department, in conjunction with these conditions, constitutes a permit to construct a water supply, sewage disposal, and/or collection system for the property as depicted. The applicant should take note of any conditions of approval, which may be indicated on the plan or enclosed herein. Construction must conform with approved plans as well as all applicable standards including Standards for Approval of Plans and Constructionfor Sewage Disposal Systems for Single FamilyResidences. Omissions, inconsistencies or lack of detail on the plan do not release the applicant from the responsibility of having the construction done in conformance with applicable standards. Issuance of this permit shall in no way relieve the design professional of responsibility for the adequacy of the complete design. The permit (plan) expires three (3)years after the approval date. Any modification to the approved design requires the submission of a revised plan and additional fees (if applicable)for approval prior to construction, No inspections will be performed y the department if a copy of the approved site plan/survey is not on site during construction or if the permit has expired. Permits may be renewed, transferred, or revised in accordance with the procedures described in Instructions to Renew, Extend, or Transfer an Existing Permit for Single FamilyResidences(For -104). It is the applicant's responsibility to schedule an inspection of the sewage disposal and/or water supply facilities prior to backfilling. This includes inspections of the sewage collection and disposal systems, water supply system components and piping, and final grading as shown on the approved plans. This can be done by calling the department at(631) 852- 5754, or through the ACA Portal atl � .E� k �uu�1.y�r�v Ci i riAccs . In certain cases, inspections of the soil excavation may be required to determine the acceptability of the soils for sewage disposal systems. Excavation inspections must be confirmed y calling ( 1)852-5700 between : 9:30 .,the morning of the inspection.Article VII of the Code, "Septic Industry i ," requires that all installers of septic systems within shall possess a valid license from the Office of Consumer Affairs. This office will not perform inspections for or grant final approval for construction of projects that are installed by an unlicensed individual. It is, therefore, in your best interest to utilize a cesspool contractor with a valid license to avoid substantial delays in your project. Final approval issued by the Department is necessary prior to the occupancy of new buildings, additions t existing buildings, or for the use of sewage disposal or water supply systems. W W M-016 Page 1 of 2 Y� IIV_P11 I-. Yllll %1) MODEL No.GEM,GRAVITY 5Y5TEM \(www TREATMENT GAPAGITY: 100 6PD TL. HORKIN6 GAPACITY, I,ObQ 6AL J FLOW RANGE: 50-100 6PD W MAINTAIN REQUIRED SEPARATION 1)15TANCE5 SEE DETAIL FOR INFORMATION,DW5 SP2 ANITARY LEA CHING POOL SIZING: EN6INEER: iR SL.DH.5.DIVISION OF ENVIRONMENTAL QUALITY w ANDARDS FOR APPROVAL OF PLANS AND C.ONSTIWTION FOR SEWAGE DISPOSAL SYSTEM iR SINGLE-FAMILY RE51DEW-E5 kTEDI DEGEMBH2 29,2011 M, ODUIREMENT PER TABLE 51 VIM H LEACFHNG SYSTEM FOR A 5-6 BEDROOM RE51OBTIAL PRO.EGT 41HJK LEAGHIN6 SYSTEM(400 SQ FT SIDEWALL AREA) cr MINIKIM 50%EXPAND®SYSTEM(b00 SOFT.51DEHALL AREA) Lu waw � ANITARY LEACHING POOL DESIGN; (2 °q: � k �. r AGHIN6 SYSTEM FLOW REQUIREMENT: � / �ryr° 00 SQ.F7 LEAGHIN6 AREA/25.0'SQ.FTAERT FT= 16 VERT FT REQ'D " JEFFREY REY T. E(JTLER, P.E. U&V x b' EFF.DEPTH LEACHING POOLS (� IN.LEAGHIN6 AREA REQ'D' = 400 SOFT.OF 51PENALL LEACHING AREA J IDE WALL LEAGHIN6 AREA PROVIDED = 400 5F O 160 x 8'EFF.DEPTH LEACHING POOL O' IN.LEAGHING AREA REQ'D' = 600 5Q.FT.OF 51DEKALL LEACHING AREA d' IDE WALL LEAGHIN6 AREA TO BE PROVIDED UPON EXPAN51ON =600 S.F 0 Z . . Z 0 CQ DRAWIN6 5P2 FOR SANITARY 5TRIGTURE/COMPONENT DETAILS � Lu O Q :< O )TE: W � ESE PLANE,ARE DESIGNED TO COMPLY HIT14... 0O IOFF161AL COMPILATION OF CODES FdAE5 AND REGULATION OF THE STATE OF NEW Lu w O Q TRK TITLE 10 DEPARTMENT OF HEATH.CHAPTER II.PART l5.5TANDARDS FOR DIVIDUAL ON51TE WATER SUPPLY AND INDIVIDUAL ON51TE WASTEWATER TREATMENT Q (y/ N (STEMS. APPENDIX 75-A 0 GDAS. STANDARDS FOR APPROVAL OF PLANS AND CONSTRUCTION FOR SEWAGE In � O 15POSAL SYSTEM5 FOR 51NGLE-FAMILY RESIDENGES-DATED 12-24-2011. Lw N (Y O � SCDHS REF. No. O uO (3 I v # � O O c�sl O 0 — .. .IyC �:ul Z W z C 1f' Q k �' $I � I m�i..l I hu 1�,�"Pf,I �; O --7 ONLY I PAGE: DATE 12/31/20 K.S. 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