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ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 53095 Main Road
P.O. Box 1179
Southold. New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
Boutholdtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential@ $10 )6 or Non-Residential @$25_
Application No3 fobS-
Permit No.
p.
Applicant Name J
Applicant Mailing Address
Owner Property Address:
?:-7JJ
tl tJ~l
Septic Tank or Cesspool_ .c--
Brief Description of Proposed Constructio~ or Alteration
-
Location of Proposed Construction/Alteration:
Owner of Property:
Owner Mailing Address:
Name and phone number of contact person 5~ Quo .t1l4v.....{..,
Tax Map No: Section tl'?-:;J Block 0 L Lot () S 0
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITT
CONSTRUCTION REQUIRES S EY WITH HE
WITH APPLICATION. NEW
H DEPARTMENT APPROVAL
ttth 61 n-u/
djt 10'1 ate ~
Received bYrrje hOQI o~f} a.).Jj.o 7
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall. 53095 Main Road
P.O. Box II 79
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown. northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTH OLD
-+.._-"
TO:
Southold Town Building Department
FROM:
Michelle L. Martocchia, Southold Town Clerk's Office
DATED:
February 7,2007
RE:
Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 3665 for a Cesspool/Septic Tank
Construction/Alteration Permit submitted by:
Susan Ouaranta
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.
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I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
~
DISAPPROVE
CO~O"" ~~~:~r-~-'<;#''''
J%c~~
Signature I J /
t/r/ ~8107
Dated' f
. 'KEY
~ Description
_______ 6 5 ~ Existing Contours (C.I. =2')
~ Proposed Contours (C.I.=l')
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N 78'11'20" E, 200'
R=21S' ,L=328.34'
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\, '\ -z- -Z- \ N/F / PROPOSED SANITARY SYSTEM 1,500 GAL. SEPTIC
\ % '?, \ 372 JERliHO TANK (8' DIA, X 5' LIQUID DEPTH) WITH HI
\ -0 0 CORF!'. DOME AND (2) 8' DIA. X 8' DEEP HING
" (lJ ~L ~ Lot #3 POOLS (LOC. OF FUTU SHOWN)
\ \ \~ 2, '> \ (Vac~nt)
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37/;; JERICHO
. CORP.
, Lot #18
~Vacant)
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PROPOSED
RESIDENCE
FFE: 71.0'
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~~~~g~~~\ \Dif.........<P.'".3
COOPER\ \j. ... .... \
" (UNPAVED DRIVE \ (~.
\ TO RESIDENCE \', :....,
900' TO THE\ \
NORTH OF \ \
"\ LOT #4) ._~\_.\\ -V~...::>;J\ ~
N/F / \ ~,:/ '..' ~'~~'I-
JOSEPH T".;" \ ,~..........\ /,",~'I-'O
MACi)Rf \ \ ~. \ ~' '? <::>
(VA<;;Ar(JT - \ \ ~ Non Disturbance
FARMLAND) \ \ \,.~ Natural Vegetation
\ \ \, \ Buffer
30'
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30' 0
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GRAPHIC
15'
I
SCALE
..~
Suffolk Co. Tax Map
District 1000 .
Section 113.00
Block 02.00
Parcel 058.00
Notes:
I. Area ofLot#4 = 35,095 Sq. Ft. (0.806 Acres) and is owned by 372
Jencho Corp.
2. Existing contours from Final Road & Drainage Plan as prepared by
Young & Young Land Surveyors ofJuly 30, 2004 and surveyed
January 28, 1992. (Datum: NOVD 1929 USC & OS)
3. Test Hole, proposed lot subdivisions, roads and water main shown on
Final Plat of The Fields at Matttituck - Suffolk Co. File Map#11370
of March 31, 2006.
4. There are no known wells within ISO' of proposed cesspools. There
are no known storm drains within 20' of proposed cesspools. There
are no surface waters within 300' of parcel. All SUlTOunding parcels
vacant within ISO' of property line.
5. Proposed Residence as per Model C - Architectural Drawings by
Axelrod & ChervenyArchitects, A.I.A., P.C. - October 2006.
6. Proposed Sanitary System is designed for a total of 6 Bedrooms.
SUFFOLK COUNTY DEPART:Y.ENT OF HEAlTH SERVICES
PERMIT FOR APPROVAl OF CONSTRUCTION FOR A
SINGLE FAMIL V RESIDENCE AND
: DATE I t-28..obH.S EF. N R lo-o6-oO'?o
l APPROVED .
TOTAL MAxiMUM BEDROOMS
.,?<,:,~~~~EE YEAR.!.F!C~~ ~~R~YAl
XCAYATION INSPECTION REQUIRED
FOR SANITARY SYSTEM .
BY HEALTH DEPARTMENT
"0" ()" .'CO.'
r'~' J. V LGJO
.'TO
DESCRIPTION
REVISIONS
Lot No "" at the the Fields at Mattituck
for 372 Jericho Cor .
Situate at Mattituck
Town ot Soutbold. Suffolk County, New York
Sewage Disposal System Plan
L. K. McLEAN ASSOCIATES, P.C.
CONSULTING ENGINEERS
4,37 SO. COUNTRY ROAD. BROOKHAVEN. NEW YORK
AFPROV. BY
-" LMY "". 11 = 30' "'......
nr..""sy, LMY Dote" Nov. 6, 2006 1
ApprovlPd By' JFC/CFD fhNo.. aSaJj.OOO 1