The URL can be used to link to this page

Home My WebLink AboutLange, Heidi RLIZABETH A. NEVILLE TOWN CLERK Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.northfork.net r~. \ REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER _--:-~:-:~'\ . ..;~;. (1. \ c \ \. \ \ ',1 .' \ St\J 1. \) '. \~. . ~~-'~i}::~ihJn Building Department __----r{", OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD 'fO: ........... \ t \\~e- \_~.-~.- FROM: Michelle 1. Martocchia, Southold Town Clerk's Office DATED: September 26, 2007 RE: Cesspool Construction/Alteration Application Transmitted herewith is a copy of application No. 3744 Construction/Alteration Permit submitted by: Fidel Zabik for Heidi Lanl!e for a Cesspool/Septic Tank Please review the application and location map and advise if this office may issue the permit. Please complete the foml 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 / DISAPP~ " Comments: ,-~~/./>>K~~~~ ~u:: T~ Signature ~ ()1 h/'7 Dated / / 09-18-2007 15:02 SOUTHOLO BUILDING DEPT 16317659502 . hdef 41o;f6 PAGEl EUZABETH A. NEVlr,LE TOWN CLERK REGIB'fl\.AR OF VITAL BTA TlSTICS MARRIAGE OFFICER RE(JQRDS MANAGEMEN'l' OFFWER FREEDOM OF INl"ORMATION OI'r'Wlm ~Town Hall, 68095 Main Ro8' P.O. Dod179 Southold, New York 11971 Fill< (681) 765.614.5 'I'ol.phono (631) 765.1800 ,otltholdtnwn.northfoJ'k.l1nl OFl<'ICE OF THE TOWN CLERJ{ TOWN OF' SOU'I'HOLD SOUTHOLD WASTEWATER DISTRICT AT'PLICATION CONSTRUCTION or ALTERATION PERMIT CJ;;SSPOOL or SET'TIC TANK / / Residential @ $IO~ or NOll-Rc;;idcnlial @$25 Application No. '3 7 YLj Permit No. I \ .' . Applicant Name~!?:l/'.._~Ik:/ (7-1)/ ).~~co Applicant Mailing Addrcss_._6~~ ~~ NbfJl i'BU'7 "JPjlJ ~,~ ~.f_~ "!<{~ ~&Ol7_ Septic Tank ~ or Ce,~spool,. . . Briefl)cseriptioll ?fProp()~tructioll or All.emlion__ .__ ~ ~~ . ..~l'W~_.(JN V'~~= Location ofProJloscd Constmclion/Alteration: Owner of Property; f1E;;i-t> i _~U/ _'_ _ Owner Mailing Address: I'~~ ~ 6b1'lr~_.~e ~__~t-J'1. ICV~ OwnerProper1y Addfess:___~1~ ~vV~~ ~ I -- . ----~ ~'1' W151 '_u_~ Name and pholle munber of contact persoll.1L~~I7!J<.--.- (pt ~~~C1O tel:iO-tt!>-'~ 6 of"#;;> Tax Map No: \ Section {~ IlIock 3.. Ul( __...P.~fl Cross Street ~ ~ ~- ..... ..-------~ NOTE: LOCATION MAP MUST BE SUBMITI'ED Wll'H APPLICATION. NEW CONSTRUCTION REQUIRES SURV!tY WITH HEALTH DEPARTMENT APPROVAL ~ .Pf'~1 Data Receivedby. ~~~'r:?~ .f1\o-\P. GLUCKMAN MAYNER ARCHITECTS 250 Hudson Street New York NY 10013 tel 212.929.0100 fax 212.929.0833 24 September 2007 Office of Town Clerk Town of Southold 53095 Route 25 P,O, Box 1179 Southold, New York 11971 Re: Application for Septic Permit Lange Residence, 1985 Edwards Lane, Orient, NY Property Description: 1000-18-3-6,13 Dept of Health Services Ref #: R10-03-001 To Whom It May Concern: We are seeking a permit for a residential septic system for new construction on behalf of the property owner Heidi Lange, Please find enclosed a completed application for a septic system permit for a new 2 bedroom residence at the location noted above, Enclosed also is one (1) copy of the current site plan as approved 14 September 2007 by the Suffolk County Department of Health Services, Should you have questions about the application or require additional information or clarification please do not hesitate to contact us, Sincerely yours, I COUNTY OF SUFFOLK [ij STEVE LEVY SUFFOLK COUNTY EXECUTIVE DEPARTMENT OF HEALTH SERVICES BRIAN L. HARPER, M.D., M.P.H. COMMISSIONER PERMIT The attached plan, when duly signed by a representative of the Department, constitutes a permit to construct a water supply 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 applicable standards including "Standards for Approval of Plans and Construction for Sewage Disposal Systems for Single Family Residences" and "Standards and Procedures for Private Water Systems." Omissions, errors or lack of details on the plan does not release the applicant from the responsibility of having the construction done in conformance with applicable standards. The permit (plan) expires three (3) years after the approval date. Any modifications which may affect the proposed sewage disposal or water supply systems requires submission of a revised plan and additional fees (if applicable) for reapproval prior to construction. No inspections will be performed bv the Department on expired permits. Permits may be renewed, extended, transferred or revised in accordance with the procedures described in "Submission Requirements for Approval of Sewage Disposal and Water Supply Facilities for Single Family DwelUngs" (Form WWM-041). It is the applicant's responsibility to call the department at 852-5754, in advance, to arrange inspections of the sewage disposal and/or water supply facilities prior to backfilling. These include inspections of the sewage collection and disposal systems, water supply system components and piping, and final grading as shown on the approved plans. In certain cases, inspections of the soil excavation may be required to determine the acceptability of the soils for sewage disposal systems. The Department must be notified at least 24 hours in advance to schedule an inspection and excavation inspections must be confirmed by calling 852-5700 prior to 9:30 A.M., the morning of the inspection. Article VII of the Suffolk County Code, "Septic Industry Businesses," requires that all installers of septic systems within Suffolk County shall possess a valid license from the Suffolk County Office of Consumer Affairs. This office can refuse to peryorm inspections or grant final approval for the 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 To EXISTING BUILDINGS, OR FOR THE USE OF SEWAGE DISPOSAL OR WATER SUPPLY SYSTEMS. WWM-058 (REV. 9/05) PAGE 1 OF2 .OMSION OF ENVIRONMENTAl. QUAUTY.OFFICE OF WASTEWATER MANAGEMENT.360 YAPHANK AVENUE, SUITE 2C.YAPHANK NY 11980. PHONE: (631)852-5700 FAX: (631)852.5755 lNSTRUCTIONS FOR FINAL ApPROVAL OF CONSTRUCTED SYSTEMS It is th; applicant's responsibility to cal1 the Department to arrange inspections of the sewage disposal system and water supply facilities prior to backfil1ing. These include inspections of the soil excavation for the sewage disposal system, when required, and inspections of the water supply well, wel1lateral, public water supply line, disposal system, piping and final grading. Other inspections may be required. Fol1owing satisfactory construction and inspections: L The applicant must submit 4 prints of an as-built plan (up to and including 11 "x17"), by a licensed design profe!isional, of the subject property showing the fol1owing: a. the lot location and metesfbounds description; b. the lot number(s) and the name of the subdivision, if applicable; c. permanent structures (i.e., buildings, driveways, walkways, swimming pools, decks, retaining walls, etc.); d. the exact location of the private wel1 and lateral, if applicable (give at least 2 dimensions measured from the corners of the building to the wel1); e. the exact location of the public water line, if applicable; f. the exact location of the septic tank and leaching pool(s), if applicable (give at least 2 dimensions measured from the corners of the building to the covers of the septic tank and each leaching pool); g. the exact location of the sewer line from the dwel1ing to the street; if applicable; and h. have a clear area at least 3" x 5" for the Department's approval stamp. 2. If a subsurface sewage disposal system has been instal1ed, the applicant must submit a certificate from a licensed sewage disposal instal1er, attesting that the system has been constructed according to the criteria of the Department. 3. If a wel1 has been instal1ed as the potable water supply, then the applicant must submit a wel1 water analysis completed within one (I) year by a certified lab, and a wel1 dril1er's certificate completed by a licensed wel1 dril1er. If the wel1 or water quality does not conform to standards, corrective measures wil1 be required as described in the Department's ''Private Water System Standards." Please note: water treatment units may not be instal1ed without prior approval of the Department. 4. Ifpublic sewers are utilized for the dwel1ing, the applicant must also submit one (I) copy of the sewer line inspection approval from the sewer district. In districts operated by Suffolk County, one (1) original of Form S-9, duly executed by the Suffolk County Department of Public Works, and one (I) copy of a Suffolk County Department of Public Works field sketch are required. 7. If public water is utilized, a tap letter from the appropriate water district indicating that service has been completed to the dwel1ing wil1 be required. In certain cases, the applicant wil1 be required to submit a certification from a licensed design professional, attesting that all components of the sewage disposal system, retaining wal1 or sewage col1ection system have been properly inspected and constructed according to the approved plans and permit conditions. Refer to "Certification of Constructed Works" (Form WWM-073). The app~ust submit a "C~te of Carbon MOn~Alarm InstaUation,"(Form ~075). HEALTH DEPARTMENT REFERENCE NUMBER MUST BE ON ALL CORRESPONDENCE OR DOCUMENTS SUBMITTED. SUBMIT ALL NECESSARY FINAL PAPERS AT THE SAME TIME. PHOTOCOPIES OF DOCUMENTS WILL NOT BE ACCEPTED. 5. 6. WWM-058 (Rev. 9/05) PAGE20F2 INS~ROUND POOL WITH RROUNDING FENCE \ , \ , , , , " "" , , "......... " EXISTIN PROPO~ -~---- --_.-"~_/'-/ i i i -_//-//1 - ,I i ! .i 66' ___________.1-- i -----it , ALTERE PROPO' " / /-/ -..-/ /// -..-..- .._....~r-.._.._.._<'<'\ 68,! // \' i r I i I /Il 1'- f-kO. / 1/ --------+ i/ 7' / /f6B' / // , / // // ~ / / / I "" /// /// 0) ___ ____ _____/ // I c::; /// / ::; /I .~/< / I ~/ ' )5: / /~ / !;} ~~ '0 /',_____///.166' / / ------ ------ / ,/ , ' +67'1 i i _+67' i "'--:.~""2J//... /-//. ," / ' ' // (~\.\'. /' '., ,," /. "'<\ - '\ ''\' " " ,," , " """ ,," . "<,,\ \' ", '" , " "',,'\, ,,\, " "\ / ",\, / " / "V)., I I / \ I J \j" -I / I /l~j " / /--/ 'V ,(/1 I / ~ ,-" , '\ ", "'" ~~Y) " < ( , I" - "" \ ,// "'" (/" , \" '" , '- " " '" "'>'" " '" "' ' , " '"-''-,- "- ,'- '" '" -"- '-~,. '" -"' " -., ,'"',- " .y' " " UO,~ ' / .. ,-", "..., 00_ , 4- , 66'----~ ---- " / -..-..... ///-------~'"- ( \ / : I I i / \ //' '9-2'____//// / ----.- ,/<;) , ^'> 0: , o '00_'" , , " ,,-- " " " " " ",,~ ../-'\~~ ,// , 66' , I --....... UNE OF BUILDING SETBACK I - , , , /-~ / \ \ /- , PROPERTY LINE '" / _\.-/'/ ,,' , " /,,///.-... ..-"'" " , " 6~.//-\../ , " , LINE OF ACCESSORY STRUClURE SETBACK " , , ".. , I 'vi ( SITE PLAN SCALE: 1'=30'-0' 1985 EDWARDS LANE SITUATE: ORIENT TOWN: SOUTHOLD SUFFOLK COUNTY, NY SUFFOLK COUNTY TAX MAP 1000 - 18 - 3 - 6.13 ZONING DISTRICT: R-80 FLOOD ZONE: "X" AREA: 1,57 ACRES Test Hole By Kreiger Well & Pump Corp, 12~18~O2 rock &: hardpan 5' hardpan &; ~Iones 15' hardpan 20' IOfl;lerock h~dcf'o~n 30' hardpan &: dor1< I>.-own sand 35' fo. brown sand 45' fin.. to medium brown sand water 55' medium to fin.. brown $ond &; mud 70' . . . , , , . , . . . ',-", . , . , ., - '/'<>~"*~t ~isedPianAPP. l'OVd . .,:----~=== 1.' / "'~>" co" J~s . .. "\,~'<"fl/; ,.: -~--~--_._- ( I( ".:::~os ~\; "-Ss",,-,,( ie; ~OiJ:..'..:1/f//' . ') ~f"',>"Z' I ,1<0'"',, 1-,> ",00)''':::>., y " ... , ",,___=::.:.~~-...-:--_t::!~~15'oo"w 200,QO' 1985 EDWARDS LANE;' -~---------:::::~~=:::::::::=:~;~~. BlOCK .3 I -"~~:. ,,'\, N38"08'OO"W 115.13' " " ~6 ~ l ~, I~ " ~ N~i6'jj'30"E 25.05'>> { "'''"~-" OW -.. \\.... If /f<, N3T32.00..W 110048.--:',\" N6S'S3'OO"[ 4396' \. .. -----..../ t-.... , '. , ... , '. , , N26'49'10"W 157,:\7'---\' , , '. , , \ .....--' '. ..'" ,<-06 '>.-/" 0 ~1'l,?oo .... 000 \,t:) "> ...... \"'" "\ ~o~0';<'O\0 't~) /".", \~' ~S<0 / /<:.:~~:.,~\ ;,~r P.~:~Zl ,.. \ _".--r ,<,'_""..-\', ,.,..~,_{~"" \ ~","",.. "~\~~~.\...>...~.({'::.:~':;>'~~~ ''':\' ..- ~"''1,..no'".:>;.t. \;.,.p'." '."~;1-'..~ \ ~""'" fO\\ '9, 't\'. 'O'};~.:;:-- \.. a.l. ~...~\;;....- ." , . t:J' .::.,~,;,....-"",",,"_I .~ ) SEPTIC LOCATION ::~>~~ _._..---;:~ ~~...--,.- ..........\\~:T{.... : ,-,.-. - ,- \ I DR" \ _ ,.-.~,")', /.:'....~).. .~_ ',:-". ' ',..,".' :::;. ,i\.;-;;.;,..;~ -. IH. ..-,:\.:.,..;.. . .. :- ,'~,.'- .:.' __ ~'- , \ ..., ~i.'\o''\\~~:~',.~~';,\;i''::<' _--- \ ,.' ,- I .... _., ..---- ~ ----- --' ~ y,.~",i'-~,,"""-'--___:-----+- 11, , \)'.6.~t ,.-:-;.--- - \ ...1",,~,;,.J<--__~<.~::.~ __--~--.-- _, '.\ \ if>;;,5o;o:"""b\'~Ll ----- - -/""'.", -.- .'-l . 'I ," , ,,,",,,"'- ':,t."..,-",-, - _.I_""~"'~ .__' ~, "t.....'~, '. ....- \ 1 ....' "':'. '::':'J.. I"~ \'." >;~~~:':';f;':' L~~..,i>.:"l:~_,,_~ ~._..~'" f ! \ \ tb.~ .;0 'to \ "'J'to~ I I \\ I '\., \ ) KEY PLAN SCALE: 1"=100'-0" ." " " ." ." / GENERAL NOTE: ALL DRAWINGS, SPECIFICATIONS, PLANS, IDEAS, ARRANGEMENTS AND DESIGNS REPRESENTED OR REFERRED TO ARE THE PROPERlY OF AND OWNED BY GLUCKMAN MAYNER ARCHITECTS WHETHER THE PROJECT FOR WHICH THEY ARE MADE IS EXECUTED OR NOT THEY WERE CREATED, EVOLVED, DEVELOPED AND PRODUCED FOR THE SOLE USE ON AND IN CON- NECTION WITH THIS PROJECT AND NONE OF THE ABOVE MAY BE DISCLOSED OR GIVEN TO OR USED BY ANY PERSON, FIRM OR CORPORATION FOR ANY USE OR PURPOSE WHATSOEVER INCLUDING ANY OTHER PRO- JECT, EXCEPT UPON WRITTEN PERMISSION AND DIRECTION OF GLUCKMAN MAYNER ARCHITECTS. NO. DATE SUBMISSION & 06.28.2007 TOWN OF SOUTH OLD BOARD OF TRUSTEES ill 07.02.2007 DEPARTMENT OF ENVIRONMENTAL CONSERVATION & 07.09.2007 SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES & 07.18.2007 SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES & 09.07.2007 SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES GLUCKMAN MAYNER ARCHITECTS 250 Hudson Street New Yori<, NY 10013 tel 212.929.0100 fax 212.929.0833 LANGE RESIDENCE 1985 EDWARDS LANE, ORIENT, NY 11957 PROJECT NO. 07002 SITE PLAN @ Copyright Gluckman Mayner Architects