HomeMy WebLinkAboutShamoon, DavidELIZABETH A. l~[Vll,l,l~,. RMC: CMC
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
southoldtown.northfork.net
TO:
FROM:
DATED:
RE:
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
September 21, 2009
Cesspool Construction Application
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD ~
Transmitted herewith is a copy of application No.
Permit submitted by:
David Shamoon
3902 for a Cesspool/Septic Tank Construction
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.
Carol Hydell
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE ~
DISAPPROVE
Comments: Final approval required from the Suffolk County Health Depadment
Signature
Dated
TOWN CLERK
REGISTItAR OF VITAL STATISTIC8
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
.~Town Hall, 63096 Main l~a
P.O. Box 1179
Sou~hold, NewYork 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.ne~
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential ~ $ l 0_,~('/or Non-Residential ~ $25
Permit No.
Septic T~
Application No. '~
or Cesspool
BfiefD.esc~iptionofProposedConsmmtionorAlteration...[.),~/._.) ~'~/'7~/~--~/
Location o f Prop osed Con~,yctiotfffdterati~u:
Owner of Property: ~././/,~,, 9,~(, ,~/~_ ~.
Owner Mailing Address: ,~,O- ,&,.~ ~ZL.
phone, um e or o, t t po son
Tax Map No: Sectio~ ,/.~.~ Block ~g~ Lot
Cro~sgtreet /~d /~/~-C~/ - -
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEy WITH HEALTH DEPARTIVIENT APPROVAL
Signature of Applicant Date
Reodved by:
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. '1000-'122-09-7.20
SCALE 1 "=50'
JULY 24., 2004.
JUNE 5. 2005 ADDED TOPOGRAPHICAL SURVEY
SEPTEMBER 21. 2005 ADDED SITE PLAN
NOVEMBER 29. 2005 REVISED AS PER N.Y.D.E.C. NOTICE OF INCOMPLETION
JANUARy 15. 2006 ADDED PROPOSED WATER UNE
MARCH 21 2006 SET LATH FOR SITE INSPECTION
MARCH 30. 2006 ~EMOVED RET. WALL ALONG DRIVEWAY & C-~GE
APRIL 10. 2006 REVISED PROPOSED DECK & POOL
JUNE 7. 2006 REVISED DRYWELLS PER NYSDEC NOTICE DATED 5/25/06
OCTOBER 26. 2006 LOCATE WETLAND FLAGS 1A-4A & 1B-SB
JANUARY 15. 2007 SET LA~H FOR SETS INSPEC~ON
MARCH 5. 2007 REVISED PROPOSED HOUSE & SET LATH FOR SRE INSPECTION
JULY 12. 2007 REVISED AS PER SUFFOLK ENVIRONMENTAL CONSULTING. INC. LETTER 06/14/07
OCTOBER 20. 2007 REVISED PROPOSED DR(WELL LOCATIONS
APRIL 15. 2008 REVISE PROPOSED SEPTIC SYSTEM
AREA = 40,816.90 sq. ff.
0.957 ac.
CERTIFIED TO:
DAVID SHAMOON
FIDELITY NATIONAL TITLE INSURANCE COMPANY OF NEW YORK
PROPOSED SEPTIC SYSTEM DETAIL
HOUSE (NOT TO SCAI~)
9.6'
CROSS-SECTION OF PROPOSED CONC. RETAINING WALL FOR
SEPTIC SYSTEM WALL
(NOT TO ~
SEPTIC TANK (1)
'.4
NOTES:
1. ELEVATIONS ARE REFERENCED TO N,G.V.D. 1929 DATUM
EXISTING ELEVATIONS ARE SHOWN THUS: ~
EXISTING CONTOUR LINES ARE SHOWN THUS:-
2. AREA OF WETLANDS = 762 sq. ff.
UPLAND ADJACENT AREA = 40,055 sq. ff.
SUFFOLK COU]',FFY DEPARTIvII2-'NT OF HEALTH SERVICES
pE,]~,'[IT FOR APPROVAL OF CONSTRUCTION FOR A
5. THIS PROPERTY IS IN FLOOD ZONE AE (EL. 8)
FLOOD INSURANCE RATE MAP No. 56105C0482 G
ZONE AR: BASE FLOOD ELEVATIONS DETERMINED
4. SEPTIC SYSTEM STRUCTURES SHOWN THUS:
PROPOSED EXPANSION POOL
PROPOSED LEACHING POOL
(~ SEPTIC TANK
;PROPOSED
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~ 0
LOT COVERACE DATA
(OVER UPLAND ADJACENT AREA 40,045 sq. ft.)
DESCRIPTION AREA % LOT COVERAGI
PROPOSED HOUSE 1.210 sq. ff. 5.0%
PROPOSED DECK 49o sq. ff. 1.2%
TOTAL 1,700 sq, fl, 4.2%
TEST HOLE DATA
(TEST HOLE DUG BY,~ ON MAY 11, 2005 AT 12:
5. THE'LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD .~'~'
OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS.
6. APPROXIMATELY 400 cu. yds. OF CLEAN FILL TRUCKED IN FROM
AN UPLAND SOURCE SHALL BE NEEDED. ?! ~,~,,: .~?.10.%¥'
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BOUNDARY AS
soUTHOLD TOWN TRUSTEES
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84'50'50"
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~.E. OR R.A.
U~,~FOR~/
W
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5~j /
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.E
I I ~'T HOLEI
/ / ~ I
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1.30.00'
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23'
UN~RIZED ALTERATION OR ADDmON
TO THIS SURVEY IS A VIOLATION OF
SECTION 7209 OF ~HE NEW YORK STA~E
EDUCATION LAW.
COPIES OF THIS SURVEY MAP NOT BEARING
THE LAND SURVEYOR'S INKED SEAl_ OR
EMBOSSED SEAL SHALL NOT BE CONSIDERED
TO BE A VAMD ]~UE COPY.
CERTIRCATIONS INDICATED HEREON SHALL RUN
ONLY TO THE pERSON FOR WHOM l~lE SURVEY
IS PREPARED, AND ON HIS BEHALF TO TH~
THE EXISTENCE OF RIGHT~ OF WAY
AND/OR EASEMENTS OF RECORD, IF
ANY, NOT SHOWN ARE NOT GUARANTEED.
PREPARED IN ACCORDANCE WITH
N.Y.S. Lie. No. 50467
Nathan Taft Corwin III
Land Surveyor
~tle Surveys -- Subdivisions -- Si~e Plans -- Construction Lo)out
PHDHF (t~.~1~7~7-~f~ Fax (R.'~1't777--1777