HomeMy WebLinkAboutBranch, Elizabeth & DavidELIZABETH A. NEVH J.E; 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:
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
August 13, 2010
OFFICE OF THE TOWN CLERK
BLDG. DEPT.
TOWN OF SOUTBOLO
RE:
Cesspool Construction Application
Transmitted herewith is a copy of application No.
Permit submitted by:
Elizabeth & David Branch
3973 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 retum 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 Department
Dated
TOWN CLERK
REOISTRAi{ OF VITAL STATISTICS
MAB, RIAGE OFFIOE~
~E~8 ~A~E~N~ OFFIOER
FREEDOM OF ~FO~TION OFFICER
oFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
..,Town Halll 68095 Main H~
P.O. Box 11'/9
8outhold, New York 119 `/
· Fax (631) 76§-6146
Tdophone (631) 765-1801
so u tholdtown.norglffork.n,
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMTF
CESSPOOL or SEPTIC TANK
R.esid6ntial~$10 / or Non-Residential~$2$__ Application No. 3973
Permit No.
Applican~ Mailing Address
Septic Tank. or Cesspool
B~et DeScription of Propos~ Cons~cfion or Alte~tion~
,
~cation of ProposM ConstmctioM~teration:
O~er Prope~ Ad.ess:
N~e ~d phone nmber of ~n~t pemon
T~ Map No: 8~tion g~ Block ~ Mt~
NOTE: LOCATION ~ ~STBE 8~D W~H ~PLICATION. ~W
CONSTRU~ION ~Q~8 8~Y ~H ~ DEP~T~ ~PROV~
DEPARTMENT OF HEALTH SERVICES
COUNTY OF SUFFOLK
STEVE LEVY
SUFFOLK COUNTY EXECUTIVE
PERMIT
HUMAYUN J. CHAUDHRY, D. 0., M.S.
COMMISSIONER
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 fi.om the responsibility of having the construction done in
conformance with applicable standards.
The pen'nit (plan) expires three (3) years at~er 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 by 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
Dwellings" (Form WWM-041).
At is the applicant's responsibility to call the department at 852-5754, in advance, to amt..ge .inspections of t_.~he
sewage d~water supply fa. fa~cilities prior to backfilling;. These include inspections of the sewage
~and disposal s~tems, wa~te~:' supPi~ system components and piping, and final grading as shown on the
approved plans. In certain cases, inspections of the soil e~cavat]on may~ 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
lan inspection and excavation inspections must be confirmed by calling 852-5700 prior to 9:30 .d.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 perform 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. 3/07) PAGE 1 OF 2
*DIVISION OF ENVIRONMENTAL QUALFTYeOFFICE OF WASTEWATER MANAGEMENTs.360 YAPHANK AVENUE, SUITE 2C*YAPHANK NY 119~
PHONE: (631) 852-5700 F~: (631) 852-5755
PROPOSED SEPTIC SYSTEM DETAIL
(NOT TO SCALE)
SEPTIC TANK
PnCHE:D t/8'/1'
t7'
~FFOLK COUNTY DEPARTt~ENT OF HEALTH S£RVLC£9
:~ PERMIT FOR APPROVAL OF CONSTRUCTIO~J FOR A
App.Owo I / - ~ .....
EXPIRES T~ YEARS FROM DATE ~ APPROVAL
DETAIL
"20'
SCALE 1 =