HomeMy WebLinkAbout430 WSD LLCELIZABETH A. NEVILLE, MMC
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
www.southoldtownny.gov
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
APR - 1 2015 r
FROM: Carol Hydell, Southold Town Clerk's Office
DATED: April 1, 2015
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4301 for a Cesspool/Septic Tank Construction
Permit submitted by:
Peter Cosola
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: Final approval required from the Suffolk County Health Department
--o
Dated
ELI BETH A. NEVHJX Town Hall, 68096 Main Roa.
TOWN CTZR,H P.O. Boz 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICERFax (881) 786-6146
RECORDS MANAGEMENT OFFICER ��0��� Telephone (681) 786-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.rief
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
CR=esiddntiaal r Non -Residential @ $25 Application No.
Permit No.
Applicant Name 1 C2 CC7� aZ A
Applicant Mailing Address_ 13 Irl I1rCJ`iA� �Z.y/> GA(z0 r l
Septic Tank . or Cesspool / /,
Brief Description of Proposed Construction or Alteration 1 `� EK) PM6 0A)C�X )S r SNC P) a r
Location of Proposed Construction/Alteration:
11
Owner of Properly: 370 w s L 0 L (-
Owner Mailing Address: 11E WNL Ye NiqJ t
(�RW) .6171 IV I -t MOD
Owner Property
Name and phone number of contact person I" rIC-a (a3DLA /0 -9R
Tax Map No: Section 10 Block' IS Lot i
Cross Street R ODA) - O Q) v r
s -R 9
NOTE: LOCATION MAP MUST ' BE SU#MITTED WITH APPLICATION. NEVA
CONSTRUCTION REQUIRES SURVEY WYfH HEALTH DEPARTMENT APPROVAL
2130111
Signature of Applicant Date
Received by:
r�
t
•
PROPOSED SEPTIC SYSTEM
S .,(-4'BEDROOA )
[2] 8 FT. DIA. x 8 FT. DEEP PRECAST CONCRETE LEACHING RINGS
BACKnu WITH 3' SAND (SW) COLLAR, 3' ABOVE GROUND WATER
[1]x.1,.086• GALLON PRECAST SEP77C TANK
1,.500
I AM FAMILIAR WITH THE STANDARDS FOR APPROVAL
AND CONSTRUC770N OF SUBSURFACE SEWAGE DISPOSAL
SYSTEMS FOR SINGLE FAMILY RESIDENCES AND WILL ABIDE
BY THE COND177ONS SET FORTH THEREIN AND ON THE
PERMIT TO CONSTRUCT.
7HE LOCA77ON OF PUBLIC WATER, WELLS AND CESSPOOLS
SHOWN HEREON ARE FROM RELD 06SERVA 77ONS AND OR
FROM DATA OBTAINED FROM 07HERSS,
AREA= 17,149 SQ. FT.
Is6sNN
j
� peP�-• a{ lea
�
o
sHm
TO BE
'All
REMOVED
ar-
RAIN RUNOFF CONTAINMENT: ve��` � Ala-
DWELLING:
la /
DWELLING:.
Sq. 2256 S Ft. c� yc � o� o pL 9�2 LP
2256 x 0.17 x 1 383.5 Cu.Ft. �J y8' ��
0%0.Provide 2 DWs. 8' Dia. x 5' Deep
Connected by Gutters do Leaders k eFFtis s• /� /
�A O /
GARAGE: 830 Sq. Ft. Ge�� �AG6
930 x 0.17 x 1 = 141.1 Cu.Ft. ° �i0 </c `CG�A�o
Provide 1 DW. 8 Dia. x 4 Deep ��� �q� �F'►r 7
Connected by Gutters do Leaders F�/�s �i �o.�•
LOT �'s REFER TO "MAP OF REYDON SHORES"
FILED THE SUFFOLK COUNTY CLERK'S OFFICE
ON ,NJLY 22, 1930 AS MAP ON. 631 (O�e
ELEVA TIONS & CONTOURS ARE REFERENCED TO NA VD '88
FLOOD ZONE FROM FIRM MAP NUMBER 3610JC0167H
ate, oda�en
■ = Monument cO��je ce ;�= or
j�g
ANY ALTERA77ON OR ADDITION TO 77 -IIS SURVEY IS A WOLA77ON 0 � �4
OF SEC770N 72090E THE NEW YORK STATE EDUCA77ON LAW.
EXCEPT AS PER SEC77ON 7209—SUBDIVISION 1�a 2. ALL CERTIFICATIONS ` ''
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR
WHOSE SIGNATURE APPEARS HEREON.
SURVEY OF PROPER.
A T SO UTHOLD
TOWN OF SO UTHOLj
SUFFOLK COUNTY, N
1000-80-05-2.1
B
SCALE 1'= 30'
r February 14, 2012
APRIL 4, 2013 (UPDATE)
JANUARY 30, 2014 (UPDATE)
JANUARY 6, 2015 (UPDATE)
JANUARY 20, 2015 (REVISIONS)
\ JANUARY 21, 2015 (REVISIONS)
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERYICE:
PERMIT FOR APPROVAL OF CONSTRUCTION FOR Ai
SINGLE FAMILY RESIDENCE ONLY
r H.S. REF. No.
EXPIRES THREE YEARS FooM
. _ 7EST-HOLE-DA P DATE O APPROVAL
McDANALD G EOSCIENf --
12/12IV4
EL 19.9' ,
14
AREA OF
SEPTIC 1010
TO BE IVXNGF4
REMOVED
�`tio ?� by peP�• a{ �eaith Sacvices
OPS
DOSTiNGY
1M
rr
DARK BRONN LOAM OC
1'
BRONN SILTY SAND ML
PALE BRONN SANDY SILT SM
6'
BROW FINE SAND SP
WA 7ER IN BRONN ME SAID SF
1 X17'
NOTE.• WATER ENCIX/NIERED 15.1' BEZOW SUA
N. Y. S LIC. NO.
YORS, P. C.
20 FAX (631) 765—
P.O
909
1230 TRAVELER STREET
.Snl / 4nI n N Y 11071