HomeMy WebLinkAboutSGDP, LLC SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 4062 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : SGDP, LLC
Address 1: 35675 MAIN ROAD
City St Zip ORIENT NY 11957
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGT,R FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-10-0046 FINAL APPROVAL REQUIRED FROM THE
SUFFOLK COUNTY HEALTH DEPARTMENT.
Name Of Owner SGDP, LLC
Mailing Address 1 35675 MAIN ROAD
City St Zip ORIENT NY 11957
Property Address 1 34600 MAIN ROAD
City St Zip ORIENT NY 11957
Tax Map No. section 19.00 block 1 lot 18.003
Cross Street TERRY LANE
Building Permit Number Cross Reference:
Issue Date: 1/31/12 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
,I� OFFO�,�-Oo
ELIZABETH A.NEVILLE,MMC ��� Gy Town Hall,53095 Main Road
TOWN CLERK p P.O.Box 1179
ti Z Southold,New York 11971
REGISTRAR OF VITAL STATISTICS • v' ��
Fax(631)765-6145
MARRIAGE OFFICER y ��
RECORDS OF MANAGEMENT OFFICER :�Oj ilk4a•�� ' Telephone(631)765-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD f
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TO: Southold Town BuildingDepartment
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LI D r c 15 '--J
FROM: Carol Hydell, Southold Town Clerk's Office
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El_„c, D,_ T.
DATED: December 14, 2011 To: c.- i'i'1OLD
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4062 for a Cesspool/Septic Tank Construction
Permit submitted by:
SGDP, LLC
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
Signature
(3//61/2—
Dated
r /1 f 2_Dated
L „Jr\ I > E 4 `1' 1 D L 6_1 4-1n h 004 k
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,i Cse;
ELIZABETH A. NEVILLE •• e$..7 Town Hall,53096 Main Roo
TOWN CLERK I P. i P.O. Box 1179
REGISTRAR OF'VITAL STATISTICS w Southold, New York 11971
MARRIAGE OFFICER Fax (631) 766-6145
RECORDS MANAGEMENT OFFICER �� � 0` Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER II 1,'0011 southoldtown.northfork.nei
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$10 I or Non-Residential @$25 Application No. "1 ' 2'
Permit No.
Applicant Name S6 OI, LLQ
nn__
Applicant Mailing Address 35473- Mal n /d_ Orient, 1J Y 119S 7
Septic Tank 17 or Cesspool >!
Brief Description of Proposed Construction or Alteration oonstractieti 0,4
Single famI/y P4vm rest del
Location of Proposed Construction/Alteration:
Owner of Property: 3 4 DP LLC SR-1/611_Mei& (es ki
Owner Mailing Address: 35175 Mal vi kci. ar1et4fj IU y i 19S 7
Owner Property Address: 314b00 Main RAJ. L)rie M' 1 i9S7
Name and phone number of contact person G 3 I - 3,23 - g0 b 9
Tax Map No: Section / Block j Lot / . 3
Cross Street Terry LAv1e,
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION, NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEP NT APPROVAL
Signature of Applicant Date
Received by: @
DETXIL OF PROPERTY '
PROPERTY LOCATED AT ORIENT (RES W/WELL) 1(d 00
_ U"/
TOWN OF SOUTHOLD 10.6 - •
SUFFOLK COUNTY. NEW YORK \_
S.C.T.M. # 1000-019-01-18.3 �. MAIN ROAD
AREA = 3.347.132 SF. = 76.8396 ACRES
SCALE: 1'=50' 11.4 ( N . Y . S . RTE 25 )
NOTE: THE EXISTENCE OF RIGHT OF WAYS. 11¢
. 11.5
WETLANDS AND/OR EASEMENTS OF RECORD 1 9S. _.
- ` EOG.
OF PAVEMENT
IF ANY. NOT SHOWN ARE NOT GUARANTEED. •-
12.3
NOTE: SPOT ELEVATIONS RESULT FROM / • ---0----" 12.5
AN ACTUAL FIELD SURVEY AND REFER TO
APPROX U.S.C.8 G.S. DATUM (M.S.L.). / LEN = 105 ----01 77,
REFER TO S.C.D.H.S. STANDARDS DATED NOVEMBER 13. 1995. / \
FOR SEPTIC TANK AND LEACHING POOL REOUIREMENTS AND
COMPONENT DETAILS.
EXISTING SEPTIC TO BE REMOVED / 10.7+ \
PROPOSED DWELLING TO HAVE FOUR (4) BEDROOMS MAXIMUM.
SEPTIC TANK TO BE 1200 GALLON TYPICAL. NO We o
N.
/ `z. \ g
USE THREE (3) 8' DIAMETER. 4' HIGH PRECAST CONCRETE U7
LEACHING RINGS. WITH ROOM FOR 50% EXPANSION. 11.3 ' m
BACKFILL MATERIAL SHALL BE COARSE SAND AND GRAVEL.
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+
y
0
11:7 011
BOTTOM OF POOLS SHALL BE fo MTNTMI IM nC '4' AnnVF I 150' MIN., + (fl (RES W/WELL)
SEASONAL HIGH GRouNownrE N
S ,I€COUI Y DEPARTMENT OF HEALTH SERVICES i m \:F) NO WELL
(sl
APPROX AREA OF O o
j EXIST. SEPTIC Y I
- TO BE REMOVED (� 01 O
TEST HOLE DATA PERMIT FOR APPROVAL PDV UCTION FORA + r ®��2 10.s
(NOT TO SCALE) + . 1 ;�A LILY ftp ENCS ONLY it I
10.5
BY. STEVEN MEZYNIESKI. I �J ,,tt%% o
JUNE 6. 2008 �� IQ 1 �lo .1�.' '[p m= PROPOSED a
DATE / _1
DRIVEWAY
GRADE EL.= 10.8' f / u
�4I?MOVED gr 4f/ PROPOSED 11.7 Q
1.0' TOPSOIL 2 STORY RES • I +
2.0' CLAY EO 'IMUM OF 1 BEDROOMS , +�0.s a
I 6
MIRES THREE YEARS FROM DATE OF APPROVAL u. I i
1.0' GRAVEL f- + \
+�0s 9
SAND AND EXIST,N\----------
4.0'
4.0 GRAVEL
REMAINS OF FOV NDAr/Oc,„..._ETE
_ GRD. WATER Abandonment of existing sanitary syst must be in RESIDENCE TEST HOLE
ELEV.= 2.8 TO BE REMOVED \
comformartce with department requirem t Submit \ 01
WATER IN
6.0' SAND AND completed form V4�V6�M(-- as proof.
GRAVEL ,_.___w.._.._ m RECEIVED +11.t
WPROP •ELL _? _� +11.0 SEP Q 2010
SANITARY SYSTEM DETAIL +10.s (VACANT)
(NO SCALE) SUFF.CO.HEALTH SERVICES
F. FL. EL=14.0 GRADE CAST COVER S Of NEW y OFFICE OF WASTEWATER MGT. +9 B
EL.= (3.0 TO GRADE CAST TO GRADE
A��
,/ �[Q FIN.GRD.- 12.0 ry--��I •� '�f- SURVEYED B Y:
Q 11 11 , p p ��/7F,•`_=-' UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION STEVEN B A R Y L S K I
INV. EL= 11.4 �^ 1200 GAL. _ II N - "NYI,
i OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW.
INV. EL. SEPTIC TANK DISTRIBUTIONIIT. `ro•,�t COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS INKED* N.Y.S. L c. N o. 050453
•
= 10.8 INV. EL. 0 POOL (�� OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. 41 MEETING HOUSE LAN E
= 10.3 =0000000=0000000 .
-11, SOUTHAMPTON. N.Y. 11968
1� INV. EL. EL = 5.8' ) / ` THE GUARANTEESRSON FOR WHOM THESURVEYINDICATED
.AAND ON HIS BEHALF TO TO
= 9.8 Nb.3'MIN. THE TITLE COMPANY.GOVERNMENTAL AGENCY AND LENDING INSTITUTION APRIL 17. 2 0 0 8
,w LISTED HEREON.AND TO THE ASSIGNEES OF THE LENDING INSTITUTION.
GROUND WATER ELEV - 2.8 - LAND GUARANTEES OR CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL
INSTITUTIONS OR SUBSEOUENT OWNERS. 6-9-2008: ADD SITE PLAN
1928-H-1A 9-7-2010: REVISED WELL LOCATION
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