HomeMy WebLinkAboutPage, David T -
SCUTHCLD VlASTEVIATER DI SPCSAL PERM T
CCrSTRUCTI CN CR ALTERATI CN PERM T
SEPTI C TANK or CESSPOOL
Per rri t Nb. 4202 R Fesi dent i al X Non-Fesi dent i al
Fee $ 10. 00 Septic X Cesspool
PERM T I SSLED TO
Narre : JASON PCRE1VBA
Address 1: JASON TI-ICtvAS AFRI-I TECT
a t y St Zi p SCIJTF-{AMPTCN W 11968
Descr i pt on of Proposed Const r uct i on or Al t er at i on
SAN TARP SYSTEM FCR SI NELE FAM LY DIELLLI NG
APPRC)JED AS SJBM TIED AND AS APPFOJED BY THE SUFFOLK CQJNTY DEPARTMENT
CF HEALTH SERA CES. Fl NAL APPROJAL FECU FED FFtM TI-E SIFFCLK COMITY
HEALTH DEPARTMENT. REF #R10- 12-0036
Mane Cf Owner CAM PACE
Mil Ii ng Address 1 2000 CREOCN ROAD
Q t y St Zi p MATTI TUCK Nr 11958
Pr oper t y Address 1 1854 NORTH PAYVI EW ROAD
City St Zip SCUTHaD NY 11971
Tax Mbp Nb. sect i on 70. 00 bI ock 120 I of 39. 003
Cross Street 04K1/mCD DRI VE
Bui I di ng Per rri t Nlunber Cr oss Ref er ence:
I ssue Dat e: 4/07/ 14 B i zabet h A Nevi I I e
Sout hold Tow a er k
illr
�� •,.iii
,.10 ti >/gUFFO(,t00
ELIZABETH A. NEVILLE,MMC y Town Hall,53095 Main Road
TOWN CLERK p P.O.Box 1179
t cn2 Southold New York 11971
REGISTRAR OF VITAL STATISTICS V44%. 1�� Fax(631)765-6145
MARRIAGE OFFICER 1' ��.,�� Telephone(631)765-1800
FREEDOMRECORDS OF OF INFORMATION ION OFFICER AGEMENT OFFICER �O! �,ill �a8.'' southoldtown.northfork.net
OFFICE OF THE TOWN CLERK-- c 7
TOWN OF SOUTHOLD �1 r, �1'�l Ifs
LJ
TO: Southold Town Building Department MAA 1 2 2013
FROM: Carol Hydell, Southold Town Clerk's Office Rtpr, DEPT.
TOWN i), ,OUTHOLD
DATED: March 11, 2013
Transmitted herewith is a copy of application No. 4202 for a Cesspool/Septic Tank Construction
Permit submitted by:
Jason Thomas Architect—David Page
Please review the application and location map and advise if the project has received Suffolk County
Health Department approval and if this office may issue the permit.
Please complete the form below and return it to me.
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: 'V ' &le7'%.?4,/, ,400F/' A/
47e....a
Signature 4
0 3/; /3
Dated
ELIZABETH A. NEVILLE ����`Z` G•tr�L Town Hall,63096 Main Roa.
TOWN CLERK d 1 ".. P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �.
Southold, New York 11971
MARRIAGE OFFICER : fi Fax (831) 766-6145
RECORDS MANAGEMENT OFFICER ='4k ao� �� Telephone (631)765-1800
FREEDOM OF INFORMATION OFFICER = '1 * -„,•, southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
ITAVITSOUTHOLD WASTEWATER DISTRICT
` 40 BoPA 9
P'G' NY
So�hold, •11971 APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$10 J or Non-Residential @$25 Application No.
Permit No. t
Applicant Name T e Vo (961:4T &4 a) " 1'111�LA < ce
Applicant Mailing Address �,� VW CP 1' , L N
Deo- 1 q`( 1 et b% -
Septic Tank or Cesspool
- Brief Description of Proposed Construction or Alteration t\.\ -1,1 TSAt--tu_ (
Location of Proposed Construction/Alteration:
Owner of Property: )del •
Owner Mailing Address: L' %5%%i; .' '2CO0 E)w-
`1` 1 i�Cyc .1 ( 0'62_
Owner Property Address: 1\` \-)- sttsA Zr.).
Name and phone number of contact person
Tax Map No: Section 1-0 Block 1:2-- Lot Ttt,27
Cross Street gc—n--4 I s dt�ict �v c o'p A>z1
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
I/ >UU/rz
Signature I Ap icant Date
Received by:
1
t.
i.
p
0 . 10.9;E DRIVE
N
a4 S e
..i(ati.. •I,17` . J41424101-e• 1
. e•s's.i. .f,�s SUFFOLK COUNTY DEPAR MEM I
i -1•, `'�1' F
'' 03'w n s NG1�rfA: .rx,N ,' :::S !
I N o, DA'T'E 10 Z3 l z— : ::E
O ' --tAPPROVED.. / F
.t os a. .IL�i/,,._.,a E
2
I @
Nim I 2 I 16 o
p a EXPO THREE YEARS FROM! r'
\O
'' m i €
a �� l °N
�k :I: nurY v;
ii _ D EXCAVATION i3P ' '{fl l IR Q�J119
E SANITARY sysTait i
I BY HEALTHDEPAR
FRENCH DRAIN DETAIL '{ N31112
� i� N ri
• • r' cin vii g
r:COARSE•• (�j P1
••GRAVEL•' (D I N �.
• STONE;• IV k rn /�� '�
.... U1 -i ✓ \�
.::.18 ► �i• s. PRS �'��FS F I
I. \ �• Seo R
'_."'i'ROPOf'RENCHt)SS-�N CROSS - _ _...__ _—_ _------_._ .._._.._ _ _ .___ _ . .._._- x \• f S69 ° �,q�.UN _D_ .._ F�Y? � i,
(160' xi.5'xl.5') 0G 3.3'w t by 0 pbF e 'lliyc QQQ
At
(360 cu. ft.) e, .1 E� s.0 e \ pUBI/c t
AREA OF WETLANDS=3„362 SQ. FT. R
63,302 SQ. FT. - 3,362 SQ. FT. =59,940 SQ. FT. 1- , \ ( I 4/4/./7.6, D . Y. s�A k"
LOT COVERAGE 3,228 SQ. FT. �:
PERCENT LOT COVERAGE 3,228 / 59,940=5.4% �� .i, \ \t , (�'I^v
i [
\ •�. p
*t _, ,o
AcA
•
TEST HOLE DATAIA • •/989 ``\ 12 _.� __-, �:::
o i}
Ai
:LQJ' LOAMY SAND \ ,� `� s`�� �'I'`��� f
MEDIUM M COARSE SAND SW 0""0.4 (/ ``\��`�� ``
•
�\ ••
4' .rte � J � \ [,
suer CLAYEY SAND� ORADIwC 10 cp \ SO'SC *cp H //8. `it
L2.8' 5.5' 1P•. 7tili9
WATER IN CLA VEY SAND SC qNC£eU
WATER IN BROWN SCC ON Ot,t74.
416.773.,._ 7, ///o/v4-/%4
\.rte oN
Q4....
WA YEN 81 GREY curry SAND SC 7,c. N.,...,..........1J' !e.
Na
MA IER IN MEDIUM 1'0 COARSE SAND SP
19'
1'
9D ZONE LINES FROM FIRM 36103C0166 G MAY 4, 1998 ANN
/A 17ONS REFERENCED TO N.G.V.D.
1 familiar with the STANDARDS FOR APPROVAL CERTIFIED TO:
CONSTRUCTION OF SUBSURFACE SEWAGE DAVID C. PAGE
'OSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES BARBARA SHINN
will abide by the conditions set forth therein and on the STEWART TITLE INSURANCE COMPANY
nit to construct.
location of wells and cesspools shown hereon ore
1 field observations and or from data obtained from others.
AL TERA 770N OR ADDITION TO THIS SURVEY IS A VIOLA TION
7ECTION 7209 OF THE NEW YORK STATE EDUCATION LAW
PT AS PER SECTION 7209—SUBDIVISION 2. ALL CER77F/CA7IONS
70N ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF
MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR
SE SIGNATURE APPEARS HEREON. ®w =DRY WELL
A=63,302 SQ. FT. 0 =LATH SET El - -=PROPOSED CONTOUR
TO TIE LINES • =WETLAND FLAG
1
SEPT. 5, 2006 REVISIONS) SURVEY OF PROPERTY Ci
OC . 19, 2006 REPLOT HSE.) A T BA YVIEW' Ui .R
DEC. 19, 2006 FRENCH DRAIN, CONTOUR, FILL CALC.) ,F..
OCT. 17, 2007 REPLOT HSE.) 0
OCT. 30, 2007 TS )
RYWELLS) TOWN OF SO UTHOLD c
SEPT. 11, 2008 POT
OCT. 8, 2008 (REVISIONS) SUFFOLK COUNTY, NY. q
APRIL 20, 2010 (CERTIFICATIONS) 1\i.i.j...:
OCT. 7, 2011 (REPLOT HSE.) 1000-70-12-393 3
JUNE 1, 2012 (NEW
(SANITARY
RSANITARY SYSTEM DESIGN)DESIGN)JUNE 15, 2012SAN TARSCALE: 1 =50
!ACTH SERVIC2S JULY 14, 2012 (NEW SANITARY SYSTEM DESIGN) PrilittlARY 20, 2004
AUGUST 17, 2012 (REVISED BUFFER DESCRIPTION) JANUARY 6, 2005 (Revisions)
RUCTION PIM A SEPTEMBER 9, 2005 (Loc. wetlands Rags, revise prop. house)
NOV. 9, 2005 (REVISIONS)
� '� -, FEB. 2, 2006 (ADDITIONAL LATH)
'f J_.% ?--0I/��,�3jMARCH 22, 2006 (ADDITIONS)
MAY 18, 2006 (REVISIONS)
IROOMS
OF APPROVAL
PROPOSED GRADING PLAN
HOUSE PORN FLOOR 6.14.0
GRIMM OVER TANK 11.15.
4.PVC PIPE,WIMP eaLR
TDP OF RINGS e.0. SRT
snale+ca® o>®1s® mxixe
m1enei aemlime es meeoeos, El - a..e.V
ara®w1vesememe oestm aaosasm+aest aes>mmcINvma
3' SAND aasaeamasesemem®mm aa@m0aIG9e�e'�'RSlsommS� EL to 1119UBEOUTLET WERTa_ •
COLLAR asmOs®®ma®eememms arem®�mes1iseomma'e'0 -TANK PLC INVERTa_Si `~
SOT EL 0.0- aOeoeM NI e9MM 70e0S .4�'ILp OimlC.,,�.- 8' SEPERAIION —�-
Ent
WSEPTIC
PC TANK
N K IDNMETER (.1 IMPARTER /BESEPIICTMK
TOTAL OF S LEACHING POOLSI e
N IN
Df r
Ow EL 211
SAID COLLAR
08 -
+ MIN,10 MASTER UNDER RING SWUMSYSTEM SMALL Bewc
e 100 FROM DELINEATED wrs
LR
STMT OF OP CLASSIFIED 80118 PER TEST BORING
0
PROPOSED SEWAGE DISPOSAL SYSTEM (2 BEDROOMS)
e"
'00 (26o.°R"" [5 3' DEEP LEACHING POOLS WITH 3' SAND COLLAR
.00• 4"F� \
,� [1] 1,000 GALLON SEPTIC TANK
',‘I --- ' E2 46 ` BOTTOM OF LEACHING POOLS TO BE3 /ABOVE GROUND WATER
APPROXIMATELY 152 cu. ft. OF FILL REQUIRED.
® - \ co ` SUBSURFACE SEWAGE DISPOSAL SYSTEM DESIGN BY: j
°Gs<\ 4°' .;\ $ ) EDWARD ARMUS ENGINEERING
• 36 DEER RUN
Igi ( WATERMILL, NY 11976
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/� ;;_„� .Y.S. LIC. NO. 496
"ECONIC EYORS, P.C,
(631) 765-5020 FAX (631) 765-179
P.O. BOX 909
1230 STREET
SOU HOLD,ELER N. Y. 11971 44L-- &/I