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ELIZA I;ETH A.NEVILLE,MMC �I°���' + ' . ®�� Town Hall,53095 Main Road
TOWN CLERK ��� "� `' • P.O.Box 1179
v ^. r. ; Southold,New York 11971
REGISTRAR OF VITAL STATISTICS • q Fax(631)765-6145
MARRIAGE OFFICER ��`®y - .0 to Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER ,d www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER ,,,,,,•�
OFFICE OF THE TOWN CLERK •
TOWN OF SOUTHOLD
TO: Southold Town Building Department gesvgDe
FROM: Carol Hydell, Southold Town Clerk's Office o 2QI6
wig
May 10,2016
RE: Cesspool Construction Application Toval OT S®
Transmitted herewith is a copy of application No. 4387 for a Cesspool/Septic Tank Construction
Permit submitted by:
Meryl Kramer for Lista Cannon
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
e
Signature
.///
Dated
yid ‘Qg�FFOj4-
Off' O
ELIZABETH A. NEVILLE �►�`� G Z ,Town Hall, 63096 Main Roe,
TOWN CLERK ► A P.O. Box 1179
3 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
�
MARRIAGE OFFICER :.� �Q `0� 1� Fax (631) 765-6146
RECORDS MANAGEMENT OFFICER : ��1 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
i
OFFICE OF THE TOWN CLERK
TOWN OF'SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$10 L.-ior Non-Residential @$25 Application No. 142P
Permit No.
Applicant Name Mfg`(l._ (<g,4ME-F,
Applicant Mailing Address {)( (p } ‘61 N R5 fZT 4y'4
Septic Tank Cesspool
Brief Description of Proposed Construction or Alteration KW-Or 1000 6A LLON SEf'TJG'
'TANK vv/ 1 8DIAci LE, i Qs -foD
Location of Proposed Construction/Alteration:
Owner of Property: LISTA C'A N NO kJ
Owner Mailing Address: C/O MEF`f L. KRA4E,P. , -E G T
[9i , 90)( 62) 6EB [6144
Owner Property Address: 2, +A M O MA( UE
Name and phone number of contact person
Tax Map No: Section G G Block Lot
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SUR Y WITH HE' I I +PARTMENT APPROVAL
l1 . (.0
Signature of s_icant Date
Received by:
S.C.T.M.# DISTRICT: 1000 SECTION: 66 BLOCK: 3 LOT: 2 / ; /
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LOT 10 _ , 12MP
.... ,..f.•.•••••.:•.-.0:;-:::.:::::::::i /
0) DWELLINGS 14 •
,' ,
W PROPOSED W/PUBLIC WATER
10 8 6 q� •
3-4 BEDROOM SYSTEM 150' j• i Z TIDAL WETLANDS
1,000 GAL S.T. EXISTING BLOCK CESSPOOL i BOUNDARY AS DELINEATED
(1) 8'DIAx12'DEEP L.P. TO BE ABANDONED AND Q
/ BACK FILLED WITH CLEAN PROPO at i --,/ ? BY EN-CONSULTANTS
j :.• N 83020' 10"
E COARSE SAND. C`�i STONPs.N,
26 '4 .00'
MON i f Q JUNE 23, 2015
: EL 21.8 n i tv
l PROPOSED FREEISTANDING PROPOSED �` O h�v
2.6'E LOT ::::NRY WALL DRY WELL 0.: SILT Fl�NCE i /,/ / a. O
PROPOSED •. u.p. / / IGH 8 DIAx5 DEEP PRP ED / /L'i
> o og
GUTTER DRAIN '': ' ^ WOOD PROPOSED !♦ /
PROPOSED Q. I
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P PROPOSEDC TW 20.0�. MASONRY �r E5 ��� \ �L ^ ( 1 WINDOW EPS ��:W 18.5 i8'r LOUVERED TREWS VER ► / ♦ 1 J Cp• : `' ti� • APRON w ' \ /OseoWELL STOOP t ,TO11/1181"41!A°.4,11'
/ice i�BW 1•.5 1ST STY DECK 1' / / / • a� ce
PROPOSED • ��, ': . •p E8, Q.
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HR / � %�� �C i / / /! l� .. f::::)..
DRY WELL -rte'' 41, ;•, '-- 8 OA . �, PROPOS 18 F ✓ / /Lrr i .Z."
t�,. ,• •. , ",� •:.. :'::.::` .:- '�iy v 8 MIN MiN ;"':: .° :•: I\ :::::: .. r .���c-., ., /1
$'DtAx5 DEEP 1 :' ►��►�,' <... : ' �� 1 :•.:•..:2 f,I'i 7/j ,0 HIGH AWING \ / / / /� i r <1
i :.:., '::':<• :.r'' 1 R N� •k: • ....:............::: ;..-•••••:•.. . : :::::::-. •\-\\\• , WALL 0 . / / / ik. i w
O�L TAN .:i: : :.: ::1-:: : :„i,;:::.::.::.::.:::.::.::.::::::.::.::.•...:: '•:;:::::'•: : :: .. . \���. r s i
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ERE OE /
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r i� Rpp • vivo, Q .: /::::::::::::::::::•::: :a?IFNCFf�I>::::::::::::: :' \\ \ r i/ / / x / /•a
1 ..:` '0� ° wgtk ::-2: 4.i : .: : : : : \\\\ \ ir �.-..,Tw•► . x x /
Y ,, I• 1 \ B 4.25 / i x
:II . 5a ;.:•.•�._ 4•::,:-..;::.:;,.:: 1!.:.:.. :. :'- WA 0 BASElC1EidT 97 , :/ ♦ ♦ ♦ l
O �'. I --_ .fa � W MASO RY PATIO f •� l I r.
•,1 , --- • "" .I�, ;. �...*.,,;:::' ::t LOW ST STY D . / / / .1
• • • I- y�' ::: ' ':;::.::::::;::::::::;::::::::::::::::::•... P P S PORCH / i
P i ;;:T I I.ry: :''T Tj � ..: .. PROP. �� ::::•::::::::: :::::::`:[:::::::::: \ \'. fir. f RO P2ND n' r (FX/STI !
• I�-�) . ' �+'n• .. -..10... .141.,41.I7 ? S ' COVERED \/ :.t \ OVER 1S ••Y DECK • S NCH �,-4C / I �I
c� ,; �II : ::°4 �Y '":' ': 1 l ENTRY PO CH r :' .`. :�::�•: '- `\h' • £TgACK OIJs� 1 Q Q)
`1 G7.V•�.. ,• ER :'fecr A•G V. r' l` .f...•..:`.. �••::•:::::::::' \/\\\\ �i,� O r 1/ / ! i V
Q :.% ::;.FT E`',iii::::' �_ / :i i.icii :::-i :` >;i; \\
- ,�•I
► W •-• ` . •,/ G " •r:7;:::::;: .: '!�••-• •r \*„
::: '.: ::::::: :::::::::.: �y:���:�\I� :' 28"OAK• (Fk/ i/ ♦ / p ��
VACANT • - - _ ;: SIN :,I: a :� \ \\ \\.�h�ltil 0 OAK S sr�, cr l r / / / . o -
I `' - _ f.:::=: ::;:::': ::::;:.: • ::: ::. \`�\\��•� • .R0• STY. C) �6q C . / / ./: .3 . cc --
AGRICULTURAL � ' �""W.V. '� '1 �i • • �`�•.` ; 'ay- � DECK Iu 8)�kJ Or CI / � �' C�
1 `� _ EL 22.1 y''- / 1 ^-`��-�-„�• •:�� EL(23.5) / T/ // / / Mr a ti, ax
150 �'----• --y�_------�• ; ( PROPOSED p �I���'I'1'�i ff n', 'rn S t3-71-- 81' :% /-/-.-/r ! o `� w [�� -
PROP ED�WATER SERVICE \ / DRY WELL TS 23.0 16 BW 14. 5. m / / / ' 1 1 1 N
`r O 1.5'E r 8 DlAx5 DEEP BS 18.0 'r -- -_)i MOM j ('�
j:' EL 22.1 0 „ PROPOSED EXISTING 1 STY FRM PROPOSED 259.00' O • ►.�y
• S 8 3 2 0. 10 W EXISlTNG EXISTING STEPPING WOOD STEPS N I
1 ASPHALT DRIVEWAY STONES DWELLING #725 "� ! PROPOSED
.•I TO BE REMOVED FRAME GARAGE TO BE DEMOLISHED PROPOSED PROPOSED T8" 10'WIDE NON-TURF TO BE DEMOLISHED HIGH RETAINING tr
i � DWELLINGS r•.-- -.,__ FI-L 23.3 OUTDOOR �" WALL 1 BUFFER
' W/PUBLIC WATER '' r.:::: '::::::-`:"f-�'- CELLAR :14.9 SHOWER TIMBER O
j� 1:`:•: t: :• :: :^•''"'- 4x4 WALL ^I �'
150' ;::::::::::::::::::::::::::::=:::::::: :::: : ::•::::::::,::.,: :':::I z -�_ Q
r:::::::::::::;::::::::•.:;::::::::::;::;:::::::::::::;:::'::::::::::::::::::::.:::::.:: : .':'1 1 r:::::;:::•::,,--._ •
(. SUFFOLK CO -- .-.�..._
J LOT 12 1= .: :. /::1,:.::'::•::::-:::•;::::::::::j �/ LINTY DEPARTMENT Cr HEALTH SERVICES
PERk1IT Fdl3 APPROVAL OF CONSTRUCTION FOR A
' TYPICAL SILT r::::': :::;::':: ::.: :::'::;':::::::':'DWELL] :. ..: ::: :::::1 I f••• . :•::'::;:: •:::::1 N
SCREEN SECTION 1::::.::,..;::::::•.;•.::.::::••::• •::::;•::.•. NG..;:.::•::•.• :: ::::::'1 I 1.':
;::::::::::::: ::::::: :: : : ::::;::::::•.:•'•••'•• •• •''•'' •'••'••':::: :► U 1.::::::::•;:::;. : .:{ SINGLE FAMILY RESIDENCE ONLY
::;:::::;:::::::• : .•• .: - ;:::: ; ::: :::::::::::: : : : : :::1 LIJ 1 r:.:;:•:::
GEOTEXTILE FABRIC •
1 0:::;:::::1
T SUPPORT POSTS �ti_ •::::;•:;•:;•::;:: :: •.;•.. :: : : 1 r:;:: (0:;::;::;:;:1 Ct. 7 Z / /`
:I f•:::::::::19._::::::::.: /� �b H.S. REF. No. C//1y /0' (�(�Z ' •
WOOD OR METAL ``- - ::;:•.::.: .;:::;:::.:•.:;:::•:;:::•::;::: 1DATE 0
..,.r../7---
/ _ • C.:::::•:::•• :t CATWALK •
FLOW DIRECTION ` -�_ � 1 1 ' $ MST Be Inspected By The - APPROVED �7
_. ::11'�ter Line( ) �-
EXCAVATED AND '-' 1: ::: : :::: uffolk County Dept• Of Health Services. • FOR MAXIMUM OF / BEDROOMS
ELEV. 22. 1 \
BACKFILLED TRENCH \ 11:1::::.:.::.::1:-:.::::'1.:::.::::::.:::::'::• •
� < ::::; Call $52-5700, 48 Hours In Advance, EXPIRES THREE YEARS FROM DATE OF APPROVAL '''-
OL DR BROWN 1 0' EXISTING GROUND -`�' To Schedule fnspection(s).
SANDY LOAM F
,Tt11-1 -111-11lL±II1 . III. II I =BROWN �' .: - -
SM SILTY SAND 3.0' _ - \‘.11::
I I�r �
'• a MINIMUM Abandonment of existing,sanitary system must be in
1 TOWN OF SOUTHOLD comfan l nce with department requirement Submit FIRM PANEL#36103C0158H
PALE i EXISTING LOT COVERAGE CALCULATION: completed form WW1v1-g O as proof. UPLAND DATUM: NGVD 1929
BROWN DEPTH SOUNDINGS DATUM: MLLW 0.0
FINE EXISTING DWELLING, DECK, & CONC. STOOP: 1, 197 S.F. THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL
UPLAND AREA: 19,511 SQ.FT. or 0.45 ACRES LOCA 71ONS SHOWN ARE FROM FIELD OBSERVATIONS
SW TO EXISTING GARAGE: 442 S.F. AND OR DATA OBTAINED FROM OTHERS
COARSEAREA: 19,81 1 SQ.FT. or 0.45 ACRES ELEVATION DATUM:
SAND TOTAL EXISTING COVERAGE: 1,639 S.F. Or 8.4% UN,pxoR/ZED ALTEr0:4Vi OR ADDl7TON TO THIS SURVEY lS A VIOLATION OF SEC770N 7209 OF THE NEW YORK STATE EDUCA770N LAW. COPIES OF THIS SURVEY
MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
13.9 ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE 77TLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION
DRAINAGE CALCULATIONS: TOWN OF SOUTHOLD LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE.
THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
A) DWELLING W/COVERED PORCH & BALCONY: 1,739 SQ.FT. PROPOSED LOT COVERAGE CALCULATION: NOT INTENDED TO MONUMENT ME PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS EASEMENTS
1,739 X 0.166=288.67 < 289cf AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE 77ME OF SURVEY
B) GARAGE: 660 S.F. • PROPOSED DWELLING SURVEY OF: LOT 11 BLOCK 2 CERTIFIED TO: LISTA MAKIMSON CANNON;
660 x 0.166=109.56 < 110cf W/REAR DECK, COVERED MAP OF: BEIXEDON ESTATES FIDELITY NATIONAL TITLE INSURANCE COMPANY;
399cf REQUIRED ENTRY & WOOD STEPS: 2,242 S.F. FILED: MARCH 16, 1946 AS #1472 -
NO WATER (2) 8'DIA x 5' DEEP DRYWELL=422cf PROVIDED PROPOSED GARAGE: 660 S.F.
SITUATED AT: SOUTHOLD
17' ) PROPOSED OUTDOOR SHOWER: 8 S.F. TOWN OF: SOUTHOLD - -
C GRAVEL DRIVEWAY=1,250 SQ.FT. KENNETH M WOYCHUK LAND SURVEYING, PLLC
SEPT. 28, 2015 1,155 x 0.166=207.50 < 208cf SUFFOLK COUNTY, NEW YORK Professional Land Surveying and Design
McDONALD GEOSCIENCE (1) 8'DIA x 5' DEEP DRYWELL= 211cf PROVIDED TOTAL PROPOSED COVERAGE: 2,910 S.F. Or 14.9% , , cr.... Papist/ P.O. Box 153 Aquebogue, New York 11931
REVISED 02-15-16 FILE # 15-52 SCALE:
1 "=20' DATE: MAY 5, 2015 iF� PRONE (631)298-1588 FAX (631) 290-1588
N.Y.S. LISC. NO. 050882 malntMning the records of Robert J. Hennessy & Kenneth M. Woychuk