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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK � P.O. Box 1179
REGISTRAR OF VITAL STATISTICS . Southold, New York 11971
MARRIAGE OFFICER ��� Fax (516) 765-1823
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'1 °, Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 125-N Residential Non-Residential X
Fee $ 25.00 Septic Cesspool X
New Existing X
Name Of Owner LOCAL TALENT, INC.
Mailing Address 1 P. O. BOX 77
Mailing Address 2
City St Zip CUTCHOGUE NY 11935-0000
Property Address 1 21855 COUNTY ROAD 48
Property Address 2
City St Zip CUTCHOGUE NY 11935-0000
Owner Telephone No. 516-734-5415
Tax Map No. section 96.00 block 1 lot 19.001
Cross Street COX LANE
Date Of Last Pump Out 0/00/00
Issue Date: 11/18/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK �C.SFutA'
Town of Southold : Application No.
Judith T. Terry, Town Clerk • i y:t,
Town Hall, 53095 Main Road _ -< i $10.00 - Residential
P. 0. Box 1179 ' ;
$25.00 - Non-Residential
Southold, New York 11971
Telephone 'i 0
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
1
DATE lHCI I •
OWNER NAME: b°c _ 1 Ta, ( C'ti\ti XIfLC,OWNER MAILING ADDRESS: e' - 'box P7
C,k-A NAA71 - /V1 ( I ')c--
OWNER PROPERTY ADDRESS: H. /) -S -C hi 441e_ Gf `
C,L �� � ���
OWNER TELEPHONE NUMBER: c(( ' ( - S-4 I
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TAX MAP NO. : Section 4 Block 0 Lot \ Ci
CROSS STREET: COC
TYPE OF SYSTEM: Septic Tank - - New Existing \O
Cesspool New Existing I
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: (P ( ')) ( 1. ( )�I ° rheirtto
LOCATION MAP: Must be attached hereto before permit may be issued.
(Locate building and system; give north arrow and feet
of distance, approximately, to building and closest road.)
Signature o Ap'.)icant
RECEIVED BY:
�
Towntrerk Office
DATE: NOV 1 1991
Tow ClerK Soutla
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SANITARY DESIGNSanitary `r ' 4'4,
6, c.,
INDUSTRIAL 3200sq.ft. x .04 = 128gpd. Kitchen _ z _444
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INET STORE with food �"�° ��r-
INN
processing. 1200sq.ft. x .05 = 60gpd x .10 12Ogpd ,vo
188gpd. !y e
GREASE TRAP : 240 gals. required-1000ga1. capacity provided. '
SEPTIC TANK : 618 gals. required-1200gal existing tank provided.
CESSPOOL west storeai e'1. �kitchs�nf t. 0 cesspool sidewall AST IRON COVE
ATEP B INSF_Ci'I
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industrial oulding = 128gpd. ,Hcch,'r. f 2M.4X � i
CH14fNEY~I r 24" { I-TOTAL 5YsTEM FLoW =308gpd - _ 20--i: . •- . '_i
INLET
- 1.5 = 20533 s .ft. - 25 = 8.2vert. ft. required MIN 4"DM -�s.. !p". ;�
30d gal. q crass 24ao i � f
1-8' Dia. x 12' deep existing •cesspool provided PPE PITCH ' FLOW LINE P 14./ —
EQUIVALENT DENSITY & ALLOWABLE, FLOW RATE TEST ;; II'
Groundwater Management Zone IV HOLE
Adjusted gross Jot• area = 1.047 acres e�s�o DATA i l
300 gals per day /acre roP sore 8-- i•.
300 x 1.047 = 314.1 gpd. •-
SAND & GRAVEL
I SEPTIC TAN,
GROSS FLOOR AREA (bldg.) = 4,4'00 sq. ft. (existing)
- 20.5' eL 38.0
'SITE AREA = 45,589 SO. FT. H. D. ref. •S` - NotE,w.P by owner 6-8-BI
or 1.0466 acres C/o - 89- i�
- — , s•— ---
� cZt-s opo
it
disposal facilities for
Prepared in accordance with the minimum Vg o0
:'hall Giriiply with the standards for title surveys as established -i-a,
• tdr "' - .of THE by the L.LA.L.S. and approved and adopted y e-14 "� t "4
�\,\ENT for such use by The New York State Land hI
434 E &� Title Association.
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7 st, x
sp " F"- r;:,•'= ,r \SITE '0,t." /
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KEY MAP
w Scale 1" = 400' '1
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IIS TA LvA TION
APPROVED FOR CONST1W floti ONLY ;
FOR LOCAL r TA L EN T, INC. .s �� � 1:7.0 -��_ pow
AT CCJ ,1 CHOGUEbP� /�• •E'/VF aid �sco�o.��� N
T O w/V 7F S o U T HOL® This appt.oval is granted for the Cs�1ructiort o! the Sanitary
A, �/ dispo.ii Etna w'atel supply tacdit,es p�rsaani to Aritcies 1/5 rent
SUFFOLK COUNTY, l ! . ? UI tate ,S1ntei4 County Sanitary Code and ss not etc-,exprc'sse8
rwr unp.reo approval to discharge trorn or occupy The
1000 - 96 - 01 - 19 structure(s) shown THIS APPROVAL WIRD TWO •+
Scale 1" = 30' FROM NII DATE t3l IOIN.
Dec. 6 1989 FEe . !EMO _. : , /,
JAN. 23, 1990 (revise sanitary design ) w - S,GN 'Jk¢
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CAST IRON FRAME AND COVER TO GRADE
•
0// //"AST IROFRAME AND COVER TO GRADE FINISHED GRADE
.VA TF.4 8/e INSECT TIGHT. `� `� rk,
7. FIN/SHEP—GRADE `
J' 2' MAX. —"�
— — — %/ L 12 MIN '., 4—24" —24.,
PRECAST CHIMNEY 20 r-:'
'' 24"MAX rrI 20•• „1r w 20" --,:v1'-.
2'MAX
l' I`— r i I% • ' '
4.•1 li ----'''.— _4_ 12" %•'
FROM KITCHEN FLOW LINE
, 4
INLET ✓' ' , MIN. 4' DIA.
MIN T DIA. 1 ;� PITCHED MIN.191N. s
P ' TO SEPTIC TANK ii
PRECAST " ' PITCHEDDMIN
DOME •
•. 118' psr H. I
\` I'
0 1=1 F=1' I-1 .E71
E-1 1=1 1 —� -1=7-1r ,
25' /
MAX. - r •
I 12"
T GRADE �rl r i ; , _
1T .N/SHED GRADE •, ,
.,....�, 8' • '�
a - .
.4' '• PRECAST
CHIMNEY "4 I y ,
7 •,- 6"MIN
I_ y ' GREASE TRAP
OUTLET ),
MIN 4"DIA
r,
2400PIPE
1/8"! 1' I ;
18" �8•
1 .r
�2' MIN
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• i,_-I__ GROUNOWAlER �✓
—6 9ACKFILL OF CLEAN SAND 6 GRAVEL CREATING ;����'o cG�� \A�
A MINIMUM OFA 3' COLLAR. j 40 '�
11
CESSPOOL ;0 .4,,i,�p �/ - N.Y.S. LIC. NO. 49618
(existing) _ I p
•A .:7-VEYORSy P.C.
\moi''. . ; 500
b O ifiboos
SOUTHOLD, N.Y. 11971 -
88 - 194 A _ -