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ELIZABETH A.NEVILLE,MMC d . \ Town Hall,53095 Main Road
TOWN CLERK " P.O. Box 1179
Southold,New York 11971
PPr
REGISTRAR OF VITAL STATISTICS N �1� Fax(631)765-6145
R
MARRIAGE OFFICE , ° �1� Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER •y6 0, www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Carol Hydell, Southold Town Clerk's Office
DATED: July 22, 2016
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4409 for a Cesspool/Septic Tank Construction
Permit submitted by:
JNS Contracting for Ioannis Zoumas
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 a.'royal re s uired from the Suffolk Count Health De.artment
Signature
Dated
"60,272-12zz:tt,
,drif OFFOL4. -..kz,.
rfift.,•,` 640 '
ELIZABETH A. NEVILLE i x., , 0. Town Hall, 53095 Main Road
TOWN CLERK ,
P.O. Box 1179
3, Coo Southold, New York 11971
REGISTRAR OF VITAL STATISTICS .„.. P".
MARRIAGE OFFICER % "r" : ,V Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER
Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
4d...n.,, 0011
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10 \ or Non-Residential @ $25 Application No. 9 Lip
Permit No.
Applicant Name 1 1\.
o4
Applicant Mailing Address / r( i4 1.-- ) fa
..) `--j 111°12
Septic Tank or Cesspool j
Brief Description of Proposed Construction or Alteration 114 v ,c„4 i
Location of Proposed Construction/Alteration:
Owner of Property: ...T.0 simij 20)44, I
Owner Mailing Address:__ 0 r 6 i 0 r4-1:70-,P Io./ i? 4•
lid tt ‘,9iii vur -go j / 11 qd
i
Owner Property Address: 51)th- S LIC
ot 1 Wit
s
Name and phone number of contact person_ t',-,)i C.it ii-Ei -7 (,),.//0 4--(
Tax Map No: Section 4 B ock _
9) Lot 6 4 yr
Cross Street ,..k."- i/15
3 \ 1 L
NOTE: LOCATION MAP MUST BE SU MITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY W TH HEALTH DEPARTMENT PPI/ROVAL
/k
t-) p 4
Signature of Applicant Date
Received by: Chi
.«
DWELL / PUBLIC WATER
DWELL / WELL LOT 115 DWELL / WELL
PART OF LOT 105
S 05059 '50 "E 70. 00 ' - -
fd mon fd mon
1 1 .5 11 .4' TEST HOLE -
eI. - 7. 0
eI. = 5. 0 eI. = 5. 7 f. f. e1 . = 10. 0 eI. = 7. 7
-_., z. ........_+_
\ , ,_____
co
WATER el . ----:-. 0. 7 \ w w w w w ` �'
10.5' 10.0' w w w w w w w w w w w
0 _
o - 24.0°- o el. = 07 W I r--, inv• = 6 . 4
Lo fr shed 14 , o +� 3. N
N J inv. = 6 . 1
N
9.31+ >-- inv. = 4. 7 inv. =5 . 6
0
o TYP ALL LP 's
ccia
�- o
fr gar
� cr 10.0' 9.0'-1- 8.9' --- 3. 1 'S � 1 - 8 ED:
Lu w w DIA X 4 ' SEPTIC TANK ( 1250 gal.)
Q eop 0.6'S n 6 - 4. 75 ' wide X , 8 . 5 ' long X 2. 0 ' E. D. LP 's (3624 gal.)
� 1--
...=a
CO N
U O U Q U
CO m cn v
i o n �- 28.0' CC)
SANITARY SYSTEM SECTI Q\ 1 " = 10' •
prop deck
SCALE:
' 0 •
- 8.8 ,
-J --I prop 7.4 \
w W wall 0. 1 'N -,I ro D --� L `� ±
. 2 sty •
Q O fr o W
21 .0 °° dwell •
-----\ a
-
ff el= 10.0 N
-'
'\6 . ,
j 1, %-'6-
28.0' D dwell
dwell L �\
.
1- 4 , 3 - porch -1.-4
Ix' 6.3 -
0O�Q a ? i
N a) ,_,_
\IN _- LP- LP `EXJ min O C�
---i N
Z x �i- LP - LP -LEX J 00 -1--i
h....: �:..;,.., .� (7,:-.::7: 7,`:(::::
_ � - . .' - .. (rv: .. a q .
.r2 j
,� cn p
100' set back line ' --2 typ: ,�T .
from water•
o i PROPOSED SEPTIC SYSTEM
m test hole o o �'
-
1-8' DIA X 4' E.D. SEPTIC TANK (1250 gal.)
op el•=5.7' o °3' �,'4 7' 6-4.75' wide X 8.5' long X 2.0' E.D. LP's (3.24 gal.)
x -c-,
,..c 0� SEE SECTIONF-71,7rel,,!:
---. .- :.-�7 . _,. . .. -.,_�_�.
C7 I. • i "_.,i 1 ;:... ,..,.. '.,7 ! R.P...�.. f'r77.1 .,..,s„ u !�
wall 0.0'N '5-146i ,- eop 0.2'S
�- - :�- : �f , . ¢ a. R
f d mor. ��� 3.9 ry
5.0' S.0' 5.�' 455. 74' r� { ,..-i::::::. ;:.,.!_ ,.:, _.
N E, : :.r: 2 _ _C: - .r ,e.10-1_6,:ocoS_
- --} 3.6 ' r. r>�:v
3.4' N
05°59 '50 "W 70. 00 ' 3.0
Lo
:,')1.-. o : f rt.; :.t�.:; `�._.�._.._ _...^., ...7. .
3.6'+ & .•.E T{.�'!..,E ifi.7.', . 3^._0,:1 D..717O '1 A
BAY AVENUE 3. 7'+ '' J-- .r.-.�`�: ,' .; _____ ...'.A �'.- .
.�' i'eti Ld�L
ENUE
tet- 3.3'+3 .4'
_
-�-- o NOTES:
pole N
0
°0 1 . METES, BOUNDS AND ELEVATIONS FROM SURVEY BY
0.5'W S 05°5�9 'S0"E 70.00' H ' BOLD F. TRANCHON JR. P.C.
'' //' JOB No. 15-157 FILE No. NASSAU FARMS DATED 7/22/15
N 82°00' 10"E 8.322-- II drain
/ 112. DATUM NAVD 1988
/ APP• HIGH S 82°00' 10"W u.98'
N 09°44'57"W 11 .99 ' WATER
N 41 °39 ' 13"E 15.46 '
,
N 02°56'32"E 34. 72'
�„_ ,,,,
,, ,�
N 05°40'01 "W 11 .03' . --�-� rows of old dock posts ANGELO S . FICO
SIS P . E.
BALDWINS CREEK ( MUD CREEK ) Engineering Design
42 Hayward Avenue Mt. Sinai, NY 11 766
631-GI2.8-2112 Fax 631-q28-2163
Approved
SITE PLAN :-
��---0r,L1 f
CUTGHOGUE A Z -7 -7: . ''
SUFFOLK COUNTY, N.Y. (CO, Vol' ,�,
SGTM 1000-138-2-6 15
SITE PLAN1 " = - ,� f �
SCALE. 20' {1=
I \SANITARY SYSTEM .,- .ardns 1 _;
A Z ? nrENT' A's'N' Drawn by: A.S.N. Date: Job No.: Rev.: 5 Sheet:
10/1115
��REVISIONS Scale: As Noted' 8/23/15 15-030 1 of 1