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� �F � EI�IZA�ETI�Ao I�iEVILI,E,IVIll�C �� � Town Hall,53095 Main Road ���� �I,��� � m P.O. Bo� 1179 � Southold,New Yorlc 11971 REGISTRAR OF VITAL STATISTICS Fax(631)765-6145 MARRIAGE OFFICER �� Telephone(631)765-]800 RECORDS MANAGEMENT OFFICER �� wwwsoutholdtownny.gov FREEDOM OF INFORMATION OFFICER ���I�� ��' ��� ���� �I.��� TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Carol Hydell, Southold Town Clerk's Office DATED: August 15, 2016 RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4415 for a Cesspool/Septic Tank Construction Permit submitted by: Eileen Santora for Mario 'I'heotokas 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 Count_y Health Department Signature Dated _ �asu��ol�.�, ELIZA.BETIi A. NEVILLE ~ `�a � . ... � G� - .. .. Town Hall, G3096 Main R,Qa, ' . TOWN CLER.K � :"y � P.O. Box 1179 REGISTitAR OF VIT.AL STATISTICS y, � Southold, New Yark 11971 MARRIAQE OFFICER �y ` �� ` Fa�c (631) 766-6145 RECORDS MANAGEMENT OFFICER �fo �� Telephone (631)76C-1800 FREEDOM OF INFOItMATION OFFICER "� � �` southoldtown,northfork.net � OFFICE OF '�HE �'OWN C]LERK .� TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT - APPLICATION CONSTRUCTIOi�t or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @$10� or Non-Residential @$25 Applicatiori No. . � Permit No. Applicant Name � �1 1-�--t=�- �i� ����c�l - _ —�.._��_,,_���___ � -- - -- � Applicant Mailing Address ,; ° � - __ • _� __U - a �'" ��;� 7���--�C-{ �..,j `� �- o _��C� ���J a���� �.,C� ��" � Septic Tazllc or Cesspool i,-��'"�� Brief Description of Proposed Construction ar Alteration �.� � � ���--��; Location of Proposed Construction/Alteration: , _� Owner of Property: I �-�� 7� �:��-�=, � �l����;�`�� Owner Mailing Address:_ ��.7 � `���(.� �=) �`"'�d'E���-� ��%�" �{` �/ �. �� �)�=�1 �� ��`� � ��r � � � ��� � � Owner Property Address: ��.,'�'--�� � � L�/���� ���� -- �- ��.�""1 j C�C����' �`�'� Name and phone number of contact person j"��'�J� ����`r�%�."r'�� �'f C.c� l��� ,,.�»�`�(���� Tax Map No: Section �j Block �� I,ot ��--� Cross Street j�-�lL�� �� — ��T�+ : L,OCr��'�OlV IYr�,.I' I1�T�7' �� SU�IVIY'I'T�+13 i�'I'I'Ii �.I'PI�ICf4.T'I(�IV. I��W CONS'I"iZTJC'I'ION�+Q S S�JIZ�Y Ii AI,'I'F� I)�+P�`��1�`I'AI�PItOVAI! r� , �'r��Z�'� �� � ;��1�� �? �'G'�!�/j� `�����r Signature of Applicazlt �%ate '' IZeceived by. � , � �,�or r �. _ TEST H�LE ����s � � � ` y� \�1 � � ':� BROWN SANDY � o� � � � � LOAM OL � SF RESIDENCE +` ` c� � CONNECTED TO PUBLIG WATER �� � � ff, � � ` �" `- ` �` �_` � °�� '"�u =� �5 � � � . , sRowra c�avEv PROJECT �� 1-8'0 X 16`DEEP 5'MIN. ` � ,�. � ���.�. _ . SAND SC LOCATION �Q � LEACHfNG POOt_SC g �\ ` 13' 1 4� �'M� aN sx � �m � .��� N� R�c�'E �-' `1 ��WPY 1-8'Q�X 8'D E E P 5 t�°o E A N S I O N Rla+t' BROWN SILTY �m ��1!j �10� � �p Zo'��x s46p, -''S IEACNING P�L \ � CLAY CL �Z 7�. „�m, �Qp • ' s •5,'�" \ �y��c�f�� ����,.�'"�,�� � S � (� � � � `��� � ��a��������' ��� �������� � � � ����� ��_ , , � o , Z�, . �� �„_,,,. r�SrH�E � �g S�N. .� o y�,G� � � o a��°�� ����F�7°h����T° tL� , � NIW. � O� �' �,('' 1 �.L G,c�`, BROWN FINE TO � �P`v ew�9, �.- ��� � � o N 1�� �m ` COARSE SAND �o �'� � PROPOSED o `��� 35° ? � o `, � z8� Sw LOCATIOt� I�� y � DftIVEWAY � � ZEST Hat.E PERFQRMED JANUARY 15,2�2 BY " PROPOSED 1,500 Zn y � cU j � SANITARY NOTES_ �• � C��N�z � � . GAILON SEPTICTANK cD �,.- � MCDONALD 6EOSGlENCE m � � f' � � \ WATER SERVICE CONNECTI�1 �a G#2tMlHDWATER ENCOUNTERED ��o.�' F O �s�'' l 1. 5 BEDROOMS ARE PitOPQSED FOR THE o_o. y ,G.F.�E�S¢,D-� � �„ S`ej• TO BE COORQINATED WiTH THE �-U dSt� �a> > �'`�ROPOSED 2 STOf2Y� a '"� �5g r SCVNA 2. TOTAL�OT AREA AREA=13,270 S.F.(O.i G n � � � SINGLE FAMILYf � '4 ��� ��A.� tc� -���'I����.' �� o� a �---���E '� 35� ��as-,�j ,� � t �'�S�I�'%���17y���/��5��� 3. ELEVATtONS REFERENCEQ TFtE NAVD 8 n�e 3�12Qf�FA �?1,��;��t�Ja�i�����'a'"��!'!€��'!�r� t�3t'��I� ��l����tP2 �, "'�r F.�.�v.s�.o a� .r ��r��Z����c� fs�rrrl ��TI�4� � rt���a�m�� �� (��� �a �o�os� �--�—�..�.�prc��� ..�._ warea sERvicE WELL r o � �6 6 EXISTING CESSPOOI TO BE PUMPEd EXISTING WELL TQ BE �—� DRY AND ABANDONEd OR REMOVED ABANDONED IN A ANCE � � � -� � �e,,. IN ACCORDANCE WiTH TNE SCDNS �1�H SCx3HS STANDARIl�S .., ,� � �vr.u-� �` STANRARDS i� � � �'� A�.i [p� � t6b � J � � N �c°xa� Cv"7 � � "= � '..! � � p m�.° � � w2; •� ARRY G�{l�PSED �Wl-� S�Sg• { � � ^..�«I --��..G� �,s � �� �¢55��� Y x 64.J� 3 "� G« s`'4.�a� ?, a SITE PLAN � a � �, � � ��/ � u / 5 .��.�'Q0� w ��, S!"FE PLAN PREPARED FRQM SURVEY BY: �„ �, -- � �µ' "�s• VACAtJT LAMD{FARM} �p GARY B�NZ,LS DATED JANUt�RY 5,�ti5 � � i � -�� �sr_pi AMD SANiTARY PLAN BY STRNLEY J. F" �,J �� � ISAKSEN,JR DATED JANUARY 14,�2. � [�. � � �y" � �? � � � B3,•r s, �sa I S.C.i'.M.DiST.1UQ0 SEG.39 BLK.5 LdT 26 �„ WATERTIGHT FRAME&GOVER W( � 97' °�" �"' ,,.� ; � � � SCAI.E:1°=30' ,��'.~ .,� ,.s � � MORTAR FROST APPROVED LOCKING DEVICE CONCRETE COVER �- � � � , � � F.F EL.1.04t C�IGRETE COVER PROOFINCti 24"PJ PRECAS7 C�tC.RISEft BELOW GRADE � � �� e,�j � t�.! BELOW GRADE RIfdGS 12'MAX,HEfGH GRADE EL 0.00�- '• �.. �' � �' G E E 0.� � � �.. �.` c:' .� t�.t "� „� ►.�s TRAFFIC BEARtfdG SlAB z . �d PVC WASTE LtNE 2°Pdla�c ,� ;� -p�"'-� � �`"� � "°Yy-- � „� PtTCHYs INCH PER F(X7T TRA�FIG BEARING SLAB r,,j�� N�, �.,, --�... �,� r� 4°SANITARY�/ASTE PIPE -- ' `"�.�"`�• � � ,� b�. �,� � � PITCH 1/41NCH PER FOOT � INV EL. -3.17 ^�� �0���..� � �"� � -���� ~" t;2, INV EL.-2.4 IPdV EL.-2.67 �a INV.EL.-3.4 -�..—tNSTALI DUMP�AY RINGS AS NECESSARY FO I ' ��'�', C,� � `., �; �� �;;� � � � BRING PRQF'OSED STRUGTURE TQ GRADE 1 ; � �'" � 10'M(N. �c� 8'Mlf�. . . , ••' �.� � s.�.. � : ,,., � � � � 4a - AtL LEACHtNG P009_S SHALL��ACED�i ACCEPTR�E � '� i f ��.tl�.�.�Y.�.._tt..^-.-., IEACHiMG SQii.S AS HF'PROVED BY THE SC�tS.tAE THE �;,.. , . "."."'."...�_""."'°^.,""�.. Plans are prepa�d by Condon Engir�rir�g,P.C.It is a EVENT POOR LEAClfING PAA7ER4Al fS ENCOUNTERED, � �ccavnno�is ro ae easrr�u�o ro surrnat E ��� �,�°`'�� f'�E��1��t �8p�a1�i11�tt���t fOVafi�f�Cl vioiation of(he Nevc York Staie Education t avr,Artick 145, 4n 8'DIAMETER _� &�DIAMETER h4ATERIAL AND BRCKFlLIED AS DECAltED.CUTTING �t, ���',� c ~ r� ,. Yl SecGon 7209,for any person un4�ss acting uruler Ihe direcf3an RiNGS k9AY BE REQt11RED. �`�-f /�✓ • atalicensedProtessianaiErsginesr,��t,ort.�a PE�ECASTSEPTICTANP(L7ETAifL � `�,�,�� ` 5urveyor,fo atter any item in any way.fi an item beari�ri�e ��o��,E��;ti,r�„�L-�,a�s�+,����,� � LEACHINGPOL}LDET�IL @� p�p� @� @pq p� ''�"�jc/'�'p"(y��p{�['y�''p'+ (^� p�("� dl(Ct1flJEiX�{flC@f�A.(Chi�4.Of�.81id$Ut�'vnrcha3la�xg]� . M �„��� i! ffiFfi i0� E9I �0C � e�a lii6.416L16tf'Ft3 H\C_J�W��I`94J'� item nisfier sea4 aad the rrotaE�n'I�tterad bp' bY GROUPldWATER ELEV�47{ON-50.a BE�OW GRADE{E�.S.Q PER 193�J SCDHS GROUPlDYNA7ER C�TCRIR MJ\I'} �R�1G�.ES D{�f� n�sm�r s��a�e�,e�d�o�� � .�a r�a�.� tt�' � � MATTTCC'11G�(,�t� ���;��,����. A IT'� � �`�� YSTE F�L � �Y�,�� (631)298-1986(631)296-2&5i F� 6ate:1(i�t5 .00tTf101t�tl�Iiif�(',i7TN,J.�7T1 �h11 V�t P'lI�f P'"L.t`11�P NOT TO SCALE 3t15/96 SCDHS COA�A.