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Mantikas, Elizabeth
�� �� � � EI,IZA�E'��A. �1�VII,LE,I�IVIC � Town Hall,53095 Main Road Z'OW�I CI,��$I� �" m P.O. Box 1179 Southold,New York 11971 REGISTRAR OF VITAI.,STATISTICS Fax(631)765-6145 MARRIAG�OFFICER � ��' Telephone(631)765-1800 RECORDS MANAGTMENT OFFICER � www.southoldtownny.gov FRBEDOM OF INFORMATION OFFICER ��+'���� ����� ���� ��� � TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Carol Hydell, Southold Town Clerk's Office DATED: September 8, 2016 RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4420 for a Cesspool/Septic Tank Construction Permit submitted by: Lauren Praus for Gus & Eli�abeth 1Vlantikas 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 Countv Health Department Signature Dated �o�4SUFFat�co ELI7.ABETH A. NEVILLE � Town Hall, 53095 Main Road TOWN CLERK � �� P.O. Box 1179 � � Southold, New York 11971 REGISTFtAit OF VITAL STATISTICS � � Fax(631) 765-6145 MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER ��f�d ��o� Telephone (631) 765-1800 FREEDOM OF INFOIi,MATION OFFICER southoldtown.northfork.net �i'S'1�liL ��' 1 H�a To tltl 1�1 �iSrA:ii,i9. TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK : L Residential @ $10 or Non-Residential @ $25 Application No. ��, �.,� .� _� �j�u ! ` Permit No. �.�"- ��� '� Applicant Name �' � -� �' �-�' �-�`� ���� ���`�`� `�` �� � Applicant Mailing Address����� �`�� �'-� � ��=� �f�' � �°'� �� �`�`� �� �` � � `�� `�� `�� � � �r �3 �' /�-�/�- �'c I�, ...�� �� �r�... ����� � c�. � �- ����°l ��,.._:�- i.�-� r� `i" l 1 /'�'') � Septic Tank �Cesspool �" �� ��-�:.._ � � � � �- �� �e��� Brief Description of Proposed Construction or Alteration �� � !�C.�.,� � �.�� �:� Location of Proposed Construction/Alteration: Owner of Property: �r- � .� ` � /' �. � '���.' � �`"'� G�-'` G� � � ��"��Owner Mailing Address: 7' � � � �' `'`� �"` �"�"° �'�'� c� y �� � r� .� 7 �'"� �..s""r �,.;,�°'e .`� `� �/ 7 �1 � �Owner Property Address: y ��:� � �'t �!� ��- � �. � �-� �R�..� ��, �..� �.. %- ,� � �/0�:� `.� Naine and phone number of contact person `"°�� `��" � �����`� Tax Map No: � `�`'�� Section �- � Block <' �-� Lot �� � Cross Street � � -� �� `�""�� �� � �� 1�T0'I'Eo I,�CA.T'IOI�t I1�IAP 1VIIJS'�' �E STJ�IVII'�"TEI) WI'�'I� API'I,��r�'Y'IOI�e I�T�W COl�TS'TI�iTC'I'I�1� �QIJ� S SiJI�VF�' WYTH I-�EAI.'T�I I)EPAR'TIi�IEl�"I' E1PPI20VAI. �. ��� ��� r �ignature of Appli.cant Date Receivcd b�y: � ; �� � ���� ���.�,�A�- I , SITE PLAI � ,,�„ �\� � ;',S.C.T.M.DIST.1000 SEC.21 BLN \� ��� ' SCALE•1'=50' '� ��� �.� � ' «w I � , :' �.�, '" /� :� ; � 3 � ��'/r '��NG ::At.»i ....r9 . ��` \` � I I�ititz� . . `��` ``•`` � ".."'�'_ �'_' ^ � ' \� � � 1 � \� � '�Q \''� °�, � U � ; � "G � ,a��..�,,,�x� _.,,_ ��. �/�� , �\��� _ � � r �u �"���NC�F � � � , � ,i ��$ �� � / � � NEW 2-STORY ADD ,ON q,� _� G �X.WELL 7 W E DRIVEW TO BE � a RE VED �/� � Q � �„ `\ i � �` µ � p,, o �` S �fd X 1 DEEP LEACHit� :' (TYP.f�2, �.� �---- J:� g ,�. j '� . �� 32.E" ' 1�.0 O I W!'4.�`HOLE � ; '� 2��� � O S� b��`� I � �UND 5� � �� i A TEST HOLE EXCAVATION INSPF.E'fiON T0�' ° �' �. '��.s,,, ��� PERFORMED BY THE SCDHS Fl�R'fiNE . ' � � �� ����' a - �'TEST E LOCATION m ----~M• �� � -8'0 X 16'DEEP 5096 oN � � i 0 EXPANSION LEACHING POOL � ; ° � LAND NOW OR FORMERLY OF: � �'� •"�.yy:�',. PATK� . ��' � � � NANCY NRLANO ,�y, �'�� CP Q NEW CK AL �'=. . " � � DWEWNG =36•�',� �r''i-."�..,-- (y) YVELL<5[PTiC 6 •i: .ti_,- �^;` .. 3 o i �s°'+ � 9°ia, -_ � N PROPOSED�,�oo EXISTIN�SEPTIC SYSTEM TO BE ��Npk, '� , � GALLON SE I�IC TANK PUMPED DRY AND FILLED WITH N�� ��,`• /�S �_� '�''� CLEAN SAND AND GRAVEL IN �' i�o �. •C.�y , ACCORDANCE WITH THE \ CURRENT SCDHS STANDARDS �sa�n� \ � WATERTIGHT FRAME 8 COVER Wi MORTAR FROST APPROVED LOCKING DEVICE CONCRETE COVER B.F EL.38.Ot CONCRETE COVER PROOFING 24"fd PRECAST CONC.RISER BELOW GRADE BELOW GRADE G E EL O.00f RINGS(12'MAX.HEIGH� GRADE EL.O.00t 1'min ',� TRAFFIC BEARING SIAB r �• pVC WASTE LINE 2'Ma�c 7RAFFIC PITCH Ye INCH PE BEARING� 4'SANITARY WASTE PIPE PITCH 1/4 INCH PER FOOT � INV EL.35.6;':::"' �: "-" � INV EL.36.5 INV EL.36.1 �o � `� INV.EL.34.8 97.1' 10'MIN. �0 51' 8 MIN �� INV.EL.35.1 8 MIN. Q � 4°':. X ��, `,� �_ 4° �a anr�R _� s��i�n��R ,� , . . - : 3 000 GAILOPI PRECAST SEPTIC TANK DETAIL 'tF.�WtN�pOC?l.T�1'AlC ALL LEACHING PaOLS SHALL�f�.ACED�ACCEP7I1&.E LEACHING , . . _. .,. SO�S AS AP�D BY T}��. D(CAVAT�d IS TO� ": `�"""`""'�������l Cad71P�1ED A MMIko�A�6'-0°l0i0 SUITABLE MdiER1AL AND BAC��LED AS�TAIIED.WTI�IG�S MAY�RE(M11�D. HIGHEST EXPECTED GROUNDVdA'TE�ELEVATION-35.5�LOW GRADF A�s't�E ExCAVA1�ON ". �.:�• ;.'.<:', .•:'�. ... , __. TO�6� '.":.''`:"': WICK FtOLE I T1��FOR E�CH iMCK F�I.E. .�':lYITN CLEAN S �;-.2. GRAVE IT Y TI Y T IL ��PTd�.ELEA N07 70 SCALE