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Pawlowski
.y ry' ELIZABETH A.NEVILLE,MMC may. ,y Town Hall,53095 Main Road TOWN CLERK ® P.O.Box 1179 CO2 a Southold,New York 11971 REGISTRAR OF VITAL STATISTICS _ .g Fax(631)765-6145 MARRIAGE OFFICER q� ®! Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK F, / D TOWN OF SOUTHOLD U AUG 2 9 2016 TO: Southold Town Building Department BUILDINGDEPT. FROM: Carol Hydell, Southold Town Clerk's Office TOWN OF SOUTHOL]D DATED: August 29, 2016 RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4419 for a Cesspool/Septic Tank Construction Permit submitted by: Paul Pawlowski 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 Signature Dated ELIZABETH A. NEVILLE e ��0� C��� Town Hall,53096 Main Roa- TOWN CLERK ca P.O. Box 1179 REGISTRAR,OF VITAL STATISTICS y Southold, New York 11971 MARRIAGE OFFICER Fax (631) 766-6145 RECORDS MANAGEMENT OFFICER y�fQ �Q� Telephone(631)765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.nex 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. � Permit No. Applicant Name. Applicant Mailing Address__ ,�® 4910K Septic Tank r Cesspool Brief Description of Proposed Construction or Alteration Location of Proposed Construction/Alteration: Owner of Property:— oelfL ✓ ,�7-^1 r PO—Lo o lJO S�it Owner Mailing Address: 7rZ Owner Property Address: Name and phone number of contact person Tax Map No:l v Section rZ, Block Lot Cross Street �y���,-� NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL ig ature of Applicant Date Received by: The offsets or dimensions shown from structures to the property lines are for a specific purpose and use,and therefore,are not Intended to guide In the erection offences,walls,pools,patios,additions to buildings and any other construction Subsurface and environmental" conditions were not examined or considered as a part of this survey Easements,Rights-of-Way of record,If any,are not shown Property corner monuments were not placed as a part ofthis survey Certifications on this survey signify that the survey was prepared In accordance with the current existing Code of Practice for Land Surveys adopted by the New York State Association of Professional Land Surveyors,Inc The certification is limited to persons for whom the survey Is prepared,to the title company,to the governmental agency, and to the lending Institution listed on this survey Said certifications indicated hereon are not transferable 8 10W�i1VM31 � �30IJJ® p3 n L� yY I0 ® SITE DATA � S301AUB 1��1ra7[l'p���� � PROPERTY IS ZONED R-40. / TAX LOT 1000-123-01-2 2 ' TAX LOT N (AIRPORT) 1000-123-01-0s �9REQUIRED PROPOSED NO APPARENT WELL/ ����POOLS VACANT n nv MINIMUM LOT SIZE 15 000 S F 1 , 19S.F. oo� WITHIN 150' OF SUBJECT PROPERTY MINIMUM LOT WIDTH 150' 119' h N U c 16.04 LOT DEPTH 175' 586' do g o MINIMUM FRONT YARD 50' 312' o - a A 12 0 20 MINIMUM SIDE YARD 15/35' TOTAL 15'/35' TOTAL AVENUE �6� MINIMUM REAR YARD 50' 130' PARK MAXIMUM LOT COVERAGE 20% (BY BUILDING) 5% (3,350 S.F.) r +14.78 +l�11 +15.24 +14.85 � � 1501 1OH- - - PROPOSED TOTAL LOT COVERAGE +17.53 PROPOSED EDGE OF / ONNECT 70 �'g� \ PAVEMENT 120. PUBLIC WATER - \\ 1 t�50 BUILDING:BUILDING: 3,350 S.F. N\ 1069.99' POOL: 512 S F 1 PATIOS & WALKS: 1,500 S.F. PROPOSED PARKING AREA- 1,350 S.F. o MASONRY DRIVEWAY APRON: 302 S.F. \ APRON < 1 14.3 I 7,014 S.F. OR 10.4% OF LOT AREA \ +1 Il +13g y TEST BORING +17.0 + Q3 STABILIZED1 I /// f 5/18/16 EL. 17.0 CONSTRUCTION I I \ TAX LOT 5.3TO \ ENTRANCE -� &LOAM SOIL 50'X20' � 1\ I I 1 1 +147 RESIDENCE p (GL) +15.3 I o I <'+'13.9 �� 1 PUBLIC WATER BROWN +16.81\ o / I SAND +17.s 1 \n \ (SM) r II � 0 $1s.0 \ +14.81 1 +14.4 £ 151 SAND +17.2 I ' rcw I (SP) 4 +17.8 I / °3 15=1 A EL. 2.3 1 II 1 w +14-9/ { WATER }6.2 14.7 b 0 _o!// C TEST BORING PROVIDED +17.s I 1 r / /( \ BY PAWLOWSKI, INC. NOTE: DEPTH TO GROUNDWATER IS CONSISTENT 177"0+177 WITH USGS MAPS; NO NEARBY WELLS FOUND TO *15.0 +16.2 O DETERMINE HIGHEST EXPECTED GROUNDWATER LEVEL +/A I I 1 0 TAX LOT 6 NOTES +16.71 0 1 \ 1 f i d_r 1. LOT AREA = 67,569 SQ.FT. TO APPARENT HIGH WATER LINE. / to I I I 18.1 +181 RESIDENCE 2. DEED REFERENCE LIBER 11507 PAGE 589. I I /70+ PUBLIC WATER (TAX LOT 1) p 50x 3. LANDWARD OF THE TOP OF BLUFF, THE PROPERTY LIES IN FLOOD 1n EXISTING PROPOSED EXP � ZONE X, AREAS DETERMINED TO BE OUTSIDE THE 0.2% ANNUAL WELL I + •6 ( MASONRY LP CHANCE FLOODPLAIN, SEAWARD OF THE BLUFF, THE PROPERTY -Fj 1 I ARKING AREA O 1p' �t O*2Tp' RD a P MIN \ LIES IN FLOOD ZONE VE (EL. 8), ACCORDING TO FEMA FLOOD 1d� f MAP NUMBER 36103CO482H, REVISED SEPTEMBER 25, 2009. TAX LOT 2 1 IN a a� POSED S RAM 4. EXCEPT AS SHOWN, SUBSURFACE AND ENVIRONMENTAL CONDITIONS +14.6 162 i +17. T 10'. 18.0 WERE NOT EXAMINED OR CONSIDERED AS PART OF THIS SURVEY. VACANT +153 1 \\ o �\M�� s =1N, ¢l / \ _ 5. ELEVATIONS REFER TO NAVD 1988. 6. ALL IMPROVEMENTS TO BE CONSTRUCTED FROM APPROVED: 200' RD-2 2 16.s PLANS AND IN ACCORDANCE WITH THE STANDARDS AND 174 I SPECIFICATIONS OF THE TOWN OF SOUTHOLD, S.C.D.H.S & 16 ao° 136 N.Y.S. D.E.C. AS APPROPRIATE. -- -- +14.7a0 a' FF't6 5' � N = ti I _ 7. PROPOSED 1-1/2 STORY DWELLING WITH BASEMENT & 4 +14.5 -� OF, 60. 50 ,0 - - --- - - BEDROOMS. 412' 20' � �-18 0 156 a 18.1 INSTALL (1) 1500 GALLON SEPTIC TANK (ST) & (2) 8' 7.5 M Q DIAMErER/ 8' DEEP LEACHING POOLS (LP). (SYSTEM +16N ,OtipROppgme 1g 0• tee`}' 0 OVER-DESIGNED BY OWNER). + 11-1/2 sNG -o . / _' TAX LOT 7.3 19 +144 RD-1/ t: 21 PROPOSED 20 RESIDENCE INGROUND MIN !WOOD +18-4 (TAX Lor ,) O pp0` 17,9/PLATFORM 184N PUBIC WATER EXISTING -3050 PLATFORM I �} SANITARY � Ati •, 1V1 0'\ SYSTEM ` 1 16.9 POOL WASH +15.2 Y1/� w f o \PROPOSED m SILT FENCE \ 0 PROPOSED \ 4'X25' WALK/ UTILITY V +17.1 STAIRWAY BOX W/ 1 TO BEACH 1 -I- SPIGOT +17. DRAINAGE CALCULATIONS t 16 _ / SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES STORAGE REQUIRED +15.7 �" TOPOF BLUFF -+15.4 PERMIT FOR APPROVAL OF CONSTRUCTION FOR A _ T�L - ROOF AREAS - - - -- WALL SINGLE FAMILY RESIDENCE 014LY I SE RD-1 2160 SF X = 360 CIF - - - BLUFF TO BE RD-2 840 SF X > = 140 CF VEGETATED WITH NATIVE WALL AUG 2 6 q®�� BEACH GRASS 32,500 S F. G RD-3 350 SF X �= 58 CF - - - � - aa•w j�`/T�� ®A`e E hl. F. Q ((JJVV APPARENT \ POOL WASH: (20% OF POOL VOLUME) HIGH WATER - VOLUME=23,000 GALLONS X 0.2= 4,600 _ _ INE. APPROVED GALLONS. _ -2 - - _ _ 4600 GALLONS= 615 CF - - - - FOR M mum Or ®FrORO®M6 STORAGE PROVIDED cr 5_2v3_0" 1�fi1 0 (-ZOO- EXPIRES THREF,YEARS FROM DATE OF APPROVAL RD-1 (1) 10' DIAM. X 6 DEEP. (6) X 68.42 - - - o ^^ate--�r►�•-++ .`..-....a-- = 410 CF RD-2 (1) 8' DIAM. X 4 DEEP. (4) X 42.24 S = 169 CIF o 3 RD-3 (1) 6' DIAM. X 3 DEEP. (3) X 22.34 $ = 67 CF POOL WASH: (1) 10' DIAM. X 9 DEEP. (9) X PECONIC BA 68.42= 615 CF Title No.: Date Revision PREPARED FOR: ANNE & PAUL PAWLOWSKI PLOT PLAN 950 LUPTONS POINT ROAD 100 PARK AVENUE MATTITUCK, NY 11952 07/05/2016 TEST BORING (631)-445-4348 MATTITUCK, NY 11952 06/23/2016 REVISED POOL ORIENTATION 06/02/2016 PLOT PLAN FOR SUBMISSION TO SCDHS Unauthorized alteration or addition to this survey Is a violation of Section 7209,sub-division 2,New Tax Map:DISTRICT 1000 SECTION 123 BLOCK 7 LOT 3 - cation Law®F E�1Situate:MATTITUCK,TOWN OF SOUTHOLD County:SUFFOLK I gdPINNACLE Map of:DESCRIBED PROPERTY LAND SURVEYORS L L P Map Lot:-- Map Block:-- ''�'°�" ® / File Date:-- File No.:-- °® 41 55 VETERANS HIGHWAY, SUITE 1 1 631 6489273 FWD Scale: 1"= 60' RONKONKOMA, NEW YORK 1 1 779 WM.PLSLI QPM Copies of this s map not bearing the land surveyor's embossed seal and signature shall notDate: MAY 18 2016 Project No.:160135 © 2016 PINNACLE LAND SURVEYORS LLP be considered to be a true and valid copy