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ELIZABETH A. NEVILLE,MMC �Z �y Town Hall,53095 Main Road
TOWN CLERK � '-Z P.O. Box 1179
y = Southold,New York 11971
REGISTRAR OF VITAL STATISTICS Fax(631)765-6145
MARRIAGE OFFICER � ���' Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD D
D
TO: Southold Town Building Department NOV 9 2017
FROM: Sabrina Born, Southold Town Clerk's Office E-UH D;IsTG DEPT.
TOWN OF SOU THOLD
DATED: November 8, 2017
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4540 for a Cesspool/Septic Tank Construction
Permit submitted by:
Samuels & Steelman Architects for Michael& Mary Heallerty.
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 V
DISAPPROVE
Comments: Final approval required from the Suffolk County Health Department
Signature
lr .2-0r
Dated
ELIZABETH A.NEVILLE J Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
M Southold,New York 11971
REGISTRAR OF VITAL STATISTICS Fax(631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER 4% Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
. TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$10 V or Non-Residential @$25 Application No.
Permit No.
Applicant Name.-
Tom Samuels, Samuels and Steelman Architects
Applicant Mailing Address__25235 Main Road, Cutchogue, NY 11935
Septic-Tank jor Cesspool
Brief Description of Proposed Construction or Alterationnew septic system with new piping
-
Location of Proposed Construction/Alteration:
Owner of Property:--- Michael arad-Ma-4 HaaqertV
Owner Mailing Address: 317 Vineyard Road, Huntington Bay NY _-11743
Owner Prop erty,,Addiess'. 10550 Nassau Point Road,-Cutchogue, NY
Name and phone number of contact person Tom Samuels 631 734-6405
Tax Map No: Section 119 Block 01 Lot-- 16
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
-IL7
_7-1
SignaYtre of Applicant bate
Received by:
,tom •
e
FIRST FLR EL 34.4 FT '°�'�.sF.RTIT-I'CAT101�1 REC1U1REL).
��, � �� _ SITE TA
GARAGE FLR ELEV+24.4 r� TIC�€� '
GRADE LINE ELEVATION 32.2 FT Co q t��P;I"I RE, �` R R'—A'C OF-R"Ii IC a SCTM# 1000-11 SSA
CLEANOUT I� ra PROPERTY: 10550 NASSAU POINT ROAD
TR°�' t I0i°j � T ADDRESS CUTCHOG E,NY 11935
GRADE LINE ELEVATION±32.0 FT. C_ OWNER: MARY 8,MI AEL HEAGERTY
I'MIN.2'MAX. �•o e #J w ' N/O/F 317 VINEYAR ROAD
r°,4..�ro(.� tl� s "ale • LAURENCE NIEBLING, DIANE NIEBLING HUNTINGTON AY,NY 11743
14"/FT MIN Cir FINP�_��.�P O'A �' a 24 Margaretto Rd, Boonton, NJ 07005 SITE: 30,507 sf=0.70 ac
8° MIN T OF POOL 80.63 FT 10020 Nassau Point Rd,
_ 1000-119-1-18 ZONING: R-40
LEACHING �- DWEWNG WITH PUBLIC WATER SURVEYOR: NATHAN TAFT CO WIN III
TANK POOL PROPOSED NEN SEPTIC SYSTEM
IE.+312' IE,+30,4' BOT OF POOL 22b8 FT FORA 6 BEDROOM RESIDENCE PO BOX 17 >
- 1500 GAL SEPTIC TANK(ST) ! JAMESPORT,NY 1 47 Z
le. +30.a' IE.+30.8' GROUND AAT'ER -CLEANOUT
LOCATION OF EXISTING SANITARY LICENSE#50467
-(2)8'DIA x 8'HIGH LEACHING POOL(LP) 5Y5TEM TO BE ABANDONED - FILLED
N/O/F DATED 719108 _ �
II' q5' S.MIN -FUTURE LOCATION FOR(1)8 DIA x 81 IN OR REMOVED AS REQUIRED DAVID J CORCORAN 316117 ADD TOPOGRAPHICAL SURVEY
OF HIGH LEACHING POOL(EXP) 8' Y NEA RETAINING WALL 38 Sherry Hill Ln, Manhasset, NY 11030 ELEVATIONS ARE RE RENCED O
SEPTIC PROFILE
TOP
s o GLEAN OUT 10120 Nassau Point Rd, w
MI NOT INTENDED To =
1014 18 22 zs 30 34 1000-119-1-17 TO N.A.V.D.1988 DATU
34 , CONTAIN SEWAGE DWELLING WITH PUBLIC WATER = V
(N.T.S.) 12� 18 120 2 28 32 32 32 ABOVE G UND 10 in 0
i 0 I + PROPANE�K E[ rTT / 'IN 3\ 38 351.62' 38 �
I WALKWAY m —5225+ — — — -- — _ _ 0 (�
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in OF SLOPE /
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,", S / I O WELLS
y'y j{ EXISTING IN RADIUS
I �a NG'? in 325+ 30— pU)`ID WITH
I I 1 1 DECK t ' rr�ESIn�N�%�:s,y, -a�TAININ6 WALL 0
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i' \ 34 N/0/F ; Oa
IDEGK I I ` ) / 'd+BE�RDOI tSz1,F 8OR4 AENT;; DE P +3 O YVATERM 00 GONG. Carl Hoelzl
I } �:"°�; TO'�AL:'GR095%F1AOR�P:REA%
I I I I 1 1 1 I I IT79':SF;81';1, ;itt`x, RETAINING wAL
EXISTING ,< FI F RST?FIN ELR ELEV2+34:4`i + 3 K FOR SEPTIC SY5 M L� 21 Whitford Rd, Stony Broo , NY 11790 0
SHED a,t I 1 1 1 I 1 - \ ,g�, GPRA6>=51a4B,ELEV,°+24.4 3 31.0+ 3 SEE DETAIL g'1 9895 Nassau Pain Rd Z a
C12 SF
I f.± I I ' 1 1 \ � / WALKWAY 328+ � ; ��slf;r;SZk�lt t +28.0 3t95+ -3 TEST HOLE �•�� 3 1000-1199-1- �
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= SBPAAG I I 1 / \ \ DW 50- 7.6 2 .5+ +2 -�L�\ 1 MURPHY NASSAU PT RD LLC
STAIRS 6 / 30 9905 Nassau Point Rd, Cut ogue, NY 11935 L0
DW \ DRIVEWAY 1000-119-1 9.1
W)
z I`( V I I I \ _ ENTRY EXISTING PUBLIC DWEWNG WITH PU C WATER CD
it N I 13 p I I I I / 2 WATER METER
GREAT �° o°sIAPE I 'I 1 — \ ` — Zh 28 GRAVED_ \ EXISTING 28 N/ F
PECONIC I r I I UNDERGROUND DRYWELLS — DRIVEWAY
FOR ST� F— . UNDERGROUND CHRISTOPHER STABI JOHANNA STABILE
I ; WATER LINE 107 Emily Way, Ea Setauket, NY 11733
zo a 1 � FROM i3UILDING STRUCTURES / . 9975 Nas au Point Rd, °a Z.
BAY z I — 2s \� 1000 119-1-10 y a•
�Y �I 1 1 I 1 �T+ / — \ I . POLEEXISTIN6 UTILITY DWEWNG WITH PUBLIC WATER J�• S o
\ _ — DRI Y 24 ip \ Lu-J. a°�3
EXISTING / TEST HOLE W.
I \ i O� ABOVEGROUND N/O/F NO SCALE
° 22 �� 4 UTILITY LINE C/O SCOTT A GONGAWARE TEST HOLE DATA 613117RS ELEV.+I 271E a�•
N I I / ' 1 _ — _ ==— • �6 �I���f�Sp Ct q�91 i PO BOX RKM,NassLIGOau
PR, PA 15658
10075 Nassau Point Rd, w rn•
uMi 1000-119-1-13.1
ZD / _ ENT may, �� E
M 6 _ G of PACE ��• ��-)1•*1,itar DWEWNG WITH PUBLIC WATER 1.0 F . BROWN SILTY SAND SM
z I 00' — EO �" / N/O/F y0
e600. 1s ByOPE Health
e!�
1 I Op'QF , ealth Des � e,n 3444 Carrollton INGRIWe,JWantaghN NY 11793UNDPALE BROWN FINES ND
+ 10375 Nassau Point Rd, /23 FT.COMMENTS:NO WATER ENC UN F�Et
2 I/2"THK �s � DRYWELLS FOR t 1000-119-1-15 �
GRADE LU TONE I 14 RAINWATER RUNOFF N
S%MAX COPING 11 \ -- F p uvzw 1�-- ~-•- """ DWELLING WITH PUBLIC WATER �e
SLOPE
2"OVERHANG Abandonment of existing sanitary sy m must be in
GRAVEL
:•;;: , TYPICAL / SITE' PLA N
DRAIN % LOCATION MAP titi// 5C : r_=30-0' conformance with departm nt req irement Submit �p o V 1703
:hI4 d STONE - • Fcy 1 350
REINFORCED GONG VENEER i completed foam ViTVJT CD as proof. STER D A LIT
RETAINING WALL MORTARED TO ° \
VV 2#4® 12"HORIZ.AND ' GONGRETE N v �"' TS
2#4® 12"VERT. RETAINING ----- .m •�,. �....m •... - -.• .w°�m•..w
LLI Iry ALLIED WALL n \� SUFFOLK CCU NT` ` • •,I$'114LNT OF HEk1L'TH .SERVICES 6122117
_ V.=30,-0"
PROVIDE WEEP PERIMI T FOR APPrRovAL. 0,T CONSTRUCTION FOR A
HOLES,lK1" FVC,
BELOW GRADE ON GRADE 16p SIe� i.IR&9IL',' RESIDENCE ONLY
FINISHED SIDE AT 4'0"
oG,WITH 12"THICK 6 / OCT 3 1 201 °;� SITE PLAN
GRAVEL AND FABRIC
FLTER ALONG BA
CK 'I
SIDE OF WALL - pDAT E- )' � �;�C' I�o.
SHtzhl NU
36" IFTti,i� i.)J1.Y.I[' 'il3 01.REINFOBEDROOMS
S
GONG E)a E) PI'iL:•... ?:qtr i YEARS € x-107-1 DATEOF APPROVAL
FOOTING K/ ° ! . ....,•. - „...__...-..- _ . .......e.�.® .
i
O.o.AND RETAINING WALL DETAIL
3#4 CONT. (N.T.S.) SCDHS SUBMISSION