HomeMy WebLinkAboutMiwhas ELIZABETH A. NEVILLE,MMC o�Og�FFO�,�Co Town Hall,53095 Main Road
TOWN CLERK �� � P.O.Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS 0 Fax(631)765-6145
MARRIAGE OFFICER ,y ��. Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER 0,� �`1 www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER
`
OFFICE OF THE TOWN CLERK D IECEa'Vpm
D
TOWN OF SOUTHOLD
' APR 1 2 2018
TO: Southold Town Building Department BUMD1 NGDBn-
TOWN OF SOUTHOLD
FROM: Sabrina Born, Southold Town Clerk's Office
DATED: April 12, 2018
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4598 for a Cesspool/Septic Tank Construction
Permit submitted by:
Le Jon Enterprises Inc. for Riffat & Absar Miwhas.
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 �`Z` OGy Town Hall, 53095 Main Road
TOWN CLERK p P.O. Box 1179
H Z Southold, New York 11971
REGISTRAR,OF VITAL STATISTICS
MARRIAGE OFFICER � • � Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER y�f®1 �a�� 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 @ $10V or Non-Residential @ $25 Application No. S�
Permit No.
Applicant Name
Applicant Mailing Address P2,o X 2?7
Septic Tank or Cesspool
Brief Description of Proposed Construction or Alteration
��us 2 y ----Q-,�cc:. Fes'' 1, w�c.t�l,► �L.,
Location of Proposed Construction/Alteration:
Owner of Property: � l r r-4 T 1` /W l- ��? gE}tt l� l o.�►-l-ik�
Owner Mailing Address: R D, e0o n 7
Owner Property Address: (Q l 7 5 V-0 u 7-4--
Name and phone number of contact person
Tax Map No: /ee D ,Section 3 Block 193 Lot
Cross Street W It
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WI'At4w.TH EALTH DEPARTMENT APPROVAL
d� *)le11g
Si ature VAppfrant Date
Received by
1 SCDHS REF# R10-02-0233
SURVEY OF PROPEL
f E�� +� AT TTIT UCK
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TOWN OF SO UTHOL
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CEhhPpO,
SUFFOLK COUNTY, l
twE�� 'c `� 1' �\► ��'
1000-139-03-49
p-� SCALE: 1 =20
� s OCTOBER 14, 2016
NOV 3, 20I6 (REVISIONS)
Gess Poovs 1 / NOV 17, 2016 REVISIONS
� I/ 1 1 1
1 MARCH J, 201 (REVISION
h MARCH 2J, SOI (REVISIONS
1 F Lo
1 \061'3 1
LO 0
� J
F TEST HOLE DATA
gyp'( McDON LD 11/2%2ClENCE
O. EL. 15'
DARK BROWN LOAM OL
00
PALE BROWN nNE
j{ ; f j' ` ' O 0/ SAND WITH 20X GRAVEL S
t� gig F eI, :' �?•?' - °, V � r —
6'
L ' ��/ p
03
f€ F �i Z?", / BROWN nNE TO COARSE
TO MEDIUM SAND SP
b.
\ EL. 4.4' ---- 10.6' WATER
c'
0 � � WATER /N PALE BROWN
FINE TO MEDIUM SAND SP
PROPOSED SEPTIC SYSTEM
Nk�
4 BEDROOM HOUSE
,\ •
1—PRECAST 1000 GALLON SEPTIC TANK
Po 2-80 LEACHING POOLS 6' DEEP
WITH 3' SAND COLLAR 3' MIN. ABOVE
•�\ , " `�a GROUND WATER
_4
Nv SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
410 h; /
v � PERMIT FOR APPROVAL OF CONSTRUCTION FOR A
01,
SINGLE FAMILY Rr:-,. CE ONLY
JUN 2 1 201
AT
REF. No, ;r
PPRO IE
® MAYF BEDROOMS
EYPIRESS THREYEARS FROM DATE OF APPROVAL
SEPTIC SYSTEM DETAIL
)5E NOT TO SCALE
18.5
G.I. GOVEK
TO GI;ADE FINISHED GRADE
EL.16.8'
H=11"
Ix t if�3 11�'1'fL�f1 SII[ 1r�I�li�rn�llll?�11�
716
E. 6MIN. [ � C; �MA50NARY CHIMNEY
.5' 12 6�e s[k ;[[ 1' MIN.
I.E. ,` 2' MAXY`<
16.2 , ' to tea, fV,E
I/4" PER FOO I.E.
MINIMUM PITCH15.T
1/8" PER E00 I.E ® ® ® ®I
NINA" DIA. PIPE MINIMUM PITCH 15.5' ® ® ®� ( 1
MIN4" DIA. PIPE ® ® E .
10
�
$x
2` '14"
MIN.
' u
1000 GAL. _ _ MIN.
-� _ >° -
4 'ASIC lV
5EPT/C TANK I.E. `
5' (21 LEACHING POOL5 3 § UR q P.C.
8'0 X 6' DEEP 3 MIN. 55-5020 FAX (631)
U
Q 8p �rQ/� GROUND P.0. BOX 909
1— 92 �.J . Fr/►l . WATER EL�4.4" �i ii i` r
1230 TRAVELER STREET 16
SOUTHOLD, 11971
� 1
Y-16-2 16
ii-is-zags ue
1IN RUNOFF CALCULA TIONS N�p1 0,
)USE & GARAGE = 1411 SQ.FT.
1411x1 x0.17 = 240 CU.FT.
?IVEWAY (PERVIOUS) = 1150 SQ.FT.
500.80.17 = 156 CU.FT. ° ,fid
397 CU.FT. \ N
17/42.2 = 9VF
?OVIDE (2) DRYWELLS 80x5' DEEP
? EQUAL
/ O
' v0 f
941 R-
I t 7
1d
"
4
C�
- �C)
PIPE i
MONUMENT
PROPOSED ELEVA T70N
IMBERS ARE REFERENCED TO
GARDEN HEIGHTS F.F. E
OFFICE OF THE SUFFOLK COUNTY CLERK �-A / F
GP PRO
). 577 j10 0
�• N
IONS REFERENCED TO NA VD 88 `� OX1M PSE �0
VALL Y TO COMPLY WITH SAID LAW THE TERM "ALTERED BY" FP P
R
E USED BY ANY AND ALL SURVEYORS UTILIZING A COPY
THERS SURVEYORS MAP. TERMS SUCH AS "INSPECTED" AND
IT— TO— DATE" ARE NOT IN COMPLIANCE WITH THE LAW. The location of public water, wells and cesspools shown hereon are
TERA TION OR ADD1770N TO 1NlS SURVEY IS A VIOLA TION from Field observations and or from data obtained from others.
BION 72090F THE NEW YORK STATE EDUCA77ON LAW. I AM FAMILIAR WITH THE STANDARDS FOR APPROVAL
AS PER SECT70N 7209—SUBDIVISION 2. ALL CERT7FICA77ONS AND CONS7RUC77ON OF SUBSURFACE SEWAGE DISPOSAL
ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SYSTEMS FOR SINGLE FAMILY RESIDENCES AND WILL ABIDE
IP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR BY THE COND177ONS SET FORTH THEREIN AND ON THE ARL
SIGNATURE APPEARS HEREON. PERMIT TO CONSTRUCT.