HomeMy WebLinkAboutMendez/Henshaw ELIZABETH A.NEVILLE,MMC �'� Town Hall,53095 Main Road
TOWN CLERK �r P.O.Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS E � Fax(631)765-6145
MARRIAGE OFFICER u "„� k� Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER ` '° www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICERt:
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Southold Town Clerk's Office
DATED: December 7, 2018
RE: Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 4685 for a Cesspool/Septic Tank Construction
Permit submitted by:
Tom Samuels for Rene Mendez & Leslie Henshaw
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: �w�...
Signature
Dated
ELIZABETH A.NEVII.LE Town Hall, 53095 Main Road
„„ �
P.O. Box 1179
TOWN CLERK Southold,New York 11971
REGISTRAR.OF VITAL STATISTICS s
MARRIAGE OFFICER
Fax(631) 765-6145
I
RECORDS MANAGEMENT OFFICER Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
OFFICE OF TM 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. OO
Permit No
Applicant Nacre Steelman Architects
Tom Samuels Samuels and
Applicant Mailing Address 25235 Main Road, Cutchogue, NY 11935
Septic Tank or Cesspool
tic new se system
Brief Description of Proposed Construction or Alteration P ystem with new piping
_ .__... . ... a. .....� ...... _ _.�w ...__
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Location of Proposed Construction/Alteration:
Owner of p'ropeity
Owner Mailing Address: 22 Garden Place, Brooklyn, NY 11201
Owner Property Address: 3945 Soundview Avenue, Peconic, NY
Name and phone number of contact person Tom Samuels 631 734-6405
Tax Map No: SectionBlock _ 01 Lot_........
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
Signatur*' f pplicant Bate
Received by:
Town of Southold
P.O Box 1179
Southold, NY 119111
RECEIPT* * * * * *
Date: 12/07/18 Receipt#: 250044
Quantity Transactions Reference Subtotal
1 Septic Permit- Construct- Resid„ 4685 $10.00
Total Paid: $10.00
Notes: Rene Mendez&Leslie Henshaw
M
Payment Type Amount Paid By
CK#17770 $10.00 Samuels, & Steelman
Southold Town Clerk's Office
53095 Main Road, PO Box 1179
Southold, NY 11971
Name: Samuels, & Steelman
25235 Main Rd
Cutchogue, NY 11935
Clerk ID: JENNIFER Internal ID:4685
POOL (LP)
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Ha'9 erman Rita L
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OU 1000 GAL SEPTIC, TANK (ST)\
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SOL : 1"=20'-0"
REVISIONS:
-SITE7/2/18
SCTM # 1000-68-01-15.1
PROPERTY: 3945 Soundview Avenue
Peconic NY 11957
OWNER: Rene Mendez & Leslie Henshaw
AGGE550RY BUILDING 22 Garden Place
ORY FIRST FLR EL +38.0
;GESSBrooklyn, NY 11201
ESS BASEMENT FLR EL +29.0
GRADE LINE ELEVATION 34.9 FT. SITE: 524,063 sf = 12.03 ac
ZST FLR GLEAN OUT AREA
+38.0 GRADE LINE ELEVATION ±34.9 FT. &RADE LINE ZONING: R-80
I' MIN. 2' MAX. ELEVATION± 34.9 FT.
FLOO
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tSEMENT TOP OF POOL 33.49 FT.
ZONED:
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R EL +29.0
SURVEYOR: John C. Ehlers
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�4 /FT, I8'rFT, 6 East Main St.
SEPTIC, LEAGHI NG
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TANK
POOL Riverhead, NY 119010 1330.
IE. +28.3' IE. +27.64' 8x12 ,BOT OF POOL 15.89 FT. LICENCE NO. 50202LL
ILIJ
IE. +28.14" IE. +27.56' DATED: 05-06-15
6ROUND WATER 2.0 FT.
8' 3' MIN TEST HOLE z ..
NO SCALE w
SEPTIC BY MARK McDONALD GEOSCIENCE
(N.T.S.) SOUTHOLD, NEW YORK 11971
TEST HOLE DATA 12 / 21 / 17 ELEV. 34.0
1.0 FT. DARKBROWNLOAM OL UJ Uj
3.0 FT. BROWN SILT ML Z UJI
17.0 FT BROWN CLAYEY SAND SC 0 w =)
226.0 FT BROWN SANDY CLAY CL ''
4 32.0 FT BROWN SILTY SAND SM Uj
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�,� 35.0 FT BROWN SILTY SAND SMUj
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INWATER >
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BROWN FINE SAND SP
o 42 FT.
01Q;_11 COMMENTS. WATER ENCOUNTERED
'}} 0� 32' BELOW SURFACE, ELEV 2.0'
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LOCATION MAP LU
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