HomeMy WebLinkAboutWexler, DonnaELIZABETH A. NEVILLE, MMC
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax(631)765-6145
Telephone (631) 765-1800
www.southoldtownny.gov
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Sabrina, Southold Town Clerk's Office
DATED: April 6, 2015
2015;!
APA
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4305 for a Cesspool/Septic Tank Construction
Permit submitted by:
Mike Hand for Donna Wexler
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
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10_,;_ or Non -Residential @ $25 Application No.
X05
Permit No.
Applicant Name
Applicant Mailing Addressy 2 �-'i �'-' L 'I Q - N
Z
Septic Tank,�- or Cesspool
Brief Descn tion of Proposed Construction or Alteration XQ C- S 1
T r el T3;-V-,1CX
Location of Proposed Construction/Alteration:
Owner of Property. (:;_� C" (-N 4-N q,- w 0
Owner Mailing Address: 'W -es �_�-
S O'yt Y-\
Owner Property
Name and phone number of contact person
Tax Map No: (o,v v Section %C) Block 4— Lot 2-- Z
Cross Street x -1b GHQ
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEAL PARTMENT APPROVAL
Signa re of Applicant Date
Received by:
v
N 86051'20" W
S 88052'40" E
WEST
S 88052'40" E
HILL
EL 14.3'
I 'I'll1'
�
ri
R
1000 GAL.
EL. 12'8 APPROVED PIPE +—
SEPTIC TANK
min. PITCH 1/6"/1'I
I
i
DEVELOPED
0'-6" I
WATER EL 3.0
PUBLIC WATER
Q
MEETS AND BOUNDS BY:
JOHN EHLERS, LAND SURVEYOR
LIC. No. 50202, DATED 05-17-2005
FLOOD MAP: 36103CO166 G, MAY 4, 98
BUILDING
ELEV. 17.0'
gTTF PI AN
bLALt: I" = .JU'-U'
PROPOSED SEPTIC SYSTEM DETAIL
(NOT TO SCALE)
MIN.
EL 14.3'
I 'I'll1'
�
ri
1000 GAL.
EL. 12'8 APPROVED PIPE +—
SEPTIC TANK
min. PITCH 1/6"/1'I
I
i
fg'a
0'-6" I
WATER EL 3.0
0.5' BROWN LOAM OL
BROWN SANDY SILT
ML
PALE BROWN FINE TO
COURSE SAND SW
WATER IN PALE BROWN FINE
TO COARSE SAND SW
--------- J17.0'
TEST HOLE BY McDONALD GEOSCIENCE
631-765-3677 08/05/05
1' MIN.
B'dia.6'deep 8'dia.6'deep
LEACHING LEACHING
POOL POOL
3' r8'i
MIN.
SEPTIC TANK
NOTES: vi
1). MINIMUM SEPTIC TANK CAPACITIES IS 1000 GALLONS. W
2). CONCRETE SHALL HAVE A MINIMUM COMPRESSIVE STRENGTH OF 3000 psi AT U
28 DAYS. / 1
3). WALL THICKNESS SHALL BE A MINIMUM OF 3", A TOP THICKNESS OF 6" AND A
BOTTOM THICKNESS OF 4". ALL WALLS, BOTTOM AND TOP SHALL CONTAIN
REINFORCING TO RESIST AN APPLIED FORCE OF 300 psf.
4). ALL JOINTS SHALL BE SEALED SO THAT THE TANK IS WATERTIGHT.
5). THE SEPTIC TANK SHALL BE INSTALLED AT LEVEL IN ALL DIRECTIONS (WITH A
MAX. TOLERANCE OF +/-1/4') ON A MINIMUM 3" THICK BED OF COMPACTED
SAND OR PEA GRAVEL.
6). A 10' MIN. DISTANCE BETWEEN SEPTIC TANK AND HOUSE SHALL BE MAINTAINED.
LEACHING POOLS
NOTES:
1). MINIMUM LEACHING SYSTEM IS 2 POOLS: G DEEP, 8' DIA.
2). LEACHING POOLS ARE TO BE CONSTRUCTED OF PRECAST REINFORCED CONCRETE
(OR EQUAL).
3). ALL COVERS SHALL BE OF PRECAST REINFORCED CONCRETE (OR EQUAL).
4). A MINIMUM DISTANCE BETWEEN LEACHING POOLS AND WATER LINE SHALL BE
MAINTAINED.
5). AN 8' MIN. DISTANCE BETWEEN ALL LEACHING POOLS AND SEPTIC TANK SHALL
BE MAINTAINED.
ORIGINAL SCHDS APPROVAL:
R10.05-0188 DATED: 10/21/05
SCTM No. 1000-70-4-22 _ _ _ (DESIGN: 4 BEDROOM MAX)
S. S:7-Y-4iLK COUNTY DE"RA S' . ,,�+: 3 OF a.....�J: t 3 ate).77R F'�VES
lJ !& o
-yL I
PERMI ; FOR AWP RUVAL OF C -C-; .°2 £ .a@,T°0r! F A
:.:�
�I
:07 i{
T TM L'
I
I
T NO
3
I
V
0'-6" I
Z
6'-0" I3' CLEAN
SAND
Q
ICOLLAR
J
EL 6.4' I
�1
s
BMJ
O
U)
NOTES: vi
1). MINIMUM SEPTIC TANK CAPACITIES IS 1000 GALLONS. W
2). CONCRETE SHALL HAVE A MINIMUM COMPRESSIVE STRENGTH OF 3000 psi AT U
28 DAYS. / 1
3). WALL THICKNESS SHALL BE A MINIMUM OF 3", A TOP THICKNESS OF 6" AND A
BOTTOM THICKNESS OF 4". ALL WALLS, BOTTOM AND TOP SHALL CONTAIN
REINFORCING TO RESIST AN APPLIED FORCE OF 300 psf.
4). ALL JOINTS SHALL BE SEALED SO THAT THE TANK IS WATERTIGHT.
5). THE SEPTIC TANK SHALL BE INSTALLED AT LEVEL IN ALL DIRECTIONS (WITH A
MAX. TOLERANCE OF +/-1/4') ON A MINIMUM 3" THICK BED OF COMPACTED
SAND OR PEA GRAVEL.
6). A 10' MIN. DISTANCE BETWEEN SEPTIC TANK AND HOUSE SHALL BE MAINTAINED.
LEACHING POOLS
NOTES:
1). MINIMUM LEACHING SYSTEM IS 2 POOLS: G DEEP, 8' DIA.
2). LEACHING POOLS ARE TO BE CONSTRUCTED OF PRECAST REINFORCED CONCRETE
(OR EQUAL).
3). ALL COVERS SHALL BE OF PRECAST REINFORCED CONCRETE (OR EQUAL).
4). A MINIMUM DISTANCE BETWEEN LEACHING POOLS AND WATER LINE SHALL BE
MAINTAINED.
5). AN 8' MIN. DISTANCE BETWEEN ALL LEACHING POOLS AND SEPTIC TANK SHALL
BE MAINTAINED.
ORIGINAL SCHDS APPROVAL:
R10.05-0188 DATED: 10/21/05
SCTM No. 1000-70-4-22 _ _ _ (DESIGN: 4 BEDROOM MAX)
S. S:7-Y-4iLK COUNTY DE"RA S' . ,,�+: 3 OF a.....�J: t 3 ate).77R F'�VES
lJ !& o
-yL I
PERMI ; FOR AWP RUVAL OF C -C-; .°2 £ .a@,T°0r! F A
:.:�
�I
:07 i{
T TM L'
I
I
T NO
I•
N 0
Oo -A
O --�
0
N OD
DEVELOPED
PUBLIC WATER
N 8605120" W 128.320'
JOCKEY —
CREEK i f
AZ \
°�r
0
O
0
0
m
N
0
0
O
0
0
ZON X al' ZONE AE a
-LONE)(
2
`'0
0
X03
0-
j7-
EL
12
DRYWELL —EL 12
EL 1y ACCESSORY — —
BUILDING DRIVEWAY
FIN. FL
WITH HOUSE Euz°
3
EL 16 1000 gal.
EL 14
�t
1
WM WM
SCTM # 1000-70-4-23 (MERGED WITH 1000-70-4-22)
S 88052'40" E =JgPgl,09PEIZTY 100.000' S 88052'40"
WEST H I LL R
DEVELOPED
PUBLIC WATER
MEETS AND BOUNDS BY:
JOHN EHLERS, LAND SURVEYOR
LIC. No. 50202, DATED 05-17-2005
FLOOD MAP: 36103C0166 G, MAY 4, 98
BUILDING
ELEV. 17.0'
EL 16
UNDEVELOPED
NO WELL
I
IC
NEST HOLE �
I
�ti � NEyyrn �
��0 0 7
\FESS
Ltt
w
C?
APPROVED PIPE
min. PITCH 1/471'
EL. 17.5'
EL. 3.0'
SEL 18
Q
�h
�i
K G72
=3206.3SQ.
1
PROPOSED SEPTIC SYSTEM DETAIL
(NOT TO SCALE)
EL 14.3'
1' MIN.
1
3
8'dua 6'dee
1
OLP
8'dia, b'deep
a
LP
3
EXPANSION POOL
r (
/ EP
ITCLEAN
6'-0" I
lOQO GAL.
3E
NOTE
O
NO WELLS W,
SEPTIC TANK
t3-150- DETECTED
�t
1
WM WM
SCTM # 1000-70-4-23 (MERGED WITH 1000-70-4-22)
S 88052'40" E =JgPgl,09PEIZTY 100.000' S 88052'40"
WEST H I LL R
DEVELOPED
PUBLIC WATER
MEETS AND BOUNDS BY:
JOHN EHLERS, LAND SURVEYOR
LIC. No. 50202, DATED 05-17-2005
FLOOD MAP: 36103C0166 G, MAY 4, 98
BUILDING
ELEV. 17.0'
EL 16
UNDEVELOPED
NO WELL
I
IC
NEST HOLE �
I
�ti � NEyyrn �
��0 0 7
\FESS
Ltt
w
C?
APPROVED PIPE
min. PITCH 1/471'
EL. 17.5'
EL. 3.0'
SEL 18
Q
�h
�i
K G72
=3206.3SQ.
1
PROPOSED SEPTIC SYSTEM DETAIL
(NOT TO SCALE)
EL 14.3'
1' MIN.
1
1' MIN.
EL. 13.5'
1
EL 12.8' EL. 12.7'
I
B'dia. 6'deep
Vdia. 6'deep
ITCLEAN
6'-0" I
lOQO GAL.
APPROVED PIPE
LEACHIIIIG
LEACHING
SAND
SEPTIC TANK
min. PITCH 1/8'/1'I
POOL
POOL
(COLLAR
+8'► 3'
f81+
EL. 6.4' I
f8'a
1
MIN.
z
WATER EL. 3.0
—
0.5' BROWN LOAM OL
BROWN SANDY SILT
ML
13.0'
114.5'
PALE BROWN FINE TO
COURSE SAND SW
WATER IN PALE BROWN FINE
TO COARSE SAND SW
----------- J17.0'
TEST HOLE BY McDONALD GEOSCIENCE
631-765-3677 08/05/05
••
SITE PLAN
SCALE: i" = 30'-0'
SEPTIC TANK
NOTES:
1). MINIMUM SEPTIC TANK CAPACITIES 15 1000 GALLONS.
2). CONC jETE SHALL HAVE A MINIMUM COMPRESSIVE STRENGTH OF 3000 psi AT
28 DAYS.
3). WALL THICKNESS SHALL BE A MINIMUM OF 3". A TOP THICKNESS OF 6" AND A
BOTTOM THICKNESS OF 4". ALL WALLS. BOTTOM AND TOP SHALL CONTAIN
REINFORCING TO RESIST AN APPLIED FORCE OF 300 psf.
4). ALL JOINTS SHALL BE SEALED SO THAT THE TANK IS WATERTIGHT.
5). THE SEPTIC TANK SHALL BE INSTALLED AT LEVEL IN ALL DIRECTIONS (WITH A
MAX. TOLERANCE OF +/- 1/4") ON A MINIMUM 3" THICK BED OF COMPACTED
SAND OR PEA GRAVEL.
6). A 10' MIN. DISTANCE BETWEEN SEPTIC TANK AND HOUSE SHALL BE MAINTAINED.
LEACHING POOLS
NOTES:
1). MINIMUM LEACHING SYSTEM IS 2 POOLS: 6' DEEP, 8' DIA.
2). LEACHING POOLS ARE TO BE CONSTRUCTED OF PRECAST REINFORCED CONCRETE
(OR EQUAL).
3). ALL COVERS SHALL BE OF PRECAST REINFORCED CONCRETE (OR EQUAL).
4). A MINIMUM DISTANCE BETWEEN LEACHING POOLS AND WATER LINE SHALL BE
MAINTAINED.
5). AN 8' MIN. DISTANCE BETWEEN ALL LEACHING POOLS AND SEPTIC TANK SHALL
BE MAINTAINED.
ORIGINAL SCHDS APPROVAL:
R10.05-0188 DATED: 10/21/05
SCTM No. 1000_70_ _ _ _4.22 (DESIGN: 4 BEDROOM MAX)
J` I4 _ UU COUNTY [DEPART, OF HEALTtl GF RVIC S
�G
PER -Ma ; � CONN ( RUCTION, FOR A
SAT" 0
W 0Z
W J O
Q H
Z
ZWO
O 3:0
HEET
l
Y .
ELIZABETH A.NEVILLE Town Hall, 53095 Main Road
J TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER yif'® a®�� Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER 1 `1► Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD RECEIVE®
SOUTHOLD WASTEWATER DISTRICT
APPLICATION MAY 1 1 2017
OPERATION PERMIT
Southold Town [(er{s
CESSPOOL or SEPTIC TANK
Residential @ $10X or Non-Residential @$25 Application No..95(}f
Permit No. ��M—0078
Owner Name 0ahti a �c
Owner Mailing Address /7777s'
Owner Property Address 1 7's A
Owner Telephone No. 7/ �3l /DUU
Tax Map No: Section 20aOa Block L Lot Aoq
Cross Street 00//c
Please check each that applies: New Construction !/
Alteration to Existing System
Residential Non-Residential
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. (Locate
building and system; give north arrow and approximate distance in feet from system to building
and closest road. New construction may submit copy of survey with SCHD approval.)
a� / z s ~ II - I ?
Signature of Applicant Date_
Received by:
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4501-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner DONNA WEXLE
------------------------------
Mailing Address 1 1775 INDIAN NECK LANE
------------------------------
Mailing Address 2
------------------------------
City St Zip PECONIC NY 11958-0000
-------------------- -- ----------
Property Address 1 1275 HILL ROAD WEST
------------------------------
Property Address 2
-------- ---------------------
city St Zip SOUTHOLD NY 11971-0000
-------------------- -- ----------
Owner Telephone No. 631-838-1000
------------
Tax Map No. section 70.00 block 4 lot 22.000
------ --- ------
Cross Street WELLS AVE
------------------------------
---------- ---------1-------------
Issue Date: 5/11/17 Eli abeth A. Neville
-------- Southold Town Clerk
(TOWN SEAL)