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Home My WebLink AboutDeSimone, Scott o�oSUFFot,��, ELIZABETH A. NEVILLE �� OG'f� Town Hall, 53095 Main Road TOWN CLERK H = P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER y O�� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER O,( �� Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 3113 R Residential x Non-Residential Fee $ 10.00 Septic x Cesspool PERMIT ISSUED TO: Name : SCOTT DESIMONE Address 1: 41780 MAIN ROAD City St Zip PECONIC NY 11958 Descripton of Proposed Construction or Alteration ADDITION TO EXISTING SYSTEM. APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTINO REQUIRED. R10-03-0118 Name Of Owner DESIMONE, SCOTT ------------------------------ Mailing Address 1 41780 MAIN ROAD ------------------------------ ------------------------------ City St zip PECONIC NY 11958 -------------------- -- ---------- Property Address 1 41780 MAIN ROAD ------------------------------ ------------------------------ City St zip PECONIC NY 11958 -------------------- -- ---------- Tax Map No. section 86.00 block 1 lot 7.000 ------ --- ------ Cross Street INDIAN NECK LANE ------------------------------ Building Permit Number Cross Reference: ---------------------------------- Issue Date: 1/29/04 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAQ.) ELIZABETH A.NEVILLE _ OGy Town Hall, 53095 Main Road TOWN CLERK y P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold,New York 11971 MARRIAGE OFFICER 1,,L Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER "7Q1 �a� Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net 2 ( 2003 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: October 21, 2003 Transmitted herewith is a copy of application No. 3248 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Scott DeSimone Please review the application and location map and advise if the project has received Suffolk County Health Department approval and if this office may issue the permit. Please complete the form below and return it to me. Linda J. Cooper * * * * * * * * * * * * I have reviewed the application and location map of the project cited above and make the following recommendations: / APPROVE V DISAPPROVE Comments: Maintain required setbacks from adjacent wells, buildings,property lines and water Bodies. EXCAVATION INSPECTION REQUIRED. i Signature /0/,-2!7 G„3 Dated OF Tc ti F01/r ELIZABETH A.NEVILLE h`Z` OGy Town Hall, 53095 Main Road TOWN CLERK p P.O. Box 1179 ti = Southold, New York 11971 REGISTRAR.OF VITAL STATISTICS MARRIAGE OFFICER O .F Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER �0'� 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 ✓ or Non-Residential @ $25 Application No. �g Permit No. Applicant Name �Ca'T1 �� C�rmovE' Applicant Mailing Address 4 A-I r�G C c�rtc , .j y Septic Tank ✓or Cesspool ✓ Brief Description of Proposed Construction or Alteration -A r Location of Proposed Construction/Alteration: Owner of Property: SC0–rf' ��"�« •s / tel��`�t tc�az` �c=. tom s Owner Mailing Address: Owner Property Address: Name and phone number of contact person1'— Tax Map No: Section 86 Block ! Lot � Cross Street E A.4ck.La.. NOTE: LOCATION MAP MUST BE SUBM TED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL 3 Sign r f Ap Icant ate Received by: "�, T �1L� ' SURVEY OF PROPERTY ON 1�-iLe SITUATED AT v� PECONIC TOWN OF SOUTHOLD UFFOLK COUNTY , NEW YORKQ'� S.C . TAX No. 1000- 86- 01 —07 SCALE 1 "=20' -' SEPTEMBER 25, 2002 AUGUST 27, 2003 ADDED PROPOSED ADDITIONS G� AREA = 26,941 .72 sq. ft. 0.618 ac. / 0 4 / �G QOv � CERTIFIED TO: �z / WA$HINGTON MUTUAL BANK, FA PT'S SUCCESSORS AND/OR ASSIGNS n;x STEWART-_TITLE INSURANCE COMPANY � SCOTT De!SIMONE MEL-LSSA --NYATT—DeSIMONE ° as SUFFOCA COUNTY DEPARTMENT OF HEALTH SERVICES a PERMIT FOR APPROVAL OF CONSTRUCTION FOR A / p � 4 - SINGLE FAMILY RESIDENCE ONLY / �� / Z ° �� DATEcj/C C H.S. REF. N0. Ifle oll APPRO ED 1 ° ° V � u� FW64AXIMUM OF SEDROOMS �� `° � ES THREE YEARS FROM DATE OF APPROVAL 4� . ° j o� 4 A G `150' J Jv d d c / n \ i C v � � TEST T HOLE DATA ;TEST 0_ JUG BY McDONAt-0 GE0SCIENCE Du SP7E'o4BER o, 2002) \ `q4 BROW, SLJI t'-AM OL O _ ��.a-.�-- . PALE dfd2 *SILT ML xal BROWN #'NE TO COARSE S440 sw 39,2 b' WATER W4 ANOWN FiNt TO CugfSiE SAJNU SW \ i s s' d y l d N)X "'�N .NOTES: 1 . ELEVATIONS ARE REFERENCED TO AN ASSUMED DATUM EXISTING ELEVATIONS ARE SHOWN THUS: �� ti F.FL — FIRST FLOOR G FL — GARAGE FLOOR 2. THIS PROPERTY IS A NON—CONFORMING LOT IN THE R-40 ZONING USE DISTRICT. 3. DEED REFERENCES ARE TO DEED , LIBER 11968 PAGE 588. 4. EXISTING SEPTIC SYSTEM TO BE PUMPED CLEAN AND EITHER REMOVED OR FILLED WITH CLEAN SAND. 5. MINIMUM SEPTIC TANK CAPACITIES FOR , 4 BEDROOM HOUSE IS 1,000 GALLONS. 1 TANK; 8' LONG, 4'-3" WIDE, 6'-7" DEEP %�r 6. MINIMUM LEACHING SYSTEM FOR &P Ice) l 4 BEDROOM HOUSE IS 300 sq ft SIDEWALL AREA. 2 POOLS; 6' DEEP, 8' dia. PROPOSED EXPANSION POOL 01, PROPOSED LEACHING POOL PROPOSED SEPTIC TANK 7. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS. THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OF RECORD, IF PREPARED Joseph A. ingegno ANY, NOT SHOWN ARE NOT GUARANTEED. STANDARD: BY THE L. FOR SUCH Land Surveyor UNAUTHORIZED ALTERATION OR ADDITION TITLE ASS( TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR Title Surveys — Subdivisions — Site Plans — Construction Layout EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. PHONE (631)727-2090 Fax (631)727-1727 CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE OFFICES LOCATED AT MAILING ADDRESS TITLE COMPANY, GOVERNMENTAL AGENCY AND 322 ROANOKE AVENUE P.O. Box 1931 LENDING INSTITUTION LISTED HEREON, AND RIVERHEAD, New York 1190 1 Riverhead, New York 11901-0965 TO THE ASSIGNEES OF THE LENDING INSTI— TUTION. CERITFICA'RONS ARE NOT TRANSFERABLE. o 5- 150' 9 'ZI HOLE � �p 00 • \ ro �• o a •�t, p �,� G °o WITH THE MINIMUM Vt`S AS ESTABLISHED v�10h OVEDSTATE YORK [AND N °# N.Y.S. Lio. No. 49668 22—