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Home My WebLink AboutDeSimone, Scott (2) ELIZABETH A. NEVILLE =�0 OG'j Town Hall, 53095 Main Road TOWN CLERK y P.O. Box 1179 REGISTRAR OF VITAL STATISTICS �y • !� Southold, New York 11971 MARRIAGE OFFICER Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER ��l .�� 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. 3114 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 SANITARY SYSTEM FOR ADDITION TO ONE FAMILY DWELLING. APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES. REF #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 -------------------- -- ---------- -=ax 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 SEAL) ' �osuFFot,�c 31 � ELIZABETH A.NEVILLE =�0 �Gy Town Hall, 53095 Main Road TOWN CLERK o - P.O. Box 1179 C** Southold,New York 11971 REGISTRAR OF VITAL STATISTICS �y • !� Fax(631) 765-6145 MARRIAGE OFFICER ,L RECORDS MANAGEMENT OFFICER �Ql �a0 Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net LUiI 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. 3249 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 DISAPPROVE Comments: Maintain required setbacks from adjacent wells,buildings,property lines and water Bodies. EXCAVATION INSPECTION REQUIRED. r Signature �b /100i> Dated i s • ELIZABETH A.NEVILLE =`1` y� Town Hall, 53095 Main Road TOWN CLERK p P.O. Box 1179 GO Z Southold, New York 11971 REGISTRAR,OF VITAL STATISTICS MARRIAGE OFFICER Oy �� Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER �f Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER O'� 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 3?j4l Permit No. Applicant Name �CoTI" nr S-"-, .,-d Applicant Mailing Address 41760 l.n Al Septic Tank ✓ or Cesspool ✓ Brief Description of Proposed Construction or Alteration Location of Proposed Construction//Alteration: Owner of Property: e-rr /1c 'S'.' Q —�esnwA-e, p Y� Owner Mailing Address: Owner Property Address: 4 o�40-� Name and phone number of contact person Tax Map No: Section tl6 Block Z Lot_ ]7 _ Cross Street NOTE: LOCATI MAP MUST BE SUBMITTED ITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL c� i� o e plicant at Received by: - - -- - SURVEY OF PROPERTY C�I�)C� . oy,�/ S'ITUATE'D AT 067 PECONIC TOWN OF SOUTHOLD UFFOLK COUNTY , NEW YORK eye ' S. C . TAX No . 1000-86 - 01 - 07 °� 1 SCALE 1 "=20' SEPTEMBER 25, 2002 AUGUST 27, 2003 ADDED PROPOSED ADDITIONS AREA = 26,941 .72 sq. ft. 0.618 ac. OR, o� CERTIFIED TO: Sze WASk-iINGTON MUTUAL BANK, FA "° � PT'S SUCCESSORS AND/OR ASSIGNS j STEWART --TITLE INSURANCE COMPANY SCOTT DiSIMONE / ME`ttSSA -.4"iYATT—DeSIMONE 4 a' SUFFOQ( COUNTY DEPARTMENT OF HEALTH SERVICES PERMIT FOR APPROVAL OF CONSTRUCTION FOR A 21 y SINGLE FAMILY RESIDENCE ONLY o �O DATE `�iD �J H.S. REF. N0. ID "ofl o �` APPRO ED FOaCIOAXIMUM OF0 6EDROOMf �� va £S THREE YEARS FROM DATE Of APPRO AL 4� / e °n JJv c � a % 0 a o. �, s o c r' I i i Al- \\ i� Nti Op' I I h,aA %k �I TEST SOLE--EA sTcST -- JU `'B _.VcDO;vAL r_ G'OSCIE7N CE Dh _.EPTE ti BEY t, EL l u ...�� ". oaLE tiK"1.M+:ti 5'lT ML , rX C UZ,G GROWN Tlry'c TO d I X �OI+R'St�_ TQC SM _392. r �u L YtP-TF_R Ib' :i90VN F)N= TO GOWIS..l SAND SW i it \ o o \ �0 � a �o \ sl d j d NOTES: 1 , ELEVATIONS ARE REFERENCED TO AN ASSUMED DATUM A EXISTING ELEVATIONS ARE SHOWN THUS: FIRST FLOOR C•�I_ - 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 d REMOVED OR FILLED WITH CLEAN SAND. 5. MINIMUM SEPTIC TANK CAPACITIES FOR 4 BEDROOM HOUSE IS 1 ,000 GALLONS. 0 1 TANK; 8' LONG, 4'-3" WIDE, 6'-7" DEEP 6. MINIMUM LEACHING SYSTEM FOR 4 BEDROOM HOUSE IS 300 sq ft SIDEWALL AREA. 2 POOLS; 6' DEEP, 8' dio. 17171 PROPOSED EXPANSION POOL ` 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 Fox (631)727-1'727 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 11901 Riverhead, New York 1 1901-0965 TO THE ASSIGNEES OF THE LENDING INSTI- TUT10N. CERTIFICATIONS ARE NOT TRANSFERABLE. \1 � �, QaG 36 2 o � , 'oma �►4IN 17� COQ USC �� A 150' No TEST HOLE p ell 10 tA •4 1 o� `: �� x,44 Q�o.lb�b 1TH THE MINIMUM / YS AS ESTABLISHED vED DOPTED YORKNSTALAND N.Y.S. Lic. No, 49668 22—.