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ELIZABETH A.NEVILLE _� * : Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER y ����, Fax(631) 765-6145
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RECORDS MANAGEMENT OFFICER �_��l 4, ,,.' 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. 3158 R Residential x Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : RICHARD SAETTA
Address 1: PO BOX 2047
City St Zip GREENPORT NY 11944
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR ONE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-03-0039
Name Of Owner NESIN, ELAINE
Mailing Address 1 32 LEXINGTON STREET
City St Zip ROCKVILLE CENTER NY 11570
Property Address 1 875 GULL POND LANE
City St Zip GREENPORT NY 11944
Tax Map No. section 35.00 block 4 lot 28.042
Cross Street COUNTY ROAD 48
Building Permit Number Cross Reference:
Issue Date: 4/15/04 Elizabeth A. Neville
Southold Town clerk
(TOWN SEAL)
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• ELiCABETH A.NEVILLE � G'f Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
1�,
MARRIAGE OFFICER �� 4, l�� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER =_ �( Jig Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER ,.�� southoldtown.northfork.net
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: March 23, 2004
Transmitted herewith is a copy of application No. 3295 for a Cesspool/Septic Tank Construction
Permit submitted by:
Richard Saetta for Elaine Nesin
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: ..i ��
91(44.4.9
Signature
V2Offal
Dated
• 4
SCDHS Ref. # RIO-03-39 NWEC Application # 1-4738-03/58/0000/
EXCAVATE TO CLEAN SAAO WW1-INSTALL METAL 115,SFEA Tl�A VE AS REOI.KEP TO PROTECT ADJACENT
PROPERTY DLIMVG SAA('TMY MVrTALLA__ '_1r- �.T tam familiar with Ilia STANDARDS FOR APPROVAL
`i$ (Cr - AND CONSTRUCTION OF SUBSURFACE SEWAGE SURVEY OF PROPERTY
+-r y ` ,,s 7, DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES AT GREENPORT
N z „ -�3i e z and will abide by the conditions set !crib therein and on the
3 ,Z, >, L'�__�, permit to construct.. TOWN OF SOUTHOLD
5 -"S D 1 ' l SUFFOLK COUNTY, N.Y.
6
PROPOSED SEWAGE T/I3'DISPOSAL SYSTEM _ _ The locations of Wells and cesspools 1000-35-04-7.4 & 28.22
6 POOLS 2'DEEP WITH 3'SAND-CQLLAR _ - - '.d-from Field observations
OF10L0 GAL.PRECAST SEPTIC T COUNTY D:PARTMENT OF HEAT. V
OF L.Ps TO BE 2 ABOVE GRo t 64���}IG§� ofblained from others. SCALE.' 1'=40'
PERMIT FOR APPROVAL OF CONSTRUCTION FORA DEC. 3, 2002
p
SINGLIL':'.,- iE`...i RESIDENCE ONLY VA'TION INSPECTION REQUIRED oo• /q 2002,fp E.s,..'"1 i
Dec 17, 200 e."1 b .7„
Y FOR SANITARY SYSTEM --1.--, ?3 200 /c
Test Boring NOTE ( SY HEA�1'fCSFPARTM T July II, 2003 (revisions)
0•r-_ s/e•1 DATE2 t-I'.�; I? P No. f IO-•K)3-003? ("1' Oct. B, 2003 (revisbnsJ
Mixed Sane' SUBSURFACE SEWAGE DIS'OSAL -k,
1 _� h `r OCT.I6,2003(revision 1
and Loam SYSTEM DESIGN APPROVED �% 1 `' Stf C.�DAw-C- �iC2V e Two
6.6—•r_L'` --- BY' JOSEPH FISCHETTI, '.E. FOR MAXIMUM OF 3
il Water in Mixed HOBART ROAD BEDROOMS • TADAL WETLAND VEGETATION BOUNDARY DETERMINED
sand s LoamSOUTHOLD, N.Y. 119 1 EXPIRES THREE YEARS FROM DATE OF APPROVAL Br DEC TEC711/CAL STAFF 9n7/03
Water n Gley 1631i 765 - 2954 \,
2'
Clayey Sand SCI /1/ j�
Water in Brawr.l LOT COVERAGE AFTER CONSTRUCTION ,{ l6A /'R
Bog PT 1000-35-04-7.4 B0' ATO
6 2265//6772 =14% S
Water in Grey 0 Z� b'jj°,-'0-4--
W
o xn,v cloy OL `.s N66.O1 `°20'.
B - - — EXISTING DRIVEWAY TO BE REMOVED EXCEPT" ' E
W<d 1r Gre, WHEN UNDER NEW DRIVEWAY G)
C/a y Surd t) s r 4ye-x. 1 •"(Jp,, 9
26, c.. _._..� CERTIFIED TO, ..,°,... �� k i ,c`3—. i°00 - e.1s,
Wrier in 8,- i ELAINE NESIN ovP :.r• ..- •6• • O C
Fine la Coors.
32• sons SW –_J NORTH RD. (^�R .i 14 Q� yt v 'R 9C+{p/-- • 1 A �Rc? 6�
12/05/02 9 AM. 1. 1 ; C
? ti. ry
4es
i Abe ' 9 j \\�
1000-35-04-74 ' 8�•
t. N6 ,i4,---
fri !, `4,.6a 3`�–xi i 04' ; iy ���` 'h. v
AREA=16,772 S.F. TO TIE LINE
1000-35-04-28.22
:9-11,---‹,',..--,- Foz0� ,6 t r3 n; �1 ,. 5
AREA-7,005 S.F. TO TIE LINE '� = _ w ,r. f7 ft. u;,y« t �„",, y�AE d,r�4°iir O. 1. `y�e
���'c�ge P ,'' fv l'''''.
oEEo)
I am familiar with the STANDARDS FOR APPROVAL " ' N. �'`� r 'io'. y„+,^ �'(0 44, M' A65�
AND CONS 1RUC RON OF SUBSURFACE SEWAGE '� �y jr,? �' ` 551”
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES E+?f�,_ Qq �, 1
and will abide by the conditions set forth therein and on the \� –�G r, r`\:,•;- 4'�"' o' U�(0
permit to construct. \` "` _,, 566t. �01•Z v.JO O�,f e`
The location of wells and cesspools shown hereon ore _ ,
from field observations and or from data obtained from others. - a, CP b' ��Qf "1411'04,,... :'
(T '71('' o Abandonment of existing sanitary system �P t.METr
ANY ALTERATION OR ADDITION TO 7HI5 SURVEY IS A VIOLA nON �F AyS 1'V , t0 be witnessed b• y Health Department. /c',do' Qso
OF SECRON 7209 OF THE NEW YORK STATE•EDUCAI/ON LAW. 'QC,?�, / p
EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CER71F1CAT/ONS 3I-Zo",,,,,>rP ,r4, ,d - 11 � � "'^�T.Y. L NO.`49618
SON ARE VALID FOR THIS MAP AND COPIES 7HEREOF ONLY IF R„_
SAND MAP OR COPIES BEAR RIE IMPRESSED SEAL OF THE SURVEYOR �3 q' .s• ST'�>L , .' PEGS I �+.
IWIOSE SIGNATURE APPEARS HEREON. 44'4 ,•, (631) - s e AX, '`') 765-1797
ELFVA7YONS REFERENCED TO N.G.V. DATUM .' "," Y 9- o,,sF P.O. ,�y• +v 6` �J
1230 7R ...,a ^a. r�
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OFFICE OF THE TOWN CLERK � �,•�,•••••••,,
TOWN OF SOUTHOLD ' ��FF��kCOG Application No. 7S—
ELIZABETH A.NEVII I F,TOWN CLERK
P.O.BOX 1179 � iO Construction
SOUTHOLD,NEW YORK 11971 ; G T ;
vs Alteration
Telephone *o "0/
$10.00 - Residential(63t) 765 1800 _ 1 $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE KARCH 19. 2004
APPLICANT NAME: Richard Saprta
APPLICANT ADDRESS: p_ n_ Box 7047, arpprr, NY 11944
SEPTIC__x__CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
New System '�
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: gl,ine Nec3*+
OWNER MAILING ADDRESS: 32 La i*+ on St 8nc]�i�lp
13r Cent r, NY 115.70
OWNER PROPERTY ADDRESS:-1
Gull Pond Lane (East Side)
Greenport, New York 11944
TELEPHONE NUMBER OF CONTACT PERSON: Rich Saetta 631-765-4900
TAX MAP NO. : Section 35 Block 04 Lot 7,4 28.22 oZ ?.11
CROSS STREET: C e q F
BUILDING PERMIT NUMBER CROSS REFERENCE:
filer
1 v
Signature of Applicant
RECEIVED BY:
own Clerk's Office
DATE: 3 6_ 3 /0