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SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3503 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : PAUL LONG
Address 1: HOWELL AVE
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
INSTALL NEW SEPTIC SYSTEM
FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT
Name Of Owner PAUL LONG
Mailing Address 1 3945 CAMP MINEOLA ROAD
City St Zip MATTITUCK NY 11952
Property Address 1 3945 CAMP MINEOLA ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 123.00 block 5 lot 3.000
Cross Street NEW SUFFOLK AVENUE
Building Permit Number Cross Reference:
Issue Date: 2/22/07 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
. ti � �� iii�.,
��,i%pF SO(/l,,o
ELIZABETH A.NEVILLE , ,O l0 Town Hall, 53095 Main Road
TOWN CLERK *; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS •
N
Southold, New York 11971
MARRIAGE OFFICER % G., ���A Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER Ol� ��� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER . CQU ��� southoldtown.northfork.net
• 0'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD -
FF8 1 2'
TO: Southold Town Building Department
FROM: Francesca Quintieri, Southold Town Clerk's Office
DATED:
Transmitted herewith is a copy of application No. 3658 for a Cesspool/Septic Tank Construction or
Alteration Permit submitted by:
Paul Long
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.
Francesca Quintieri
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: , -� — ,� �� �� ,_t ��
.0
Signature
D2-- Q2-- Q'7
Dated
P
ELIZABETH, j a
if
�+//D�SUFfQL�CO
A.NEVILLE G.y�; Town Hall, 53095 Main Road
TOWN CLERK % p - % P.O. Box 1179
REGISTRAR OF VITAL STATISTICS � yy. Southold, New York 11971
MARRIAGE OFFICER %, G '��1� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER L y �oe Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER O'' jigiapl001 southoldtown.northfork.net
.k Or Ott(lacrs on 91-04.e l4.e d, OFFICE OF THE TOWN CLERK
0 to I Tp£.tf 4L1(n-4— TOWN OF SOUTHOLD
r` "CvL p d ;a_i 4'L C'tj Is cn --Fit
(-_Fh +ham 1 id i ti 1 t-- SOUTHOLD WASTEWATER DISTRICT
P-p-01.,1 ',44--)(.1r r L1 45 Ke_,. APPLICATION
rT+C crr-fied AK ei(A Thts
nv c)19 ti'ik(-tA CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
I V)Ck_ IC S
Residen ial @ $10 / or Non-Residential @ $25 Applicatio s ►.
Permit,10. 3,503
Applicant Name /,_,: L--0 +-2 L---
Applicant Mailing Address H 1 �-- t_ A L (,_---
k/
,_-=k/V L tt'h'ti�A l-J C - 1 i" --).-•k / I V L
Septic Tank >- or Cesspool ,\
Brief Description of Proposed Construction or Alteration I/\ S -\`Z-L- /\2c
SL 1 2 C - <-k.c T ../.
Location of Proposed Construction/Alteration:
Owner of Property: '1- ' C_ L--C r`..' 6-
Owner Mailing Address: 11/4{ S (.. GA(,J't f' W I 1AI(-4‘ )1A) 1\17)
l`Vv 11.t -1 1-u c t' I N u1 l / y .s "Z__
Owner Property Address: 3 cZ `I t/\-1/4•1t,' A i s,,,i_.--L) c r 1 j L C 41 v] C1 i w a Lc-/t k
Name and phone number of contact person
Tax Map No:£',:u , Section / Z-3 Block 5 Lot 5
Cross Street „(4,/,..-:-L1/4.- 5 `/-:---/r=-z.: , k. A-1. -1,- ._._
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SU ' Y WITH I AL EPARTMENT APPROVAL
Signature of Applicant Date
Received by: 1).
333,
' ,1-3, T • SC"RVEY OF PROPERTY ••
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ytHF TNA , 00_ WQ ^.y D.474 _ -'SITUATED AT I .71
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•pm a . p .N a yv ,. TOWN OF i SOUTHOLD3 IS
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' e• ' o,•� s ;O ,5 �" ` SUFFOLK COUNTY, NEW YORK
• H .10.0°.°°' ,k ,�/ c7 n. ��T • S.C. TAX No. 1000-123-05-30
PROPPCNCH D I - -RAIN �/ • >:'.• w zy� _ s SCALE 1"=30'
.e' ""5v. e-Tri_ , . '"moi/ -L _-�_ A .oz MAY 17. 2005 I
eoPOi �„ .�' O �� : J S ESE U PER SUFFOLK E20000 3MTA CONSUL60 arm,]ACED 5'5.05
.� t!-21.1.1
.� d �.. O ,Sly
,..:13„ mr rr -wCU5T 23 2005+00ED PROPOSED HOUSE
P •£b - '•j JEER 28.2005+DOE➢FRENCH ORAN.HAY SALES a DRADEUS
1 A l' m _ ..+,+a ‘3.3-.,,SEL AS Ei:FCI.I(ENVINONNEMARLE CONSULTING.ir.c.ltr rLlo:UTEC •:2065 a,2i'a!OS
`,f. -� .. ��.. E 2500.,202 EGO,J1.TALECT�ONS.Of PROP AiEONCNSVMCA8 MR/W 1S OF PROP 003310 MTE4 1
Z'. A.., �f p J l��.y. ...EMBER, ;109 REnSED PROP SEPTIC>.SrtM TO 8E 8.FOOD IMAGE 20UNGi,ON
O : SA P Y
ru
AREA L = 8,996.78DI sa. N.
_ I d HI NOTES, r� �E uNEr 0.207 0
�'
I O'PERFORATEE2 O 9. `, ; VIGI'JD TIE IN/ALL r,EXISTING vArioNS ARElEVATIONS ARE E REFERENCED TSINOWN TNUYs..]9 DATUM
E1E043 THEA \ t .��)t COSTING CONTOUR ELEVATIONS
ARE SHOWN THUS. ,1
f .9 J PROPOSED CONTOUR
ARE SHOWN T 5540
FRENCH DRAIN DETAIL
• ti• • , O • /PROPS ROY• N f4E PROPOSED CONTOUR LIES ME SHOWN THUS.__._._ ..-G$ __--
>c i PROPOSED 'I3 1' p5 HAY BALES _ _ • __
$ yA NATER L .�1F. -58 a F-- _ --PROPOSED '1 1 MST FLOOR
F zz 1tE F i L", --t P'ROPO 0RA5 _NE ,40-�,l `-..- 5-5-HIE, - ro.OF w I{
1 i-8e i w ii � 6 ■ ;8"FROM PRGPERT" .R.I - eolraM NU
J
FRENCH DRAIN _ 12 d•19-1 I I ( CPPJEL 2.FLOOD ZONE INFORMATION TARN FROM:
8'SROM PROPERTY UNE ft j V� ' ^ ROOD INSURANCE RATE MAP Ne.7810300082 0
�i `( i1.est_ i 1 axe AE-. NAE FLOOR E2EMASTS.8.000 0,10 6 MEMO=041285
--' -EONS A1,0' 11
a IS w� St HOUSE !� ; - j 11--. DONE rE. D FLOW ELEVATIONS DETEmnIm (SAO ACodl:
I E —I g•_—__ 3 COSTING RULING COVERAGE HOUSE
N (4 1 DANCE)LS 1.473 N.N.
I 10 I!,f (ON i.� �I. ' OR Is.ax a TOTAL Lot AREA. A. J
F
18(/1`1 (
4 TASTING IMPERVIOUS LOT COVERAGE _HOME.GARAGE WALKS
_j MAY BALES- .,PPL I' reWE i DECK.STEPS.TOTALARMS.OUTSIDE MOWS)R 1,895 Aq.».
'`.-OF � OR 21.121 Of TOTAL WT AREA.
II _ ! 'I, R!i r _ +�/ wa. 1 1 5.PROPOSED OMAN COVERAGE(MOUSE.PORCH 0 BARNS)5 2.120 AR.».
ExlgnNb HOV5E $ 11*I moi. 35 SSA%a TOTAL LOT NSA
S.PROPOSED IMPERVIOUS L LOT COVERAGE HOUSE.PORCH(ARAM.W.wa. 4
y TO BE REMO`/ED d �1 ' �`l 4.
1 - �S at
ibr ARFA '4.n.
3E t� tii -PROPOSEDi ,,r._ -J a GEDaooM HOUSE Is 1.200 GALLONS.
lialiri
EXf5nN6 OPB1 -.`'' [�I,
1. v PORDH TO BE 1'2)� _ e.IMNNYUM LEACHING SYSTEM FOP T BEDROOM NOUN IS s0o w»aOEWAN.:AREA.
R �� � '•r TY�'L %� S POOLS;r DEEP.a•GM. 1
00
I PROD — ��G o -,----
SEPTIC SYSTEM DESIGN BY PROP03E0 EXPANSION POOL � y
.OF NAY BNFS tt kf I
I o 10 IF- %� JOESEPH FISCHETTI. P.E.
W
�`%Y.. N.Y.S. P.E. Uc- No. 052510 PROPOSED Ir'`O'"N°P°°` I
01 _ j P.O. BOX 616
ca° wl< SOUTHOLD N.Y- 11971 (� PROM=anc rNa
1 ro AA INF.
III _ ,,,r ,,a1-.. wr+�° w »
�� k.,gyp WIN OsT., HDP 59'37 ���� G 0SSER6ATIO800�%0R DAT 'INURED
FROM O 0 HEREON ARE FROM FIELD
aR�RA`° 5,q4" w 0[\110
'w� S ,6 p t;C • elliklik • PREPAREDE'N GG RILE suR Ers 1 R ANNUS
srrnrce FOR,111E suGE1s N rsNAs61.n
E QT _ De THE LIALS NC MpRO.FD AND N%ilm
1' R PROPOSED SEPTIC SYSTEM DETAIL IliS."
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es .>el✓Y.?3 �OC°SRMTbM
I}- - a.5 _. YL 'w �5 �5: 003"` t,*M,''a' .Ac_ 'PI �� FI0 6
L •A '�'� Mc P Ta; N.1,S LSC NP. 49666
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1ION c 9 POOL s'+00srE aF *�,;n,oaa:O.Lrs ±lanmN�o°�'Ip �js — --—-----
.V1111i6C 1 7200 OF rNE NEW MRx ill,.
G DHoseph A. Ingegno
SEPTATANK LTJ aPrs
. Gs REAI BEARK
LEA Hy P44S.L61. o u.ESIN ,
aris K BO D AMNO,PC,NS
Land Surveyor
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PO a ONF 1E MR.
RAN. u 4 w .aw.c, - • ' s . �NCE IE ,C,NIc was.No 4061
_NE N,,..s1-rwr.^N" ER000 400 'The Surfers-.Suodrvieiona - Rite,ane - Co.uLFuctron Loyout
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• ,..as,IN SEM.IMI[1418,NO"OUSE W H.w1404.. N. - .-DON S OF
AINEi1E..0.40wR�Pr aeEE PHONE(631)27-2090 89,(631)727-+72' '1
:HE OR 0ENOE OF RIGHT OF WATS 'FREES .'GATED 4r M4LANG ADDRESS
_ ANO.N SHOWN A OF RECON°.IF .. _... •
ANT, R SHOWN ARE NOT GUARANTEED 522 RW.NOic 4yENt,'E P.0 Box 1911
RNER1EAO Ne +o a'190'. R erneod.New fork 11901-0965
25-1991-