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ELIZABETH A.NEVILLE • Town Hall, 53095 Main Road
TOWN CLERK ` ® P.O. Box 1179
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Southold, New York 11971
REGISTRAR,OF VITAL STATISTICS -' �� Fax(631) 765-6145
MARRIAGE OFFICER � _ v, ,� �
RECORDS MANAGEMENT OFFICER /h� ®0i� Telephone(631) 765-1800
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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. 2717 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO):
Name : CATHERINE MESIANO
Address 1 : 12 MILL POND LANE
City St Zip EAST MORICHES NY 11940
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-01-0050
Name Of Owner THOMPSON, DAIVD
Mailing Address 1 1530 S.E.13TH STREET
City St Zip FT LAUDERDALE FL 33316
Property Address 1 1400 SOUNDVIEW ROAD
City St Zip ORIENT NY 11957
Tax Map No. section 15.00 block 3 lot 22.000
Cross Street THREE WATERS LANE
Building Permit Number Cross Reference:
Issue Date: 1/11/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE 0 G1 ; Town Hall, 530vo Main Road
TOWN CLERK % ® - P.O. Box 1179
co, Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax (631) 765-6145
MARRIAGE OFFICER :oifi `. �1
RECORDS MANAGEMENT OFFICER �_��1 . 1.1 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ ���,��'� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD •
--0roN [1d Win,
TO: Southold Town Building Department �� f I ii 1
L i L; J,/11\1, _ 7 ) !LJ
FROM: Linda J. Cooper, Southold Town Clerk's Office �._ _1
BLDG C7PT.
DATED: January 2, 2002 TOWN 4F S%}LITHOID
Transmitted herewith is a copy of application No. 2812 for a Cesspool/Septic Tank Construction
Permit submitted by:
Catherine Mesiano
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: F — - - %i
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OFFICE OF THE TOWN CLERK �'������"u'•••�����
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TOWN OF SOUTHOLD ��' QG Application No..
FJVABETH A.NEVILLE,TOWN CLERK O
1 .
P.O.BOX 1179 iC
• � � Construction
SOUTHOLD,NEW YORK 11971 0 ' rn
• cti Alteration
Telephone 0��0 �Q�i�1 " $10.00 - Residential
(631) 765-1800 l �,IP' $25.00 -Non-Residential
-- --•,,,,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION •
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. .
Fee .$
DATE /2. J3/lo/
APPLICANT NAME: 4J (2-(2,7h,ar)tx:
Ai.2e..
ADDRESS: ) 7 Il 12 L
e /Y ( C L fl Ci - )1f ci d
SEPTIC k CESSPOOL Y
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
'CArh/24-1.4„Zryt 0/ ,A- ,-;72G
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: JJ,- j .1. .1 /ya..„
OWNER MAILING ADDRESS: ) 5 3d 5 . 6. 1 3.`4" S-f.
f*- .2e, , PL. 33311
OWNER PROPERTY ADDRESS: I Li p v
TELEPHONE NUMBER OF CONTACT PERSON: Q 54I - 9-G 7- / 7 3
TAX MAP NO. : Section i 5 Block 3 Lot 2. 2-
CROSS
ZCROSS STREET: ,Vd .,� .
BUILDING PERMIT NUMBER CROSS REFERENCE:
(1--/blizAL
Signatur of Applicant
RECEIVED BY: -C(1'
'
/Tom? Clerk's Office
DATE: frZ�3 O/
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1 f'
WOWMOWS (Th h :-% SURVEY OF
TEST HOLE DATA LOT
(TEST HOLE DUG BY McDONALD GEOSCIENCE ON JUNE 19, 2001)-
BL 1 31
BLOCK F
1 0' MAS' OF
°" ` ""SILTY `°"" OL
ORIENT BY THE SEA
I BROWN LGANf SLT ML
SECTION ONE .
3'
FILE No. 2777 FILED NOVEMBER 21, 1957
• a GREs aro MILAN SILT ML SITUATED AT
0c11• ORIENT POINT
aat Tsa7 _ TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
OWELUNG BROWN SIL
TY SAND " HOOEY GRAVEL SI` S.C. TAX No. 1000-15-03-22
I VACANT ' SCALE 1"=40'
S^ tY JANUARY 26, 2001
(� JULY 6, 2001 REVISED AS PER S.C.D.H.S. DATED MAY 17, 2001
F /Llf T_� JULY 13, 2001 REVISED PROPOSED SEPTIC SYSTEM
{VTI
• -r: - TA r AREA = 13,518.79 sq. ft.
r ' ,Y (�`^�� A 0.310 ac.
^� O�� BRDIIII FINE TO OCURSE SA)W SW
Poe- Oa i
I" E 4 CERTIFIED TO:
'`.-7• S 88'57''40" E .
I TEST HOLE ' 36MAID ND 23' FIDELITY NATIONACTITLE INSURANCE COMPANY OF NEW YORK
o s ONc. MDs. DAVID J. THOMPSON
•III
c T MELL N 85.57'90- '
(I 31 RRL) o o •s 125.00' Ra100 00.
I LOT
a_ ' I _ (� 'y N ELEVATIONS ARE REFERENCED TO AM ASSUMED DATUM
I -: _ g EXISID4O EIEVATIONS ARE SHOWN THUS:IMO
2}• ' 2. REFER TO FILED MAP FOR TEST HOE DATA.
t.i $ ��� ':= _s' - 23- . = 3. WORN SEPTIC TAMC CAPACITIES FOR A 1 TO 4 BEDROOM HOUSE IS 1000 DAWNS.
-S. r I Y. `,-_'`W=-`'• 1 TANK:e' LONG. 4'-3 WIDE. B'-r DEE'
ea
_ "`— -_`-r—°=" 4. MINIMUM LEACHING SYSTEM FOR A 1 TO 4 Oil HOUSE IS 300 ft SWEWAU.AREA.
---_s ` Lr Fir'''' ' 1 POLL. 12' DFIP. B' dia. '
W I --_ ..Q..75,--
_ i `O1f,C
1 --2-:
C --/-. . - =z-'��_ PR D EXPANSION FOOL
Q 111 3 N § /O,PROPOSED LEAGtlNC POOL
M / . v 1 V��7 PROPOSED SFPFIC TANK
/// 3. THE I�ppCCAATION OF WEL.S AND CESSPOOLS SHOWN HEREON ARE FROM FEW
•• t� j OBSERVATI AND/OR DATA OBTAINED FRCMI OTNEAS
TAMC COZIER
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_ A MONIED N ACaOfAMrE ION RE MINN
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, FOR SUCH USE BY 11E AM
0211 SLUE IAD
. 69.89s Yr N 85`87'40" Pre. PIPE M
Z0.70:41,22 46.41' --W So4•e 171 %c��- r- '`£^�
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0 FILED IN
BySpahSly , Op11 L° .-- — -- —
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PERMIT � ; IIae I {
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DECL•1 saw. ATE
SUBJECTv®ca v s x Ig�O�PAGE
9 gLI /_ �A' . }'` HS : . O. �( °' Of —0 OSZ7 r� �pl� Joseph A. U'ig139no
nTFE 11WD°F�IM1�D
DOSSED
v Land Surveyor ,
per.... - _
Appa '. kC� T ram• , ; i?s2Guc;r7:7� 11;'s'�`nl f,.%f hi,�`".TlieV//,. FOR ',afa+3UJM OF /BEDROOMS S ..,,,..5.-a,, Is ONLY TTI.' oICATI HFAEwi.TT IE s
>' ITT►£ PAM Title soYeys Subdivisions Ste Plone Construe/kin Layout
de erral 'icyn r f sF _„3...._(_J, (". . 2-�v EXPIRES THREE YEARS FROM DATE OF APPROV E. .i.':-''' TA" ` T, BIE. pHONE (63 )7 Fax (631 727-132 ,
, E 1 27-2090
SrI�v I q.-c.G1 11/f 1- "Gi , -��si�► THE Ewsi19lge or Nr of-WAYS of aFs wrw�AT
ANO/OR EANT$sDF N ,`iF ADf>rlSs
' AMY. NOT SHOWN'OWE•NOT GVARANtEED. IMO ROANottE MICE RQ'Box 1931
•. `IiMMIF.M), Res York 119D1 Ra rleo_c L$10•Yoek 11 1 ,7 •
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