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ELIZABETH A.NEVILLE 1,,�,' �; Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
Southold,
REGISTRAR OF VITAL STATISTICSPrr
y = New York 11971
MARRIAGE OFFICER ,L Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER `may"�Q 1,'„10.� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER � southoldtown.northfork.net
OFFICETTOF THETOWNCLERK
SOUTHOLD WAS aiSPIF DISPODSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2910 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : CATHERINE MESIANO INC
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 #R10-00-0198
Name Of Owner MATHERS, ALLEN & MARY
Mailing Address 1 30 KENINGSTON ROAD
City St Zip GARDEN CITY NY 11530
Property Address 1 1245 SLEEPY HOLLOW LANE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 78.00 block 1 lot 10.015
Cross Street WILLOW POND LANE
Building Permit Number Cross Reference:
Issue Date: 10/30/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE �,,�A.o G'f : Town Hall, 53095 Main Road
TOWN CLERK % o - % P.O. Box 1179
REGISTRAR OF VITAL STATISTICS i, Southold, New York 11971
MARRIAGE OFFICER ., 4* `�,,,, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER "'/Ql ���iii Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER���,���� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD F [cigfl
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TO: Southold Town Building Department �[1 1; f f;T - 2 2002 11,Lj)
FROM: Linda J. Cooper, Southold Town Clerk's Office ; �.,
DATED:
Transmitted herewith is a copy of application No. 3027 for a Cesspool/Septic Tank
Construction Permit submitted by:
Catherine Mesiano, Inc. for Allen & Mary Mathers
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 locat'on map of the project cited above and make the following
recommendations:
APPROVE !
DISAPPROVE
Comments: r i%'"
it, i / !/
oi e
Signature
/0/3 0 2—
Dated Dated
„OFFICE OF THE TOWN CLERK '',C��FFOLkI'
TOWN OF SOUTHOLD ��' QG Application No. 3d�
ELIZABETH A.NEVILLE,TOWN CLERK 0 .117
P.O.BOX 1179 .G Construction
SOUTHOLD,NEW YORK 11971 0 •
rn
�,. Alteration
Telephone s O �Q�;� $10.00 -Residential
(63x) 765-1800 : - � $25.00 -Non-Residential
TOWN OF SOUTHOLD
e•
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. •
Fee .$
DATE '76 /2/OZ-
. 7 (S o2/4 .Z
APPLICANT NAME: . CATHERINE MESIANO, INC.
• APPLICANT ADDRESS: 12 MILL POND LANE
E. MORICHES; NY 11940-1222 •
SEPTIC X CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF_ PROPERTY: ���.l: 6.).‘
OWNER MAILING ADDRESS: 30 401.
OWNER PROPERTY ADDRESS: id- V5
TELEPHONE NUMBER OF CONTACT PERSON: 7/c- 706 - / 27?
TAX MAP NO. : Section 7i - Block / Lot /0.
CROSS STREET: .„c:LJ r D PCr)L-d L
BUILDING PERMIT NUMBER CROSS REFERENCE:
N --� • .
/ •
Signature of Applicant
(JUIUCA---
RECEIVED BY:
own Clerk's Office
DATE: /Q /Ll G 'L
O 1Lu PROPOSED SEPTIC SYSTEM DETAIL SURVEY OF
LOT 13
dp a MAP OF
s'�0 `E A ? NAMED� 01. — —.e. . SLEEPY HOLLOW
II.P� ....Ara 1/4•/1• -ON '�"\ �+1/rh• - I mL _ - FILE No. 6351 FILED FEBRUARY 4, 1976
IS79es • ��--wwvv a :�, IV SITUATED AT
lc Ix1sTNG I—M—I -.4 s SOUTHOLD
UTHOLD
OS�y �9V. HOUSE 01,82 '°'° '" GROOMELEV ""'°' TOWN OF SOUTHOLD
`.h V ��TM( SEPTIC TANK (1) LEACHING POOLS (5) SUFFOLK COUNTY, NEW YORK
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7M�C C®u,S IIpAOFPRLNi A 4 9fDf100Y KM 6 1,50,,iGlIP4 1 YMWY TURK 1�y0g1pI JUN A:Bm11WY MISE 6.lm.G 11 90ro1L AQ
�f mal i WALCO 000 1 WNW A POW K.S,1' TOMOS 6 NO*WOW 11OPC�Of c 2.1D0lx0 PP00t05�AR 10 ff 000161X00101 a ASA 1W2O.. COMMoma (5 @Yl) S.C. TAX N o- 1000-78-01-10.15
IDOK 6110A.TRLE.MO OWn AND/001 60_6_ _
a ALL MLLE.10102 NO 10P OWL COMM REKOR IC ID JOT NI AMMO KASE a>w Rd SCALE 1"=40'
v. a A to'.+:.Oc NMC 6[161.IAAO.O POOLE No tum,Ix 9001 RE IOWAN.
mU,v ane SIL' 'Plc roti�PsROLL ILL SEALED SiulNRm IFu Au hm1 A WAX MOW.a:1/.� e AA 6 Alle�I...WW1.ALL LOONO POWs No sa11O WO SMALL soma".
OCTOBER 18, 1999
P\t,
'��` OA 10.min.0.�1 REPRO ONx�ND WNW. n'•`•'' JANUARY 13, 2000 REVISED PLOT PLAN
�' N _ PLEASE NOTE SEPTEMBER 12, 2000 REVISED SEPTIC SYSTEM
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12z 1 S 83.35'10" E p AREA DF KENNETH BFCp �' •
soniFTAc z FEBRUARY
19, 2001REVISED REVIISEPLOT OPLAN
N
' <•'/ FOUND I1 °s s5"m"O CEORlA1NA C 3 J Sanitary System 1Lot to be installed JULYgUGUSi 25 2001 REVISED PLOT PLAN
I • PwE J LOT 72 x Va 4 under driveway. SEPTEMBER 25, 2001 ADDED DOCK STEPS
Z- I DWEIL C 2.11 c ;`-'� DE(EMBER 26, 2001 LOCATED FLAGS & LAWN
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I. c3. I N,Z o7pl APRIL 2, 2002 REVISED SITE PLAN
6; I o MAY 20, 2002 ADDED TEST HOLE
,i.1,'X",.,..,N � LN c j JUNE 12, 2002 REMOVED PROPOSED WATER LINE
%1s1"N d �^ / A �� 419. \ woo° AREA = 44,792.20 sq. ft.
P.� d 17 b �\ _ i,DIN, ENyFI nx • •:� FLAG I 3'L' DOCK
�o O / I. �, I' �� \ \ (TO TIE LINE)1.028 ac.
tto,C3573 C.
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,� . ` .:PRNE \\f5.• �7AIM R:7:1�_� 'FOUND A ND 1P \ `7-
g 1 '.0- 4 011. +�' 1.+ ,.. 4 EDGE OFILAwN .. I_so WELL 'f• f2 \
�'ti� ! o' room), E woo°sr"(e —re,�RDW OR
FRN
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END OF F,U . 04's' 120.00' N 83.3 , -�\ ••"'•1 s \\ AL \ilk \\ a' �Y�
WATER Kim/ ` . ( 8 00'00" W 1104 - ,'J-� I .LO 1.6 �1 \ 111k\ 1rsr
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GLENN y� �{ -$ �L"� •� '
ROAD � � , TI as
e• Zz��� O D SUF` CO pp 11vdNTOF J . VASES.28' ,tom -T1
o� • N LE DWELLING Nest, _ --11 m
e LOT PERMIT FOR APPR ;) 1 FOONSTRUCITO =R A — ��
0 " A'/%P SINGLE FAMIL' 4•. mEN ONLY s `Pti- ,-°
DWELLNG AlARTA TROP/A q p r c Gri
(WELL OVER 150 DATE 1-30-02_ REF O. r-00^O_-./p
TEST HOLE DATAO MSS& ` _�r
t.ELEVATIONS ARE REEERDICOD TO N O-VD.1928 DATUY (TEST H0�DUG BY I4 ON MAY'•2002) CERTIFIED TO: APPROVED l/LI6� ___ '' `1
5O5ID40 ELEVATJONS ARE SHOWN THUS:.12.2 y -. -I��2' �'•' . CAD
-�
E GSLINO CONTOUR LINES ARE SNNOWN THUS.-----10- - ' , �,,,,s,,,a,.,,,,, O. PIONEER LAND TITLE Corp. '0A ' C'rrH*1 w
2.REFER TO FILED YAP FOR NEST HOLE DATA ��1 I.
WWI 6No ALLEN S. MATHERS F FOR fTrfAXLtii[I,iROF�II'• •OMS ��a
tP
PROM EXPANSION,O« \ 73' MARY E. MATHERS EXPIRES THREE 'FROM DATE OFAPPROVA0
C PROPOSED LEAKIENG FOOL IRLDDLORRED ALTFAARIN OR ADDITION pJ-.•te-•STs��
7D THIS SURiEY 6 A VIOLATION OF or :�:`'•'y.,+ Ji (o
SECTION 7209 OF THE NEM YORK STATE PREP .,(. :
°° PROPOSED SEPTIC TATO( ROE WON AM Wil EDUCATOR OF T 6 SWIM YM NOT BF/9V10 •` Joseph /-1. Ingegno
CORES rT.
4.THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD THE LAUD SURVEYOR'S INKED SEAL OR CO T,
mamma AND/OR DATA OBTAINED FROM OTHERS. SELL`'w'LL NOT BE CONSIDERED COO L�
IL FE.000.20K 9LFD8YATON TAM FROM: 7D 0E A VIEm TRUE amt• 3 7 >:T-`la,
iii. Land Surveyor
FLOOD INSURANCE MATE YAP No.3810300160 0 D.Ler CERTIFICATIONS MOORED HEREON SHALL RUN i f'•
lY MY TOILE PERSON FoR TM7Y TRE SURVEY J
ZONE K 616E FLOOD E1E9AT0LI5 DEIEWeiF'D •11A1D1 6 RFPAR).Al®ON FF$IEWLF TO THE li Y r(�
TOME IDI MODS OF LOO-YEAR FLDOCT AREAS GF 100-TEAR ELMO TOT AYERHF TIRE 10 PANY.00/ETa0DMAL ADO=AND 'O G70
MA,SU
cams DF LESS LIM I roar ata TD1L DRARU1cE AREAS Lo'THAN �� Limon vamp==ED HEREON,AND
Surreys-5ubdhidoro- 5"60 Marrs - Construction Lipoid
.P 1 SQUARE LEIS,AND MEAS PRDTL`LFD Or LEVEES FROM Tao-YFAA FLOOD 70 7H E ASSIGNEES OF TIE LENSING DRlL- �n 411
NPAIL . V1=4-44:11ZONE X, AREAS°STEMMED ID LE OULIKLE 500-YT/R FLomAAw. Irl ro W.z swn N1 1OS1 APE NOT T E PHONE(631)727-2090 Fax(631)727-1727
4 6.5,C.D H.S.REFERERCE N-810-00-0198 THE EXISTENCE OF RIGHT OF WAYS ,7
\ 7.UPLAND AREA IS 37.752 aq.N.THE TOTAL LO COVERAGE OF THE PROPOSED CA D OFFICES LOCATED AT M42L G ADDRESS
` HOUSE.DECK POOL AND GARAGE IS 12.0%OF THE UPLAND AREA ANYAND,NOT SHOWN AREOR EASEMENTS NOT GUARANTEED. V`"'-' 1380 ROANOKE AVENUE PO Box 1931
1 ,, 8.LATH SET FOR N-Y.SD.E.C.INSPECTOR SHOWN THUS:A —N� ,� NYS Lle.No 49668
F0JFR11Fi1D,Now Yank 11901 Riverhead,New York 11901-098S
".6s. SIH-810
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