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ELIZABETH A. NEVILLE 1���hy # Town Hall, 53095 Main Road
TOWN CLERK o P.O. Box 1179
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Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ‘`.°6 Fax(631) 765-6145
MARRIAGE OFFICER `% ���
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RECORDS MANAGEMENT OFFICER "'/Q1 #��'„,.. Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
OFFICETTOF THE TOWN CLERK
SOUTHOLD WAGS WATgEppR DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2928 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : DONALD FEILER
Address 1 : MAIN ROAD
City St Zip MATTITUCK NY 11952
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 #R10-01-0254
Name Of Owner CAMPISI, JOSEPH
Mailing Address 1 2 AMBROSE LANE
City St Zip NORTHPORT NY 11768
Property Address 1 4404 OLD MAIN ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 55.00 block 2 lot 8.008
Cross Street NORTH ROAD
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 ���h°� # Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
col 2
REGISTRAR,OF VITAL STATISTICS0Southold, New York 11971
MARRIAGE OFFICER, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ,=y�Q a0�i��, Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ••�� southoldtown.northfork.net
` \ OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO:\ 5-Southold Town Building Depaitaient
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: October 17, 2002
Transmitted herewith is a copy of application No. 3047 for a Cesspool/Septic Tank Construction
Permit submitted by:
Donald Feiler
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
r
Comments: •, r /'
Signature
4/0/4..
Dated
•
•
OFFICE OF THE TOWN CLERK ,l" VitrC®G j
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TOWN OF SOUTHOLD ,�. �®� i` Application No. b `t
ELIZABETH A.NEVILLE,TOWN CLERK o
P.O.BOX 1179 _t Construction
SOUTHOLD,NEW YORK 11971
13 Alteration
• $10.00 -Residential
•
Telephone 644 � ,
` ���'
(631) 765-1800 =®1• �,t'.� • $25.00 -Non-Residential
•
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
•
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE 10 1 d 2.
APPLICANT NAME: )� L rL
APPLICANT ADDRESS: MP t•N POPf0 t f1,11-)G--'
SEPTIC ! CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
'fJ w uV�1� t C.
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ,-)Me-PH CPy'1 p tS
OWNER MAILING ADDRESS: GAmiru,,,„ � �
� I R,4 Ly (. �1 g
OWNER PROPERTY ADDRESS: ®LD ►M al t.) 9-0Pqr)
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TELEPHONE NUMBER OF CONTACT PERSON: 2518-545-3
TAX MAP NO. : Section 5-6'
Block ® Z Lot 6
CROSS STREET: Iba- 1 _O
BUILDING PERMIT NUMBER CROSS REFERENCE:
(-6Z
Signature of Applicant
RECEIVED BY:a64
Town Clerk's Office
DATE: (0 (t1 (6-1i
,
OLD , e
.kboN
S ' '8� Ftp.0,- ROAD SURVEYTOWN OF OF SOUTHOLD PROPERTY
-4'' SITUATED AT
• FINIAD 141. 1jS86230• E SOUTHOLD
RPE• 26.32
31.329.82' SUFFOLK COUNTY, NEW YORK
'q S.C. TAX No. 1000-55-02-8.8
8 T0 ,�'w1 SCALE 1"=60'
"' � � NOVEMBER 9, 2001
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4' 'V AREA = 87,124.81 sq. ft.
o,�' � 2.000 ac.
ti
> NOT'S:
1. LOT NUMBERS SHOWN THUS:LOT REFER TO
__ MAP OF LAND SURVEYED FOR JOSH WIEDERMAN & JOHN GILOWSKI AT SOUTHOLD N.Y.
APPROVED BY SOUTHOLD TOWN PUNNING BOARD
ON JANUARY 30, 1974
2. ELEVATIONS ARE REFERENCED TO AN ASSUMED DATUM
EXISTING ELEVATIONS ARE SHOWN THUS: tooD
TEST HOLE DATA 3. MINIMUM SEPTIC TANK CAPACITIES FOR A I TO 4 BEDROOM HOUSE IS 1,000 GAI..ONS.
• (TEST HOLE DUG HY MCOONALD GEOSCIENCE ON MARCH 12. 1999) 1 TANK: E' LONG, 4'-3' WIDE, W-7' DEEP
4. MINIMUM LEACHING SYSTEM FOR A 1 TO 4 BEDROOM HOUSE IS 300 sq ft SIDEWALL AREA.
• 101.9 0 1 POOL: 12' DEEP, B' dla.
1///4 poet mar tom a
PROPOSED MANSION POOL
,roMOW WWI MID al
% PROPOSED LEACHING POOL
V
a ,�, mea e�o 5. ® PROPOSED SEPTIC TANK
• II-Roo c2"'II:4
+i' 5. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD
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FOUND i x rxc■ro1FM 10 mow rm o s• OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS.
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CESSPOOLS
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UNAUTHORIZED ALTERATION OR ADOIRON PREPARED IN ACCORDANCE WITH THE MINIMUM
M
TO THIS SURVEY IS A VIOLATION OF ' STANDARDS FOR RVEYS AS ESTABPSHED
SECTION 7200 OF THE NEW YORK STATE BY THE LIA.LS.AN. "ROVED AND ADOPTED
EDUCATION LAW. FOR SUCH USE i 'E NEW YORK STATE LANG Joseph A. Ingegno
W COPIES OF THIS SURVEY MAP NOT BEARING n:
' `�°SURVEYOR'S INKED
I.DR �� ` Land Surveyor
C TO AUD TRUE Cts Be CONSIDERED e = 1.1
M CERTIFICATIONS INDICATED HEREON SHALL RUN '1.:--V' a f ��I-
ONLY TO THE PERSON FOR WHOM THE SURVEY /�;
O IS PREPARED.AND ON HIS BEHALF TO THE �' "G u
TITLE COMPANY GOVfO1NMFJTTAI AGENCY AND ,�1, ' Title Surveys - Subdivisions - Site Plans - Construction Layout
= LE NDINO INSTITUTION USIED HEREON,MID V.
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TO THE ASSIGNEES OF THE LENDING INSTI- 1 4. +
TURON CfRliFlCA110NS ARE NOT TRANSFERABLE + , - PHONE (631)727-2090 Fox (631)727-1727
POUND THE EXISTENCE OF RIGHT OF WAYS F• .-rt��� OFFICES LOCATED AT MAILING ADDRESS
sPIAI AND/OR EASEMENTS OF RECORD, IF . .`�,•f .f N.Y.S. Lic. No. 49888
ANY, NOT SHOWN ARE NOT GUARANTEED. J 1380 ROANOKE AVENUE P.O.PBox 1931
`',= ;"1.s.'-‘ RIVERHEAD, New York 11901 Riverhead, New York 11901-09v'u
21-54i