HomeMy WebLinkAboutSilberstein ELIZABETH A.NEVILLE,MMC Moon Hall,53095 Main Road
TOWN CLERK P.O.B-1179
Southold,Now York 11971
REGISTRAR OF VITAL STATISTICS F.(631)765-6145
MARRIAGE OFFICER Tot.phone(631)765-1800
RECORDS MANAGEMENT OFFICER --tatholdt—nnyg-
FREEDOM OF INFORMATION OFFICER *
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Sabrina Born,Southold Town Clerk's Office
DATED: February 7,2019
RE: Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 4697 for a Cesspool/Septic Tank
Construction Permit submitted by:
Robert I.Brown for Silberstein
Please review the application and location map and advise if this office may issue the permit.
Please complete the to=below and return it to me. Thank you.
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments:
Signature
Dated
�olvfoj'e1,s
ELIZABETH A.NEVILLE Town Hall,53095 Main Road
F.O.
TOWN CLERK ca Box 1179
Southold,Now York 11971
REGISTRAR OF VITAL STATISTICS Fax(631)765-6145
MARRIAGE OFFICER
RECORDSMANAGEMENT OFFICER Telephone(631)765-1800
FREEDOM OF INFORMATION OFFICERaouthaldVn.nortbfa,kt
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$10A_or Non-Residential @$25 Application No.W-7
Permit No.
Applicant Namelu A/21)
Applicant Mailing Address
Septic Tank_)I_or Cesspool
Brief Description ol'Proposed Construction or Alto ation
Location of Proposed Construction/Afteration:
Owner cff'roperty:_JLI�,U1 ,4 4,_iro'
Owner Mailing Address:��rD
-XY
Owner Properly Address:
Name and phone number of contact person 1A �- '01_9
Tax Map No: Section q1t Block Lot
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
Date
Received by: .......-----— - : I�
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AREA 67239 5OFf on 2 0 1 ACRE —-----
EXIST NG BUILDLNG FOOTPRINT 2 52 5DFI
NEW AMMON: �29-501'r
NEW TOTAL BUILDING rOOTP-1 2,98 1 EQFT NO NEIGHBORLY 5EPTIC 5�TEM5
LDCATEDWITHIN 50-OfU5TNr-W
PATIOS,PONCIr,',,511r[).FTC 3, 9 5DFr
TOTAL COVERAGE: G.GO 50FT NO,
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LOT OCTVf�f 9,100 67,23S -Ro'EN 7% A11ROAMITE IF- OT I
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ELIZABETH A.NEVILLE,NIMCT—Hall,53095 Main Road
TOWN CLERK P.O.13-1179
SSouthold,New York 11971
REGISTRAR OF VITAL STATISTICS Fax 1 (631)765-6145
MARRIAGE OFFICERIliToluph—(631)765-1800
RECORDS MANAGEMENT OFFICER —uthldt—ygov
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Sabrina Born,Southold Town Clerk's Office
DATED: February 7,2019
RE: Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 4698 for a CesspooliSeptic Tank
Construction Permit submitted by:
Robert I.Brown for Frolmhofer
Please review the application and location map and advise if this office may issue the permit.
Please complete the form below and return it to me. Thank you.
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments:
................
Signature
Dated
ELIZABETH A.NEVILLE Town Hall,53095 Main Road
TOWN CLERK P.O.Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS Fez
(631)765-6146
MARRIAGE OFFICER
RECORDS
MANAGEMENT OFFICER Telephone(631)765-1800
FREEDOM OF INFORMATION OFFICER south.Idt—...,thf.vk..rt
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residendal @$10A or Non-Residential @$25— Application No.
Permit No.
ApplicamNarne
Applicant Mailing Address.,
............
Septic Tank, Cesspool
B of Docqnionoffln dC
Proposed
Loc,,it('()i3/i'/'2o(f'P/r'oIp4''61sedConstiuction/Atteratioii�
Owneroffioperty:
Owner Mailing Address:
...... L\j"y ILI"-
Owner Property
Name and phone number ofcontact person
Tax Map No: Section Block,, Lot J!Z
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY W),I'"HEALTH DEPARTMENT APPROVAL
gignat.re opt Applicaat
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