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Home My WebLink AboutWindquistTO: Southold Town Building Department FROM: Sabrina Born, Southold Town Clerk's Office DATED: January 13, 2020 RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4826 for a Cesspool/Septic Tank Construction Permit submitted by: Eileen Wingate for Daniel Lundquist. 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: Final aRnroval required from the Suffolk County Health Department Signature Dated 'Orw ELIZABETH A. NEVILLE, NIMC Town Hall, 53095 Main Road TOWN CLERK _ P.O. Box 1179 Southold, New York 11971 REGISTRAR OF VITAL STATISTICS � Fax (631) 765-6145 MARRIAGE OFFICER Telephone (631) 765-1800 RECORDS MANAGEMENT OFFICER` www•southoldtownny.gov 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: January 13, 2020 RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4826 for a Cesspool/Septic Tank Construction Permit submitted by: Eileen Wingate for Daniel Lundquist. 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: Final aRnroval required from the Suffolk County Health Department Signature Dated OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown. northfork.net Residential @ $10 or Non -Residential @ $25 Application No. i Pennit No. Applicant Name` Applicant Mailing Septic Tank or Cesspool ` Brief Description of Proposed Construction or Alteration Location of Proposed Construction/Alteration Owner of Property:DW I , �64 Owner Mailing Address:_` Owner Property Address: -1 t t �RTo I a Name and phone number of contact person Tax Map No: Section Block Lot__ Cross Street I € "F' L_'/ __i LOCATION NL.i P MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURtr , 'ITH HEALTH DEPARTMENT APPROVAL r t SignattireofAWjtant Date Received by: a- e��1FFDL,�- ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS OFFICER MARRIAGE RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown. northfork.net Residential @ $10 or Non -Residential @ $25 Application No. i Pennit No. Applicant Name` Applicant Mailing Septic Tank or Cesspool ` Brief Description of Proposed Construction or Alteration Location of Proposed Construction/Alteration Owner of Property:DW I , �64 Owner Mailing Address:_` Owner Property Address: -1 t t �RTo I a Name and phone number of contact person Tax Map No: Section Block Lot__ Cross Street I € "F' L_'/ __i LOCATION NL.i P MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURtr , 'ITH HEALTH DEPARTMENT APPROVAL r t SignattireofAWjtant Date Received by: a- I c 81 ivAoHddv.qo W Siva WHA S8V3A 328HI S3HldX3 OL MP q6iooawls do wnwixvw HOA 0 CO 0 UJ 'ON co ROZ, 0 090, 0:z �14i O F- 41 ,kjKlO 3ON30133NA1111Vq 3IDNIS CL a) V IdOj NOLUMMISNOO 40 IVAOUddV HOA llviu3d C) 2�U, - • =-. . S301AH N S Hl-lV3 H .4 0 IN 3 WIHVa3a AIN noo )iloj i n S 0 :.VO 4) c)ChiO uj 20 iL q I 14 U�l I NO Im MSE MOORE -1 81 ivAoHddv.qo W Siva WHA S8V3A 328HI S3HldX3 MP q6iooawls do wnwixvw HOA 0 CL ;- 14 U�l I NO Im MSE MOORE -1 L ivAoHddv.qo W Siva WHA S8V3A 328HI S3HldX3 MP q6iooawls do wnwixvw HOA 0 CL ;- 0 UJ 'ON co ROZ, 0 090, , E �14i 41 ,kjKlO 3ON30133NA1111Vq 3IDNIS CL a) V IdOj NOLUMMISNOO 40 IVAOUddV HOA llviu3d a 2�U, - • =-. . S301AH N S Hl-lV3 H .4 0 IN 3 WIHVa3a AIN noo )iloj i n S :.VO 4) 14 U�l I NO Im MSE MOORE z L g 2 0 CL ;- 0 UJ co 14 U�l I NO Im MSE MOORE z g 0 CL ;- 0 UJ co 41 7. od :.VO 14 U�l I NO Im MSE MOORE O'T a24 p z g CL ;- 0 UJ co C 7. od O oa O O'T a24 p CL of 0 0 U z ,T CL ;- UJ co od O oa O CL of 0 0 U