HomeMy WebLinkAboutLindh (2) ELIZABETH A.NEVILLE,MMC y' � t t a�'e Town Hall, 53095 Main Road
TOWN CLERK 'i? 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
FREEDOM OF INFORMATION OFFICER
www•southoldtownny.gov
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Southold Town Clerk's Office
DATED: March 12, 2021
RE: Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 4950 for a Cesspool/Septic Tank Construction
Permit submitted by:
Direct Drainage-Inc. for Courtney & Alex Lindh
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
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Dated
C
ELIZABETH A.NEVII.LE �" Town Hall, 63095 Main Road
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TOWN CLERK P.O.Box 1179
11971
Mw NeYork
REGISTRAR OF VITAL STATISTICS ° Fax(Southold,, No York 46
MARRIAGE OFFICER tt„ Telephone(631) 766-1800
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICE " southoldtown.northfork.net
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OFFICE OF T1-IE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
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CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
10 or Non-Residential $25 Application No. m..
Residential @$ �
Permit No.
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Applicant N �a.nc._r �... �” w l
Applicant M iliiw A l pe s ��.°.�.w. " .. w �.. ....w,. ._ ....... __...
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B i e e� tion,,oi'Pro used Construction A S�-c'_N� .
Se tic Tank or Cess ool I
1 p tion or Aj9ei°"'aio1.�...� .�'�� �1:. .'�"�� �.�.� ..
Location of Proposed Construction/Alteration:
Owner of `:
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Owner Mailing .dae : :_�."- ... ... .. � ..�.mm,
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Owner Property .l ��J ��� �� .�.. _`. __ ... ��.EIC ... .1 .���� ���_ .. � ...�._._. ... ........._� .
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Name and phone number of contact person ,
Tax Map No: 1 0 0 Section :VQ Block ._ Lot 49
Cross Street 1Q.�( < *'` �?��' -c�`e.
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES S ,1 V,j0( WITH HEALTH DEPARTMENT APPROVAL
t : of Applicant Date
Received by:
Town of Southold
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Date: 03/12/21 Receipt#: 278555
Quantity Transactions Reference Subtotal
1 Septic Permit- Construct- Resid. 4950 $10.00
Total Paid::. $10.00
Notes: 70.-5-48 (Lindh)
Payment Type Amount Paid By
CK#1105 $10.00 Direct, Drainage
Southold Town Clerk's Office
53095 Main Road, PO Box 1179
Southold, NY 11971
Name: Direct, Drainage
363 N Dunton Avenue
East Patchogue, NY 11772
Clerk ID: JENNIFER Internal ID:4950
COUNTY OF SUFFOLK
STEVEN BELLONE
SUFFOLK COUNTY EXECUTIVE
DEPARTMENT OF HEALTH SERVICES GREGSON H. PIGOTT, M.D.,M.P.H.
Commissioner
SANITARY REPLACEMENT/RETROFIT OK TO PROCEED
Letter in Lieu of Permit
March 11, 2021
Property Owner: Alexander Lindh
Property Address: 2175 Pine Neck Road, Southold,NY 11971
TN4P#: 1000—070.00 05.00 -048.000
SHIP ID #: 20-01315
The pre-existing sewage disposal system at the above referenced property is being replaced/retrofitted with
an innovative and alternative onsite wastewater treatment system (UA OWTS) in accordance with Section
X.A. of the Department's "Standards for Procedures for the Replacement and Retrofits of Existing Sewage
Disposal Systems for Single-Family Residences and Other Than Single-Family Residences"("Standards"),
effective July 11, 2019. The installation of the I/A OWTS is being performed and reported in accordance
with the Standard and Article 6 of the Suffolk County Sanitary Code, and the Department has issued an
"Ok To Proceed"with the sanitary system replacement/retrofit.
If you have any questions or comments regarding this I/A OWTS installation please call 631-852-5459.
Sincerely,
)Ukk(O-K
Justin P Jobin SCMiS OK TO PROCEED
Environmental Projects Coordinator RIEPLA E IEN 01F I=AILED S NITARYSYSTEM WIT11°IAN
I/A O WTS
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DIVISION OF ENVIRONMENTAL QUALITY
Publicliealth 360 Yaphank Avenue,Suite 213,Yaphank NY 11980(631)852-5811 Fax(631)852-5812
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