HomeMy WebLinkAboutConnors, James ELIZABE~I~ A. NEVILLE TOWN CLERK '
REGISTRAR OF VITAL STATISTICS
I~LkRRIAGE OFFICER
P~ECORDS iVL~MNAGEI~[ENT OFFICER
FREEDOM OF INFOP~L~i~IO~I OFFICER
· :,, 2 .... OFFICE OF TtIE TO~NN CLERK
.i' { ~g% \ ~ .~ - TOWN OF SOUTHOLD
}%O.*- - :-'. :... Southolcl-TSwn Building Department
FROM: IJnda J. Cooper, Southold To~m Clerk's Office
To~vn Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtoivn.northfork_net
DATED: August 18, 2004
Transmitted herexvith is a copy of application No. 3368 for a Cesspool/Septic Tank Construction
Permit submitted by:
Donald Feiler and James Connor
Please review the application and location map and advise il'the project has received StLffolk County
Health D~artment approval and if this office may issue the permit.
Please complete the form below and retRrn 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
ComnlelltS' ~
Dated
F-~IZABETH A. NEVTT "r 0 V~ CLERK
'RE ,~,I~TltAtT OF VITAL STATISTICS
MAHRIA. GE OFFICER
!?RECORDS MAI~AGEMEN~ OFFICER
~EDOM OF LNFOthMATION OFFICER
Towa Halt, 58095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
s out~old~ow~ noi~h£ork.net
'"OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential ~ $10 For
Applicant Name
Applicant Mailing Address
Non-Residential ~ $25 __
Application No_ __
Permit No.
Septic Tank Y, or Cesspoolt~-
Brief Description of Proposed Construction or Alterafion~ ~
Location of Proposed Construction/Alteration:
Owner of Property: ,,..~ ~'ht~ ~--------~ ~C) Ix) {'~O (~
O,wner Mailing Address: ~lr)S~-t~'L~ ~lfl'~ } ~--~f~'
Owner Property Address:
Name and phone number of contact person '~). ~-[ ~
Tax Map No: I ~ Section ' ~"O Block C~ ~ Lot ~"7.~ , ~
Cross Street ~.. LC~ ~t~)O~ ~::~ ~O/~_
NOTE: LOCATION ~ ~ST BE SUB~TTED ~H ~PLICATION. NEW
CONSTRUCTION ~Q~S S~~TH ~T~ DEP~T~ ~PROV~
Receiv~ gy:~ ~ - . .
DWELLING
VACAq
SURVEY OF PROPERTY
SITUA TED A T
SOUTHOLD
TOWN OF' $OUTHrOLD
SU:FFOLK COUNTY, NEW YORK
$,C, TAX No,-1000-50-03-22.3
SCALE t"=40'
.DECEMBER 2, 1999
AREA = 45,815.61 sq. ff.
1.006
S THPJ2E ¥~ARS FROM DATM OF APPROVAL
CERTIFIED TO:
JAMES CONNORS
WASHINGTON MUT.gAL BANK F.A.
ABSTRACTS INCORPORATED
O~ ~ALTIt
~ m r~o ~e r0~ ~r~'~ HOLE
TEST HOLE DATA
eph A. Ingegno
Surveyor
(851)727-2090 Fax (631)7.27-1727