HomeMy WebLinkAboutDunne, Steve ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEM_ENT OFFICER
FREEDOM OF INFORNIATION OFFICER
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.nor th fork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO:
FROM:
DATED: December 7, 2004
Transmitted herewith is a copy of application No.
Permit submitted by:
Hugo A. Cano for Steve Dunne
Southold Town Building Department
Linda J. Cooper, Southold Town Clerk's Office
3407 for a Cesspool/Septic Tank Construction
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
Comments:
Dated
ELIZABETH A. NEVILLE
· o~ CLkRK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 53095 Main Road
P.O. Box 1179~
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TO~VN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERS~IT
CESSPOOL or SEPTIC TANK
Residential ~ $10 /Or Non-Residential@S25
Application No. ~ (//~ ~
Permit No.
Applicant Name. ~0
Sq~tic Tank or Cesspool. v/
Location of Proposed
Owner of Property:_
Owner Mailing Address:_l~l
Owner Vr°perty Address:A q (o c)
Name and phone number of contact person ~rl\)~0 /~. C~1130 -
T~ Map No: [00 0 Section ~ Block
Cross S~eet ~ - ' ' -
NOTE: LOCATION ~ MUST BE SUBDUED ~TH ~PLICATION. ~W
CONSTRUCTION ~Q~S S UR~~TH DEP~T~
I ~Tm Imnlllor wtl~ Jhe STANDARDS FOR APPROVAL
AND CONSTRUCTION OF' SUBSURFAC~ SE#AGE
D~O,STtL ,.,cYST~'_MS FOR SINGLE FA.~IL Y RESIDENCES
o~d I~111 abide by II~e con~illo~.~ sel Iorll~ ther~ ~nd on Ihe
peril Io co~slrucl.
SURVEY OF
L 0 T
SUBD/VISION
'Fr 6 2004
HILL CREST ES TA TES, SEC TION 1
FILED AUG. 15, 1983 FILE NO. 7218
A T ORIENT
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
1000 - 13 - 02 - 8.11
Scale 1" = 40'
Aug. 25, 198B
SE~T. '~, 200J3 IS. 0J.L INFO. )
ANY ~L ?EHA TION OR AD~ITION TO TH~$ SURVEy ~ A VIOLATION
O~ Z~-C?ION 7209 ~ T~ ~W Y~K $TATE ~UCA~ L~.
~CEPF A~ P~ SEC~ ~OB - S~ ~ ALL ~T~S
~Od ARE VA~ F~ ~ ~ ~ C~S ~RE~ ~Y ~
~SE ~ T~E A~S ~.
T~ }o~a~}ol~s of well and cesspools AODITI~'KALL y ro COt~L y WITH SAID LAW T£~ ' AL TERED BY '
' ~ST ~ U~ 8Y ~y ~ ALL 8~V~Y~8
shown hereon ore from field observqlions ~ AN~rttER ~ ~. T~
ond or /rom dale ob/o/ned from others. ' ~OL/~.IF - TO - ~ TE ' ~ NOT ~ C~E WI~ ~ ~.
V/ELL
CERTIFIED TO,
FIRST AMERICAN TITLE INSURANCE
COMPANY OF NEW YORK
TITLE NO. 131 S 2285
JMRIS MARDtFIG
GAlL WA T$ON MARDFIIG
SOUTHOLD, N. ¥.
N.Y.S. LIC. NO. 49616
)RS, P.C.
FAX (631l 765 ' 1797
S TREE T
11971
88 - 530
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