HomeMy WebLinkAboutFalbo, Jimmy ELIZABETH A. NEVILLE
TOWN CLERK
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
TOWN OF SOUTHOLD
TO:
FROM:
DATED: February 1, 2005
Transmitted herewith is a copy of application No.
Permit submitted by:
Jimmy Falbo
Southold Town Building Department
Linda J. Cooper, Southold Town Clerk's Office
3239 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: j
APPROVE
DISAPPROVE
Comments: ~~
Signature
Dated~'~-/~//
EL~.~BETH A. NEV~x.~
TOWN CLERK
REGISTRAR OF VITAL STATISTIC~
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF Ii~IFORMATION 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
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
{
Residential ~ $10 ~ or
Non-Residential ~ $25 __
Applicant Name ~ ~*.~y
Applicant Mailing Address_ /O{?~o O(o/
Septic Tank_ or Cesspool
Brief Description of Proposed Construction or Alteration
Location of Proposed Construction/Alteration:
Oxvner of Property: f~'~ ~--~/do
Owner Mailing Address: /~gezo ~ _Fo,,-,~
Owner Property Address: J'~.~e
Application No.3~-~ ~
Permit No.
Name and phone number of contact person
Tax Map No: Section /0o0 Block 0 ~ Lot
Cross Street_ [:xr~ ~-~.~ /~ta e~
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
15 8 0
SURVEY OF
DESCRIBED PROPERTY
SITUATE A T
MA TTITUCK
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. T.M. DIST. IO00 SEC. 122 BLK. 02LOT9
15 30 45 60 75 90 105 120
SCALE: I' = 30' DATE: JANUARY29, 2004
ALL PROPERTIES IMPROVED
SERVICED BY PUBEC WA TER
ACROSS STREET WITHIN 150' OF PROPERTY
SOUND A VENUE
(OLD SOUND AVENUE. NORTH ROAD)
135
CERTIFIED TO: JAMES FALBO ~
JOB NO. 2004-105
MAP NO.
FILED:
REVISIONS:
REV. PER S.C.D.H.S. COMMENTS
HANDS ON SURVEYING
46 NORTH ROAD
HAMPTON BAYS, NEW YORK
11946
TEl_' (631)-723-1954 - FAX:(631)-723-1329
MARTIN D. HAND L.S
493.64'
TEST HOLE DA TA
MIXED SAND AND LOAM
PALE BROWN FINE SAND
~16.2'
WATER IN PALE BROWN
FINE SAND
· -17"
;NDORSEMENTS
LOT AREA: 15, 756 SQ. FT. = 0.362 ACRE
ELEVATIONS REFER TO APPROX. MS/. DA TUM
AND ARE THE RESULT OF ACTUAL FIELD MEASUREMENTS
NO SURFACE WATER EVIDENT WITHIN 300'
EXISTING SANITARY SYSTEM LOCATION AS SHOWN
(TO BE ABANDONED ~ PUMPED CLEAN & BACKFILLED
WITH CLEAN SAND
OFFSETS SHOWN THUS ( 9.1') ARE TO PROPOSED STRUCTURE