HomeMy WebLinkAboutBailey, Tabatha 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
TO:
FROM:
DATED:
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Southold Town Building Department
Linda J. Cooper, Southold Town Clerk's Office
February 10, 2005
Transmitted herewith is a copy of application No. 3435
Permit submitted by:
Tabatha Bailey
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.
for a Cesspool/Septic Tank Construction
Linda J. Cooper
I have reviewed the application and location map of the project cited above and make the following
recommendations: ~
APPROVE
DISAPPROVE
Comments:
Signature
Dated
ELIZABETH A. NEV~,LE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
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 x/or Non-Residential ~ $25 __
Application No.~ ~"-
Permit No.
Applicant Name' \
Applicant Mailing
Septic Tank or Cesspool
Brief Description of Proposed Construction or Alteration ',. ')e ~_,3---~'~ ~ ~0_~ Cc__
Location of Proposed Construction/Alteration:
Owner of Property: ....... ' -.
,,..,, ~-~-o<_,o.~\-x . ~-.
Owner Mailing Address: ~:~
Owner Property Address: ,~ .
Name and phone number of contact person (,\~c\e__% t,3, -i~-hcxh'~¢~ -~ ~. '39--/-"-/qq~
Tax Map No: Section I ~,5-I Block ID~ Lot Ii9. ~
NOTE: LOCATION MAP MflJS{ 'BE SUBMITT'~ WITH APPLICATION. NEW
CONSTRUCTION REQU/Il? SURVEY WIT. ItE>~LTH DEPARTMENT APPROVAL
_ M} (~-,¢ Sjgna~ °f Applicant :3 Date
LOT (~
,I
SURVEY OF
LOTS 8 & 9
]lAP OF
FLEETWOOD COVE
FILE No. 1263 FILED JULY 1, 1958
SITUATED AT
CUTCHOGUE
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-157-04-10.1
SCALE 1"='40'
MARCH 15, 2001
APRIL 19, 2001 ADDED EXISTING SEPTIC SYSTEM
MAY 10, 2001 REVISED SITE pl~N
APRIL 2g, 2002 ADDED WETLANDS & TOPOGRAPHIC~L SURVEY'
AUGUST 22, 2002 REViSED PROPOSED HOUSE LOCATION
DECEMBER 16, 2003 REVISED PROPOSED HOUSE
FEBRUARY 27. 2004 REVISED PROPOSED HOUSE
APRIL 27, 2004 REVISED PROPOSED SEPTIC SYSTEM
JULY 25. 2004 ADDED ADDITIONAL NOTES
AREA = 25,949.79 sq. ff.
(TO TIE LINE) 0.550 ac.
NOTES:
TEST HOLE DATA
~'~T HOLE' DUG BY ~ ON F.~ARCH 22, 2001)
Joseph A. Ingegno
Land Surveyor
pHONE (631)727-2090 Fax (631)727-1727