HomeMy WebLinkAboutJett, Joseph
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION':l:ln'ICER
\, '\ \
~ ' , ",' \ OFFICE OF THE TOWN CLERK
\.';;, \'IIJ\~ \) , ,\ TOWN OF SOUTHOLD
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T _~SoutholJ1'own Building Department
FROM: Michelle 1. Martocchia, Southold Town Clerk's Office
Town Hall, 53095 Main Road
P,O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
DATED:
May 5, 2006
RE:
Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 3590 for a Cesspool/Septic Tank
Construction/Alteration Permit submitted by:
Joseph Jett
Please review the application and location map and advise ifthis office may issue the permit.
Please complete the form below and return it to me. Thank you.
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I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
~
DISAPPROVE
Comments: O:~;a ~;;&<. ~ -~~
~~/4-
Signature
~S-~8~~
Dated / /
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
sou th old town. 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_
Application N03SQO
Permit No.
Applicant Name:::::J;.s:..o r-1- SQ.*
Applicant Mailing Address If 3 - 0 I ~ C] --rt.. 0(,/ II.-R..
St~ c;.; dl Y\. L, \ \ \ oy
Septic Tank_or Cesspool_ I '
Brief Description of Proposed Construction or Alteration
Location of Proposed Construction! Alteration:
S ~ ....L
Owner of Property: 0 ~ ----l.Q.' \ \.
Owner Mailing Address: S~
Owner Property Address:
...-,-- ~ fl. (.3'~
Name and phone number of contact person......! ,-^--^-"",. ',( lA-I (\I\() UU.J(1..L--, .;2&-,-10 I ()
Tax Map No: Section~ Block ())' Lot a l/. 3D
Cross Street '?~ -As'\CuA, c\ ~ / (VV:U../"'\ 'L.d
I
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES S~VEY H HEALTH DEPARTMENT APPROVAL
>=->-OG
Date
Si ature
Received b~~Cut.ih9'].9
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SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
PERMIT FOR AFPROV AL OF CONSTRUCTION FOR A
SINGLE FAMILY RESIDENCE ONLY
DATE'i/t'i 0'- SREF. O. f(/.-05-02.2--
APPROVED
FO MAXIMUM OF ..:L BE ROOMS
ExPIRES TIIREE YEARS FROM DATE OF AFPROV AL
"1
EXCAVATION INSPECTION REQUiRED I
FOR SAWTl\. rEM
TEST
10/5/0
BY McDONAl
E By HEALTH DEf'l\Jt7MENT
.EJ...ICU
iJROWH SAMJY LOAM ot.
____2.
BROWN SL TY SAND WITH H€.A-.'Y GRAVEL Sltl 0
.tlt-"..
~ __ 7"
PALE BROWN FJN€ TO IED/W SAND Sf'
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BROWN FIV€ TO COJoRSE SAND
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WA TER IN BROWN FIE TO COARSE SAW Sit'
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I am familiar with the STANDARDS FOR APPROVAL
AND CONSTRUCTION OF SUBSURFACE SEWAGE
DISPOSAL SYSTEMS FOR SINGLE FAMIL Y RESIDENCES
and will abide by the conditions set forth therein and an the
permit to construct.
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The location of wells and cesspools shown hereon are
from field observations and or from data obtained from others.
AN Y AL TE:RA nON OR AOOlnON TO THIS SURVf:Y IS A VIOLA nON
OF SECTION 7209 OF THE NEW YORK STA TE: EOUCA nON LA w.
EXCEPT AS PER SECTION 7209-SUBO/VISION 2. ALL CERnFICA T10NS
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONL Y IF
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVf:YOR
WHOSE SIGNA TURE APPEARS HEREON.
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~V-D5-0~URVEY OF PROPERTY
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TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y
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P.D. BOX 90.9
7230 TRA VELER
SOUTHOLD, N. Y. 11971
"MAP OF ORIENT BY THE SEA,
THE SUFFOLK COUNTY CLERK'S
'174 AS FILE NO. 6160.
D5-216