HomeMy WebLinkAboutPasierb, Marilyn/Bloch, Matthew
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ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICE,B.----~: ' -',
FREEDOM OF INFORMA!!pN9FF\~CEil .
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\ ;' ~ TOWN OF SOUTHOLD
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TO:
~id\t()~n Building Department
FROM:
Linda 1. Cooper, Southold Town Clerk's Office
DATED:
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Town Hall~~~~Oad
P.O. Box 1179
Southold, New York 11971
Fax (631) 765.6145
Telephone (631) 765.1800
southoldtown.northfork.net
Transmitted herewith is a copy of application No, 3492 for a Cesspool/Septic Tank Construction
Permit submitted by:
Meryl Kramer
Please review the application and location map and advise if the project has received Suffolk County
Health Department approval and ifthis office may issue the permit
Please complete the form below and return it to me,
Linda 1. Cooper
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I have reviewed the application and location map ofthe project cited above and make the following
recommendations:
APPROVE
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DISAPPROVE
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Signature ~
Datef~ ~ t
Comments:
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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
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential@$1O tI'" or Non-Residential@$25_
Application NO.~
Permit No.
Applicant Name Mt:"~'(L. K~
ApplicantMailingAddress_ 'YO ~ '~'b
GR€EN~~T:, ~l"+4-
Septic Tank-X-or Cesspool_ ~ ,.L.
Brief Desc~ of Proposed Construction or Alteration \ e)(L~1 - Stph c...
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Date
Received by:
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Sep 23 04 02: 04P. _ ~r:'" 1. k.........
631-477-8936
LETTER OF AUTHORIZATION
MARilYN PASlERB & MATTHEW BlOCH
675 Water Street Apt. 19F
New York. NY 10002
We hereby authorize MERYl KRAMER. ARa-lITECT to act as our agent in obtaining aIL.
pennils required by TOWN. SUFFOLK COUNTY and NEW YORK STATE for the renovation c
our residence at 680 TRUMANS PA1H. EAST MARION, NY
Owner
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DWELlING .
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EDWARD FORTE
.t CATHERINE J. FORTE
DWELlING
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3;~~~:ARY SYSTEM PLAN
ALL SURVEY DATA SUPPLIED BY JOSE H A. INGEGNO, AND
SURVEYOR, RIVERHEAD, NY DATEDJ LY 14, 2004
(TEST HOLE DUG BY McDONALD GWSC/ENCE ON JUNE 4. 2004)
46
SUFFOLKCOUNlYDEPARTMBNTOFHEALm SEltVICES
I'ERMlT FOR APPROV ALOF CONSTRUcnON FOR A
SlNGLEFAMILY RESIDENCE ONLY
DATE b.-J-f5-oS .NO. ~lO-o4- 015(,.
APPROVED
FOR MAXIMUM Of BE S
EXPIRES tHREE YEARS FROM DATE'OF APPROVAL
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DARK BRONN SILTY LOAM OL
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PLEASE NOTE
Senitary System !l21 to be installed
under driveway.
Ct~1I1!S Pt SOUTI-IOLD
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F' HayB...,P/ 4" . SITE
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BROWN Sll T ML
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BROWN FINE TO COARSE SAND
WITH HEAVY GRAVEL SW
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PALE 8RGWN FINE TO COARSE SAND SW
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~TEST HOLE DATA
....L..NOT TO SCALE
NOT TO SCALE
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