HomeMy WebLinkAboutSullivan, Bob & Jackie
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Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown. northfor k. net
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRlAGE OFFICER
RECORDS MANAGEMENT OFFICER
FR~Il()~ .OF INFORMATION'OFFICER
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
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FROM:
Linda J. Cooper, Southold Town Clerk's Office
DATED:
September 8, 2006
Transmitted herewith is a copy of application No. 3626 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Mark Schwartz for Sullivan
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
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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: Maintain required setbacks from adiacent wells. buildings. propertv lines and water
Bodies. EXCAVATION INSPECTION REOUIRED. ~-.p1 ~'l". - P
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Signature
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Dated' ,
EUZABETH A. NEVILLE .. ~
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 53095 Main Ro
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P.O. Box 1179
Southold, New York 1197
Fax (631) 765-6145
Tffiephone (631) 765-180(
8outholdtown .northfork.n,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRlCf
APPLICATION
CONSTRUCfION or ALTERATION PERMIT
CESSPOOL or SEPU,-- TA:Nf{
Residential @ $10 i or Non-Residential @ $25 _
Application No. 3. ("d-.b
Permit No.
ApplicantName~..t' \<.. \<.... 'So c.""",~"" '- '" "c.\-.,t-ec.~l.
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ApplicantMailingAddress ~.O. f.1....... 1:\"3'3 lc...u+(!'vv-.~u-e.. I N"I \\C\"!>>S""
Septic Tank~or Cesspool_ .
Bri~fDescription of Proposed Construction or Alteration \ '800 'a" \ "S ~ f he:. ""'c:- \....
(1.) 8 .1'8 X 10" ~P.~ I#~\....".) f....u ~..r Q''''\~''J \0,....;; l~\~ o..lc\~'_1'I.
Location of Proposed Construction/Alteration:
Owner of Property: ~o\" o..""Id .1...r~dl Su\\\~....-t\.
Owner Mailing Address: \ \ ~ ~........ ~ l:o" (' oo.d.
Go.t'A,pl"\ c.\~ I to.I'f \l530
Owner Property Address: '2. \ ., 5 f'.3 C!.. S.So." \lO\" t. rc\.. .
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Name and phone number of contact person 7"! + - + I ~ 5;
Tax Map No: IdoC) Section I 0 "\- Block l '3 Lot '8
Cross Street
NOTE: LOCATION MAP MUST BE SUBl\I1'1TED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURvE EPARTMENT PROV AL
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Received by: ~~
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2 STORY
FRAME HOUSE
. GARAGE
578036'20" W 311.693'
5.1'.: 18OOgat. SEPTIC TANK
(10' DIA. 5' DEEP' WrTli " UQUJD DEPTH)
LP.: 8' OIA. X 10' DEEP
E.R.: 8' DIA. EXPANSION RING
HOUSE: 5 BEDROOM, GARAGE: 2 BEDROOM
SITE PLAN
SCALE: 1" = 30'-0'
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TEST HOLE DATA
DATA SUPPLIED BY: McDONALD GEOSCIENCE
BOX 1000, SOUTHOLD, NY 117ql (631) 765-3677
REVISIONS:
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SCTMI 1000-104-13-8 Z
LOT COVERAGE: 14.8 % 0
PROPERTY: 30824 SQ. FT. E f!'
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EXISTlNG HOUSE : 2&11 SQ. FT. 0 ~
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HOUSE DECK a. COVERED POROI POROI: 506 SQ. FT. c:( :J:
HOUSE . GARAGE: 1032 SQ. FT. 0 m
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SHEDS: 116 SQ. FT. Vl :5
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-9- r-SUFFOLK COUNTY DEPART,t.ENT OF HE,ALlli SERVICES
PERMIT FOR APPROVAL OF CONSTliicTION FOR A
SINGLE FAMI RESIDEN9E AND
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APPROVED
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May02,2006
5tEET NlI48ER:
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