HomeMy WebLinkAboutEsposito, Basilio
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ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECdatlSMi\NAGEMEN''FdFVlCER
FREEDOIll: 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
MARIL ')
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
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TO:
ld Town Building Department
DATED:
<eh.,.f~'m,",h 1:,2080-
SouthoId Town Clerk's Office
1/3/0r'}
FROM:
RE:
Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 3575 for a Cesspool/Septic Tank
Construction/Alteration Permit submitted by:
Basilio Esposito
Please review the application and location map and advise if this office may issue the pernlit.
Please complete the form below and return it to me. Thank you.
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e app lca
at'on map of the project cited above and make the following
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APPROVE
Comments:
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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.northfork. net
"
ELIZABETH A. NEVILLE
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
Residential @ $IO~r Non-Residential @ $25_
Application N3S75
Permit No.
Applicant Name 13'9 9 ( Lie E ~ ;;, C) .9 ( to
,
Applicant Mailing Address / Cl uS- 13 (/ Pi) ~ /::>0 f'{ ()
,
St:l-vTIlt?~ Ii 1../ 1/ q 7/
Septic Tank~or Cesspool . .
Brief Description of Proposed Construction or Alteration
R,-erV:d', "'S c eY" 9n(l \.
Location of Proposed Construction/Alteration:
Owner of Property: !3a <; I L i ,? E g /~ 0 ~ II c:?
/
Owner Mailing Address: I 0' if ~ /::7, v D j;) S' ~CJ N !/ R [)
5' ~ C/ ~ 1'7 I () /'-/ f / / f 71
Owner Property Address: 17 i,f.5- /3 A Y . '8/10 R (::: I~ D
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q R t= F I'f r 0 R T H 'f / / '1Lf/f - '2 7 2 ?,
Name and phone number of contact person DR""'!!'''' I:'CJho <:1'70 c.')j - 70- 2 '8 Z-!
Tax Map No: 10" 0 Section L~ " Block if Lot 7
Cross Street K I::: R i-!l'i 1'/ . [:1,1. ". j)
fey
/3/11,: /-;? ~..., -~
Signature of Applic t
Received bY~~l\O 0 .0 ~/Yfu( fJ : fh..-;
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
31 n)DIo
ate
Sutvey of Lot 27 & 28
Amended Map 'A' of
'Peconic Bay Estates'
!riled May 19,1933
as Map # 1124
SCT# 1000-53-4-7
Surveyed: January 12, 2006
Amended: April 26, 2006
Amended: June 19, 2006
Situate: Arshamomaque
Town: Southold
Suffolk County, NY
Area = 0.56 Acres to HW
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Certified to:
Basilio Esposito
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SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
PERMIT FOR ApPROVAl OF CONSTRUCTION FOR A
SINGLE FAMILvReslDENcEAND
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EXCAVATION INSPECTION REQUIRED
FOR SANITARY SYSTEM
By HEALTH DEPARTMENT
-"2'
DATE \VZ..o/c.
APPROVED
TOTAl MAlaMUM BEDROO Y'e
EXPI~ THREE YEARS FROM DATE OF APPROVAL
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SEPTIC. DETAIL
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EL. 1.5
ROBERT H. FOX
NYS PLS# 501!TT
POBOX#538
RfVERHEAD, NY
631-722-33110
6/1<1/2006 'i.25.c,<lAM
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