HomeMy WebLinkAboutOhl, Clifford
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 tholdtown. northfork.net
FEB - 6
OFFICE OF THE TOWN CLERK
TOWN OF SOUTH OLD
~----. --,.-
-'--TO:
.,,~
Southold Town Building Department
FROM:
Francesca Quintieri, Southold Town Clerk's Office
DATED:
Transmitted herewith is a copy of application No. 3650 for a Cesspool/Septic Tank Construction or
Alteration Permit submitted by:
Clifford Obi
(Sent previouslv on 11-22-06)
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.
Francesca Quintieri
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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:
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Signature
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Dated
.
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EUZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
.. Town Hall, 53095 Main Roc
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
sou tholdtown.northfork. ne
,
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 NO.~
Permit No.
Applicant Name C/i lft?/d OM
Applicant Mailing Address Vb K.eu ri~~ R.c{., 1-1V?~vtJds JV,'I /66.5
Septic Tank ",/or Cesspool_
BriefDesc~tion of Proposed Construction or Alteratiori! IfJI' w./ Ooa/s (Nul h,: 1/
CD//{ /?-r-cL.- tv ((['UA.-r 4./q~ I
Location of Proposed Construction! Alteration:
Owner of Property: C Ii IftIV// 01, /
.
Owner Mailing Address: 2./ to k f 11\'if}JfoVl
RI. . L ~v,/(JYotJk /l/(,-
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Owner Property Address: /]]0 FI't'-l.t0CJtI<I Rei
(VI t J, cn, t<.A? .
(, Si6 -8'g)-.5 27/
Name and phone mnnber of contact person (.Ii (1"".1 {}'-t! :2 J -; - Jr.; i--~ '1(12-
Tax Map No: Section j 37 Block to Lot CR
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURvEY WITH HEALTH DEPARTMENT APPROVAL
~~~y' Y~6
. . o((~atureof. plic t' Date
ReceIved by: -
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NEW SEPTIC SYSTEM
( 3 BEDROOM HOUSEl
,- 1000 GAL PRECAST SEPTIC .TANK
, - LEACHING POOL 8'''' x /2 FEET DEEP
EXISTING CPs. TO BE FILLED IN OR REMOVED
ELEVATIONS ARE REFERENCED TO NGVD.
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= 15,854 sq. ft.
N
SURVEY OF PROPERTY
AT
CUTCHOGUE
TOWN OF SOUTHOLD
SUFFOL K COUNTY, N.Y.
1000 137 05
SCALE I" = 40'
MA Y 3, 2006
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rSU'lFOU~ f:.';;-j\/
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I am lamlllar wllh /tie STANDARDS FOR APPROVAL
AND CONSTRUCTION OF SUBSURFACE SEWAGE'
DISPOSAL SYSTDIS FOR SINGLe FAMIL Y ReSIDeNCeS
tIfId wII abIde b, /lie "tldl/lons sel lorlh Ihereln and on the
permit 10 _hwt.
The local/ons 01 wens and cesspools
shown hereon ore /tom field oII.ervoffon
IItId or from .'11 ~'.d /tom others.
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