HomeMy WebLinkAboutFoss, Lillian J
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Town Hal!, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
sou tholdtown. northfork. net
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
" TO:
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. SouthOlcrJwn Building Department
FROM:
Michelle L. Martocchia, Southold Town Clerk's Office
DATED:
February 5, 2007
RE:
Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 3662
Construction/Alteration Permit submitted by:
for a Cesspool/Septic Tank
Lillian J. Foss
Please review the application and location map and advise if this 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: ~~~~~~~~41f!
......
~~ .//?/. -
Dated" /
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
..' Town Hall, 53096 Main Roa<
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telepbone (631) 765-1800
sou tholdtown, northfork. net
OFFICE OF TlIE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential@$IO / or Non-Residential @$25_
Application No. ..310(,,2-
Permit No.
Applicant Name )" ,-t{I'u,' J FDSe;
Applicant Mailing Address (II SO 4 t' {( > ,J. € A~
.:)~'':/' <; IA ,\n<2 ~r V 'I &-'7 b
Septic Tank_or Cesspool_ \ ~ . ( -1J
Br\ef Description of PropoHed Conspuct!qn 5/f Alteration-PCfT'n oft' sf., I It f 0' q
fl!::4c..::h.l f--e 0 J't?l.. V-'e loll , \0[ " "'<:::(
Location of Proposed Construction! Alteration:
Owner of Property: J- ..II" ce /1 T FD S C;
Owner Mailing Address: /11 S6. +.J ,I/s t'J.Q . 4- II f
SaG(4 5 u n M.. I\..J Te; '7~ '7 b
Owner Property Address: I 35 J" h er"'f'J k ^ e.
SDu.:tlhol& t....)~/ i/C( '7 /
Name and phone number of contact person) I H '7 '3 - s- g-t/ - ,/3<1 L
Tax Map No; Section ~'7g- Blo~k 09 Lot 0 '7:5
Cross'Street Qo /l1Vv\!D,.CL UJ,
,
NOTE: LOCATION MAP MUST BE SUB1\11TfED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURvEY WIT, H HEALTH DEPARTMENT J'P'OV AL
,. dL . ~-;o 7
Signature of Applic Date
Received~'f'0P~ Q dls.JOI
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SURVEY OF
DESCRIBED PROPERTY
SITUATE
SOUTHOLD, TOWN OF SOUTHOLD
SUFFOLK 'COUNTY, N.Y.
SURVEYED FOR: EDWIN T. FOSS
LILLIAN J. FOSS
TM# 1000~078-09-075
ElEVATIONS TAKEN FROM
EAST END TOPO MAPS AS
FILED IN THE SUFFOLK COUNTY
OEPT OF PUBLIC WORKS.
GUARANfEEO TO.
EDWIN T FOSS
LILLIAN J. FOSS
FOR SCOHS USE ONLY
TEST HOLE BY
MCDONALD GEOSCIENCE
ON 26 NOV 04
EXISTING GROUND
DARK ~ROWN LOAM OL
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BROWN SILT ML
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SURVEYED: 22 NOVEMBER 2004
S&LE 1"~ 30'
AREA = 16.908 SF.
OR
0.388 ACRES
SURVEYED BY
STANLEY.I, ISAKSEN. JR.
P,O BOX 29'~
NEW SU~'. OLK N Y
631-73 -5835
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'i$UARNflEES INDICA TED HERE ON SHAlL RUN
ONL Y TO THE PERSON FOR WhOM THE SURVEY
IS PREPARE;}, AND ON HIS BEHALF TO THE
TmE COMPANY. GtJ1IERM,IENTAL AGENCY,
LENDING INST1Tl/TlON, IF LISTED HEREON. AND
TO THE ASSIGNEES OF THE LENDING INST1TUTION.
GWoRANTtES ARE NOT TRANSFEIYIBLE TO
AODfflONAJ.. INSTm.JT1ONS OR SUBSEQUENT OWNERS.
UNA/J'11"K)RIZED AL TERA T10N OR ADDITION TO THIS
SUR\lEY IS.... \I'IOLA, T10N OF SECTION 72tJ9 OF
THE NEW YORK ST....TE EOUCATIONLAW.
COPIES OF THIS SUR~ MAP NOT BEARJNG
THE LA.HO SUR\lEYORS EMBOSSED SEAL SHALL
NOT BE CONSIDERED TO BE.... VALID TRUE
COPY.
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