HomeMy WebLinkAboutMoglia, John
ELIZABETH A. NEVILLE
TOWN CLERK
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
sou tholdtown. north fork. net
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION~R
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~FFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
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TO:
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Southold Town Building Department
FROM:
Michelle L. Martocchia, Southold Town Clerk's Office
DATED:
March 15,2007
RE:
Cesspool Construction! Alteration Application
Transmitted herewith is a copy of application No. 3671
Construction/Alteration Permit submitted by:
for a Cesspool/Septic Tank
John MOl!lia
Please review the application and location map and advise if this office may issue the permit.
Please complete the forn1 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: ~f~~~11~~'~ ~ ~A'
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Signature
03~r~7
Dated' ,
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 @ $1 0 / or Non-Residential @ $25 _
Application N~bll
Permit No.
Applicant Name ,)'d H1V ;Y~L/A
Applicant Mailing Address / [} 1ZJI!L..fl:... f'7'/c:',
/171'2..
Septic TankLor Cesspool_
Brief Description of Proposed Construction or Alteration
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/!Jew Co<<I'/'
Location of Proposed Construction! AlteratiOl)i ..J ~.fl") mD31 ~
Owner ofProperty:~3 <t() /01:(;. .oJ? IC/(
Owner Mailing Address: S()~D\ d..-J.J 'I I \ '1/ j
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Owner Property Address:
Name and phone number of contact person
Tax Map No:!OOO Section r7
Cross Street /tI111;v 1YtJ ( 6'~
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVE rIYH T DEPARTMENT APPROVAL
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Signa of Applic t
ReceiVedby~orrtfh2 3J 1..5/ 07
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SURVEY OF PROPERTY
SITUATED AT
BAYVIEW
TOWN OF SOUTH OLD
SUFFOLK COUNTY, NEW YORK
S.C, TAX No, 1000-87-05-18
SCALE 1 ~",,50'
APRIL 1 0, 2006
JUN( 6. 2006 .o.DDEO 'NELL LOCATION
AREA = 12,875.00 sq. fl.
0.296 ac.
LOCATION OF SANITARY SYSTEM AND/OR
WATER SUPPLY FACILITIES NOT GUARANTEED
SEP 18 200b
OFFICE OF WASTEWATER MANAGEMENT
SUFFOLK COUNTY DEPT, OF HEALTH SERVICES
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