HomeMy WebLinkAboutSouth Fork Properties
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
southoldtown .northfor k. net
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REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGj;MENT OFFICER
FREEDOM OF INF6RlVINfION OFFICER
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
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Michelle L. Martocchia, Southold Town Clerk's Office
DATED:
March I, 2007
RE:
Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 3670 for a Cesspool/Septic Tank
Construction/Alteration Permit submitted by:
South Fork Properties
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:
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Signature ~
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Dated f I
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
.~ Town Hall, 53095 Main RoB'
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765.1800
sou tholdtown. northfor k. net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD W ASTEW ATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$IO /or Non-Residential @$25_
Application N~l 0
Permit No.
Applicant Name .5:..,-(1-1 ~12.1{ fru.PGt2..1)f.J
Applicant Mailing Address Po JJoji, bf5Lf. S-rrf/41-1PTC<JI ;J Y l/Cf6r
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Septic Tank Vor Cesspool_
Brief Description of Proposed Construction or Alteration
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Location of Proposed ConstlUction/ Alteration:
Owner of Property: ~f" r:;;...IO R..-,,<Q.-r'65
Owner Mailing Address: PO 12.1'1,y; ('(.'11
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Owner Property Address: sea f( 6N/l/G/ 120, . )ovrHl)i;P
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Block
SUFFOLK COUN'IY DEPARTMENT OF HEAL 1H SERvrCES
PERMIT FOR APPROV At OFCONSTRUcnON FOR A
SI.NGLE FAMILY RESIDENCE ONLY
DATEJO- Vll-OLf. \o-oLf-
, APPROVED
POR MAXIMUM
MS
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ExCAVATION INSPECTIoN REQUf_
FOR SANITARY SYSTat
BY HpJ",TH DEPARfMINT
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THO"AS fl5CH[R
LAWYERS TITLE INSURANcr (ORP
NORTH fORt<' BANI"
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DCISTING ELEVATIONS ARl: S~ THVS'
2 R[Ft:R TO nUD ..AP .OR ~ HOt..[ OAT....
3 "INIlIUW SEPTIC fAJrtI( CAPA,CrTlES fOR A 1 TO . BEDROOW HOUSE IS 1,000 GAU..OtCS.
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.. ........,UW LEACHING SYSH.1ii FOR" 10 4 8EDROQW HOVSl IS .JOO ~ II $IDlWAlL AREA
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@ PROPOSED cLACHlNG POOl
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5 TliE LOCATION or WELlS ANO CESSPOOlS SHOWN HERrON ARE nlOW rJEtD
OBSER'VAllONS AHD/OR DATA OBT....NED FRQW OTHERS.
TEST HOLE DA TA
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TOTHlSSlIRVEYISAYlClL'lT!C:lNOF
SECTION 7209 or THE NEW)'(lRI( STATE
fOUCATlOH LAW
;,- 7 COPIES Of THIS SUfM"Y MIlP 'lOT BEARING
THflANOS~'SIHl([DSEAlOR
0I80SSED SUL SHALl. HOT BE CONSI[)(RED
TO BE A \/NJO mUf COPY
CE:RTlflCAllON$ lNOlCAITD HUlfQN stVo.LL RUN
ON!. I' TO THE PERSOH FOR WHOtot THE SlMv'EY
IS PRE:P~. AND ON HIS BEHot.L.F TO rn(
mlL COWPANY GOYE'RNIiiOITAL AGENCY AND
LENDING lNSllTiJnot.; usrm HEREON. AND
TO Tl-IE ASSIGHUS or THE L(N[)ING INSTl-
nmON. CERTIFICATIONS .oRE: HOT ~5nRABU
THE LX1STtNC[ Of RIGHT OF WI-. '!"s
AHO/OR EASEWENTS OF RECOfW. IF
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N.r.S. lie. No. 49668
eph A. Ingegno
and Surveyor
ritle SurYey5 Subdivi~ions
Site Plans
Con.rlruction layout
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PHONE (631 )727-2090
~QX (631)727-1727
OFFICES Loc;,TED AT
322 ROANOKE AVENUE
RrvERHEAO, New York' 1901
WJUNG MJORESS
P.O. Box 19JI
Rlverneod, Ne. rort 11901 0965
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