HomeMy WebLinkAboutGeraci, Stephen
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
APR25
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
. ....-1
TO:
Southold Town Building Department
FROM:
Michelle L. Martocchia, Southold Town Clerk's Office
DATED:
April 24, 2007
RE:
Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 3680 for a Cesspool/Septic Tank
Construction! Alteration Permit submitted by:
Stephen Geraci
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
Comm""'" ~~m::t'~~~
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Signa~:; ~r h
Dated ' I
ELIZABETH A. NEVILLE ... ~
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 63096 Main Ros'
., P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
sou thoIdtown .northfork. net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10 I or Non-Residential @ $25 _
Application No&~
Permit No.
Applicant Name S~b~ ~el
Applicant Maili~ Address / i , E Avf5
IV-.y. /1772- .
Septic Tank_or Cesspool-X-. '
Brief Description of Propos Construction or Alteration
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Location of Proposed Construction/Alteration:
Owner of Property: ~gpV ~A9C I
Owner Mailing Address: /I~ ~17 ,4t1C,
~,4r-CHJ1ME., '/UJ' //777
Owner Property Address: ~::;I1:~rJ~lii~ 1
Name and phone number of contact person ~.4/tJV ~ 61/ 75" d - SSY6
Tax Map No: , Sec~ 10,/ Block 1)7 Lot ct?7.3
Cross Street 0"vv /;e,.?;G' 722)
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c, r NOTE;.:. LOCATION MAP MUST BE SUBMITTED .W APPLICATION. NEW
. CONSTRUCTION REQUIRES SURvEY ALT E ARTMENT APPROVAL
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Date
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ORIGINAL GROUNU
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FOR SCDHS USE ONLY
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SCDHS# Rl0-05-0028
GUARANTEED TO:
STEPHEN GERACI
GI.:ARANT[ES INDICA TED HERE ON SHALL RUN
0/;'( r TO THE PERSON FOR WHOM THE SUR\I["Y
15 PREPARED. AND ON HIS BEHALF TO THE
n7L[ COMPANY, GOVERNMENTAL AGENCY,
L[tJDING INsnTUTlON. IF LISTED H[f?[QN, AND
TO THE ASS/GNEES OF THE L[NDING INSTITUTiON
GUARANTEES ARE NOT T1?AN$FERABLE TO .
ACCmONAL /NSnTVTlONS OR SUBSEQuENT OWNERS
L'NJ.UiHORIZED AL TfRA nON OR AOOlnON TO THIS
s;,.;;,~y 1$ A V1OLATlON OF SECTION 7209 OF
""'= ,.[11' ;'OFiK STATE EDUCATION LAW.
'::::0;[5 OF il-'I$ SURIlEY MAP NOT BEARING
[}if LAND $URV[YQRS EMBOSSED SEAL SHALL
"'OT ff CONSIDERED TO BE A VALID TRUE
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SURVEY OF
LOT 2
IN
SUBDIVISON MAP FOR MABELLE DEMPEWOLF
SITUATE
CUTCHOGUE, TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
SURVEYED FOR: STEPHEN GERACI
TM# 1000-104-02-007.3
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NOTE: THIS lOT Will BE SHOWN IN A MINOR SUBDIVISION WITH LOT NUMBERS
SPECIFICALLY PREPARED FOR THE SUFFOLK COUNTY OEPT. OF HEALTH
SERVICES ON THIS MAP. IT WILL BE SHOWN AS LOT #2.
SCDHS APPLICATION NUMBER SIO-98-0009
SURVEYED' 7 DECEMBER 2005
SCALE 1 "= 40'
AREA = 41,872 S.F.
OR
0.961 ACRES
SURVEYED BY
STANLEY J. ISAKSEN, JR
P.O BOX 294
NEW SUF: OLK. NY
6.31-7.3 -58Y:.
1. 2 FEe 07 SHOW REV. HOUSE AND GARAGE:. REVISE OW LOCATION
05R1458
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