HomeMy WebLinkAboutWiederlight, Marc
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 11 79
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown. northfork. net
!Ii..! 2 I 7
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO:
Southold.L:nJ.,n Building Department
FROM:
Linda J. Cooper, Southold Town Clerk's Office
DATED:
May 18, 2007
Transmitted herewith is a copy of application No. 3712
Permit submitted by:
for a Cesspool/Septic Tank AL TERA TION
Al!nieszka Drozdowska for Marc Wiederlil!ht
Please review the application and location map and advise ifthe 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.
Linda J. Cooper
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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:
Bodies. EXCA V A TION INSPECTION RE
,
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Sign~~~B~7
Dated I e
.
EUZABEm A. NEVILLE ... ~
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 68095 Main &0
.- P.O. Box 1179 .
Bouthold, New York 11971
Fax (681) 765-6145
Telephone (681) 766-1800
southoldtown.northfork. nel
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10 L or Non-Residential @ $25 _
Application No. D 1 \d'-
Permit No.
\
ApplicantName ftGDl-e.SZ[L\-l- DIZ.aZIDO(.(F~~^.
Applicant Mailing Address 'F D. 'Oo\C ~ ':,
HA-iT\TlJtIL, ~~. 1I'i S L
Septic Tank_or Cesspool_
Brief Description of Pro posed Construction or Alteration A-l:::r"iTlf"'U TO l':Y\\O.t'i IoCY.
IC;r. ~LUL "- ~\\J'i. ~ ..,~ ~ (':lOR ~l:>nhlC")t.:l ( ~U~.
Location of Proposed Construction! Alteration:
Owner of Property: t-...Iit-1tC. ~. LoIE'0E~l-\6Hl
Owner Mailing Address: .'?.)n I-InlJPI .-p.,,,,I,)L.t\~ H.Ut
OoDT+\Dt.:b) ~'i' \\~'7\.
Owner Property Address: 50 rR~n ~k"1t=FT
/.:j811) SLJH'n/K, ll",.'-I
Name and phone number of contact person .&,>'-b\P~ ::1:l\lO.z:t:::.ow5\!.. >>- 0. qg - II f) S
Tax Map No: 10f..>'0 Section J I') Block JI Lot ,..;2c:2.
--
Cross Street ~ D6~I\-T~
NOTE: LOCATION MAP MUST BE SUBl\11n'ED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH REALm DEPARTMENT APPROVAL
~,,{11 d ~.1.dxJl[,~ '5' -I~ -07
Si of Applicant Date
Received by: ~L.
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EDGE OF \4 'ENT
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EXISTINe rATER MAIN
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EXE OF PAVEIIENT
POLL
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TEST HOLE BY:
McDONALD CEOSCIENCE
DATE: AUGUST 23. 2006
EL. Jl6.0
BRO"'N sur ML
EL. Jl8.0
BRorN SILTY SAND S1I
EL. Jlt.O
PALE BRO"N flNE TO MEDIUM SAND SP
EL. B.O
llNAUTHORlZED ALTI'lfAT10N OR ADDfflDN TV rIllS SlIJlVl'J' IS A
"'OUTIOII 0' SECTION 71" OF rSI NEFf YOM STATE tDUCATION
LAW. COPIES 0' THIS stlRI'Er IIAP NOT .EAlUNC raE LAND
SURVEYORS INKED aR EMBOSSED SEAL A1tt Nor CONSJDERED TO
BE A TRUE "AUI' con. DISTANCES SHorN Tiff/III PIfOPERTY
LINES TO IXIST1f1C S71tm:rvIUS ARI nJII A DlClne PflItPOSE
A/iD USE. AND AIt8 NOr l/1tt/llllD IV CUIDI III Tn IMCTlON
0' 'ENCES DIt Of'IUR .s1'IfumJlUS. CZ1tllFlCATIOII 1/lIHC1TD
REMON SHAU ItUN ONLY IV THE PEItSON 'Olt WHOM rifE
. SURVEY IS PERPAUD AND ON HIS BE.AU, 10 77/E C'OJIPANY OR
ACENCIES LJSTrO HERION AND TO THE ASSICNEES 0' 1'IIE
LENDINe INS77TUTltlJI. CEIt1'I'It:ATIOIIS AltE ft(JT 1'RANSTIMBLl
TO JJ)DmONAL INST17'UTIDNS Olt SU8S6qUt/lT OrtNERS.
APPLICANT:
EUEN "IEDERLICHT
AREA: 1B,125.00 Sq.Ft.
ELEVATIONS IN ASSUMED DATUM
SCALE: f. =20'
DRA."N BY: R.K.H.
FILE No.: q37B-06
DATE: AUeUST 23. 2006
UPDATE: SEPTEMBER 6. 2006
LISA McqUILKIN
.. LAND SURVEY/Ne ..
274 EAST J/A/N STREET
EAST ISLIP. N. Y. If 730
TEL: 631-277-3605
FAX: 631-277-3906
SURVEY OF
DESCRIBED PROPERTY
AT NE" SUFFOLK
TO"N OF SOUTHOLD
SUFFOLK COUNTY, NE" YORK
SCTJI: 1000-ft7-04-22
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