HomeMy WebLinkAboutGorgone, Nick
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Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFC!.~TION OFFICER
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTH OLD
TO:
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Southold Town Building Department
FROM:
Michelle L. Martocchia, Southold Town Clerk's Office
DATED:
September 24, 2007
RE:
Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 3742 for a Cesspool/Septic Tank
Construction/Alteration Permit submitted by:
Eric Nielsen for Rosanne & Nick Gorl!one
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
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DISAPPROVE "
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Dated /
EL~ETHA.NEVITLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
.......
.J Town Hall, 53095 Main Ror
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
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OFFICE OF THE 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. cf] Cf ~
Permit No.
Applicant Name B'UC!.. I")I~~~'
Applicant Mailing Address ? 0 . . f'y)')(' ~?::,
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Septic Tank~or Cesspool_ . '
Brief Description of Proposed Construction or Alteration k JPf1" l I ~ . ,:6 ~t" .riA .cOlA
Location of Proposed Construction! Alteration:
OwnerofProperty:_':R()~Q IL1I P J, 0,(' 1( Go'(jOlA..D
Owner Mailing Address: Po _ ,00,>< ~ ~
~LleJA U-'-{. \\Qsc9-
Owner Property Address: S'~S 0l---f IIl-f ~R lliF f':xJJ "::>~
~n( ') T~ (,! "" \. " 'i u q I I
Name and phone number of contact person
Tax Map No: \<X::OSection '70 Block OJ Lot ,~. \~
Cross Street
NOTE: LOCATION MAP MUST BE SUBJ\U1TJW WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
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Signature of Applicant Date
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GROfJIo/() WA TOt CL. 3.2
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1- 1000 gal. SEP TIC TANK
3- L.P.s 8' , . 4' deep WITH
3' SAND COLLAR 3' .ABOVE
GROUND WA TER
SEPTIC SYSTEM CROSSECTlON
ELEVA TlONS REFERENCED TO N.G. V.D.
LOT NUMBERS REFER TO "MAP OF GOOSE NECK"
FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE ON
NOVEMBER 22, 1948 AS FILE NO. 1663.
ANY AL TERATlON OR ADDlnON TO THIS SURVEY IS A VIOLA TlON
OF SECTIO/'l 72090F THE NEW YORK 'STATE EDUCATION LAW.
EXCEPT AS PER SECTION 7209-SUBDIVlSION 2. ALL CERTIFICATIONS
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONL Y IF
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR
WHOSE SIGNA TURE APPEARS HEREON.
I am familiar with the STANDARDS FOR APPROVAL
AND CONSTRUCTION OF SUBSURFACE SEWAGE
DISPOSAL SYSTEMS FOR SINGLE FA MIL Y RESIDENCES
and will abide by the conditions set forth therein and on the
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SURVEY OF PROPERTY
AT BA YVIEW
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NY
1000-76-02-30.1
SCALE' 1"-30'
SEPTEMBER 4, 200.3
OCTOBER 16. 2006 (PROPOSED HOUSE & B.OH INFO)
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SUFFOLK CCUNTY D"PAriT""n:i 0:' ~:EA~TH SE"VICES
PERMIT FOR Ar>P=>O'/l\l OF CON')mUCTION FOR A
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TOTAL MAXIM" . OMS -0
REE YEARS FRmt, DATE OF APPROVAL
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McDONALD GEOSCIENCE
10/13/06
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