HomeMy WebLinkAboutFasolino, Umberto
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'1 ELIZABETH A. NEVILLE
TOWN CLERK
ItEGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
F:ECORDS 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
8outholdtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTH OLD
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TO:
Southold Town Building Department
FROM:
Linda J. Cooper, Southold Town Clerk's Office
DATED:
November 9, 2007
Transmitted herewith is a copy of application No. 3761 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Eric Nielsen for Umberto & Robin Fasolino
Please review the application and location map and advise if the 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.
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Linda J. Cooper
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APPROVE
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I have reviewed the application and location map of the project cited above and make the following
recommendations:
DISAPPROVE
Comments:
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Bodies. EXCAVATION INSPECTION RE
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Dated /
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ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
." Town Hall, 53095 Main R.
P.O, Box 1179
Southald, New York 119'
Fax (631) 765-6145
Telephone (631) 765.180
sou thold town ,northfork. r
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10 t/- or Non-Residential @ $25 _
Application No, 37b(
Permit No,
Applicant Name t:fl-ll.- N'ii:'l-Se,.J
Applicant Mailing Address .p Q. ('), D)C q ''" ~ ru,.,
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Septic Tank~or Cesspool_
Brief Description of Pro posed Construction or Alteration At>o" n.,~) 7"'" z- "'-~
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Location of Proposed Construction! Alteration:
Owner of Property: c{,...e:,ZIVfI:> j ~)'V Ck,.-...MJn
Owner Mailing Address: -Z Z-bO~",*- ~'hJ~ 0 "M:;:".
C-'-'-"'i~~&.IAe-
Owner Property Address:
Name and phone number of contact person ZI4c.. IV,Cose"J
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Tax Map No: i 000 Section B:?, Block 0,-/
Cross Street nl--l V, f>, t-fI</v"r
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Lot 0 ''L-
Received:aL
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
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~ s:gnature of Applicant
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Date
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H.S. REF, NO. 90-50-125
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PARK AREA
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GEOSCIENCE
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~CLA'rCY $AND $C
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,DUCK POND- ROAD
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VACANT
SUFFOLK COUNTY DEPARTMENT OF HEAL.TH SERVICES
PERMIT F'OR ApPROVAL OF CONSTRUCTION FOR A
S!NGL!: e:'AMILY ReSiDENCE ONL.Y
Mt*N AND ~ALE ~ ".
TO Cl>Ma' $AND ..
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.NOTE CHANGE(S)
by Dept, of Health Service8
DAT~ liar Ci 7 H.S. Ri!F. No. r<. \ 0'-'07 -00'1 If
ApPROVED ~ ..:)A~Q
FOR MAXIMUM 01' I BEDROOMS
T. DATE OF APPROVAL
EXPI
NEW EPTlC SYSTEM
78DROOMS - __ r ,
1- i'Of)(;AL.PRECAST ROUND SEPTIC TANK \0 q, '( 4 ~r-i=, cepM
2- L ACHING POOLS 8 FT. _ " 10' DEEP
EXIS lNG SEPTIC SYSTEM TO BE REMOVED IN
ACC DANCE WITH SUFFOLK COUNTY HEAL TH
DEP REOUIREMENTS
LOT2
"MAP OF WOODBINE MANOR"
FLED DECEMBER. 15, 7986 FLE NO. 8239
,; AT CUTCHOGUE
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NY
1000 - 83 - 04 - 02
Scale: 1" = 40'
JUNE ~ '/987
OCT. ~ 1990 (B.O.H.)
JU Y ~ 791' (FOUM:JA TION)
JU y ~ ~ fFNAL)
JU Y" 2001 (ADDITION)
TION OR ADDITION TO THIS SURVE:Y IS A VIOLA TION
7209 OF THE: N€W YORK STA TE EDUCA TlON LAW.
PE:R SCCTION 7209 - SUBDIVISION 2. ALL CE:RTIFICA TIONS
VALD FOR THS WlP AND COPES THeRE:OF ONL Y IF
COPES MAR THE: IIIIPRE:SSE:D SCAL OF THE: SURVE:YOR
:4 TURf: APPeARS HE:RE:ON.
. ~. ry~ N. Y.S. LlC. NO. 49618
~N1C SURVEYORS, P.C.
(63/J 765 - 5020 FAX (63/J 765 - (797
P. O. BOX 909
.' 1230 TRAVELER STREET
SOUTHOLD, N. Y. 1/97(
I om. 10 ilior .,ilh Ihe STANDARDS FOR APPROVAL
AND CO STRUCTION OF SUBSURFACE SEWAGE
DISPOSA SYSTEMS FOR SINGLE FAMIL Y RESIDENCES
and .,if( ide by Ihe condlllons sel lorlh Ihef.ein and on Ihe
permil 10 construct.
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87 - 468
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