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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 Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork. net
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO:
Southold Town Building Department
FROM:
Carol Hydell, Southold Town Clerk's Office
DATED:
February 12,2008
RE:
Cesspool Construction Application
Transmitted herewith is a copy of application No. 3783
Permit submitted by:
Robert's Custom Homes
for a Cesspool/Septic Tank Constmction
Please review the application and location map and advise if this office may issue the permit.
Please complete Ihe form below and retum 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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Comments:
DISAPPROVE
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Signature
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Dated . /
I
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
southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTH OLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential@ $IO-2L or Non-Residential @$25_
Application No. 3lE 3
Permit No.
Applicant Name Xoocr..g, C!..us.--IoP1 f-k,iheS
Applicant Mailing Address Po goY- 3"/,),
~)oJL nq {2"j--e.lL-- 0'-( Il-R d-.
Septic TankA-or Cesspool_
Brief Description of!roposed Construction or .t\lterati~
rr>n~J~+rdY! of' riI PU) 0UJ11!p 1:nf}f[{)'7 cYi"-lUI,/)]
Location of Proposed Construction! Alteration: } /
Owner of Property: ~Oh.ev~~ Co_dnl.-{ jjJljC:S
Owner Mailing Address: ~o ~ l}; d-
\ k_l\~. _j~JC DLj 1/7Id--
Owner Property Address: \=" l-P~ ),J~ ~
~d?~ue.
Name and phone number of contact person f?nh~ 1'-1
Tax Map No: Section I D,3 Block
Cross Street '\'<\; dwoer\ 1'<. d
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NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY ~~ALTH DEPARTMENT APPROVAL
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~ W"" of AppHomt D'"
(In fi1 jh d 5' !f{J/51
I J-../ Lot (p
Received by:
CY
I am '..... w/M M. STANDARDS FOR APPROVAL
ANI1 ct'JNSTRUCTION OF SUBSURFACE: S~WAG~
OISPOSAL SYSTEMS FOR SINGL~ FAMIL Y R~SIO~NC~S
and wOI abide by Ihe condllions 6el forlh Ihereln and Qn /he
permit /Q cons/rllcl.
SCDHS REF .;I: RJO- 07 -/15
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SURVEY OF PROPERTY
A T FLEET'S NECK
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. 1':
1000-103-14-06
SCALE: 1--30'
FEBRUARY 6, 2007
Feb. 14, 2007 (corners set)'
S~PT. 13, 2007 (C~RTlFICA TlON)
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SEPTIC. SYSTEM CROSS SECTION
I - 1000 GAL. $(PTIC T'"
3-.... U.." I.EACHlNfi POaLS WITH
3 SAID ctlLLAR iSff) BOTTOIrI 'OF Lf:ACH1N6
POOL TO Sf: 3' ABOVf: MOONS WA Tf:R
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r". iocations 01 we/Js and
shown hereon are from field obs rva/ions
and or from data obtained from /hBM.'rE: . c."'.
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ELf:VA ~ ARf: R:!,f:liENCED TO NGV~~~ E:'..___.. .'
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LOT NUMBERS REFER TO "MAP OF EASTWOOD ESTA TES \~v~
SECTION TWO" FILED IN THE' SUFFOLK COUNTY CLERK'S
OFFICE ON NOVEMBER 30, 1964 AS FILE NO. 4210.
ANY AL TFRA TlON OR ADDiTION TO THIS SURVEY is A \llaA TlON
OF SECTION 72090F THE NEW YORK STA 7E: EDUCA TlON LA II(
EXCf:PT AS PER SECTION 7209-SUBDlVfSiON 2. ALL CERTlF1CA TlONS
HEREON ARE VAUD FOR THiS MAP AND COPiES THEREOF ONL Y IF
SAID MAP OR COPiES BEAR THE IMPRESSED SEAL OF THE SURVEYOR
WHOSf: SiGNA 17JRE APPf:ARS HERf:ON.
. ="RIPE
. Y.S. LlC. NO. 49618
ECONIC S ORS, P.C.
(631) 765-5020 FAX (631) 765-1797
P. O. BOX 909
1230 TRAVELER STREET 07 112
SOUTHOLD. N. Y. 11971 -
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