HomeMy WebLinkAboutGambardella, Michael & Linda
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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
OFFICE OF THE TOWN CLERK
TOWN OF SOUTH OLD
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DATED:
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TO:
Southold Town Building Department
MAR 7 2uu8
FROM:
Carol Hydell, Southold Town Clerk's Office
March 6, 2008
Transmitted herewith is a copy of application No. 3787 for a CesspooVSeptic Tank ALTERATION
Permit submitted by:
Mark Schwartz for Gambardella
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.
Carol Hydell
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I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
v-
DISAPPROVE
Comments:
Bodies.
Signature .
03/~ hB
Dated' /
.'
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
.~ Town Hall, 53095 Main Roe
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (6811 765-1800
sou tho1dtown. northfor k. n ei
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
:ONSTRUCTlON or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $1 oA- or Non-Residential @ $25 _
ApplicantName /1f I(IC~ kf/tv'/f1t- r z-
Applicant Mailing Address Pt7 (3a;{. '7 '} ) (U JC. !-/'cJC vF
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ApplIcation No.
Permit No."3 7 8 7
Septic Tank~or Cesspool~
Brief Description of Proposed Construction or Alteration
/1tJIJI 17 OM J I /J (. TC~~T1 OAJ ..r
Location of Proposed Construction! Alteration: /' _
Owner of Property: ./1/ C I17ft;t _ ( (I ~ /f l.9'Jf"1-7 iJ/97UtJ C u... "f
Owner Mailing Address: 1 C; WE S' T4J"'/e <;' ;<?.O
G/'f72--t:/~ CI!7/ /U '( /1';30
Owner Property Address: 9' 4- f 0 /U /1.).r /Jc..; /?:J/ -....r ~
~ rz:.- 6-kc: v L
Name and phone number of contact person
Tax Map No: IO(7() Sectioil ~I J> Block t7 (0 Lot 07
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVE WITH HE ARTMENT APPROVAL
Date
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PARTIAL SECTION
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DRAWN: MH I MS
SCALE: 1" = 40'
JOa-:
JarlUOryl1,2001
SHEET HUMBER:
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TEST HOLE DATA
DATA SUPPUED BY: McDONALD GEOSCIENCE
BOX 1000, SOUTHOLD, NY 117~1 (631) 765-3677
ExCAVATION IN""""';N ""o--UI1?-I.::D J
FOR SANITARY SYI,iiEM
BY HEALTH DEPARTMENT
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