HomeMy WebLinkAboutDiresta, Carolyn ELIZABETH A. NEVIlJ,E
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 53095 Main Road
P.O. Box 1179
S~uthold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO:
FROM:
DATED:
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
September 26, 2008
bLDG. DEPT
RE:
Cesspool Construction Application
Transmitted herewith is a copy of application No. 3830
Permit submitted by:
Denise Heyse for Carolyn Diresta
for a Cesspool/Septic Tank Construction
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.
I have reviewed the application and location map of the project cited above and make the following
recommendations: ~
APPROVE
DISAPPROVE
Comments:
Signature ~
1]ILIZABETH 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 SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential ~ $10"~ or Non-Residential
Applicant Name ~ 0~'/-~
Applicant Mailing Address
Septic Tank t-,~or Cesspool
Brief Description of Proposed Construction or Alteration
Location of Proposed Construction/Alteration:c.
Owner of Property: ~fO
Owner Mailing Address: ~.~ ~ f
~ 0
Owner Property Address: /V [~) ( t,/' .fi ~_/"
N~e ~d phone number of contact person
Tax Map No: Section/Z 7 Block
Cross S~eet
2 t'
NOTE: LOCATION MAP MUST~q~SUBMITTED WI~H APPLICATION. NEW
CONSTRUCTION REQUIRES SURVE WITH HEALT PARTMENT APPROVAL
s r oIT ia,
Received by:
x
SUFFOI-K COUNTY [:)EPN~'T~ENI' 0~= HEALTH SERVICES
pERNtlT FOR AP=ROVA~ OF CCN~'[~UcTtO'~ FOR A
AppRO¥ED
Ey, PtRES THREE yF../~S FROM
APPROVAL
SURVEY OF
LOT 28~
MAP OF
GOLDEN VIEW ESTATES
FILE No. 7770 fiLED AUGUST 50, 1984
$ITUATE
LAUREL
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-127-09-28
SCALE 1"=40'
JULY 22, 2008
AREA = 40,055 sq. ff.
0.920 ac.
Nathan Taft Corwin III
Land Surveyor
PHON[ (651)727-2090 Fax (651)727-1727