HomeMy WebLinkAboutRacanelli, DomanicoELIZABETH A. NEVILLE, RMC, CMC
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.nor th fork.net
TO:
FROM:
DATED:
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
December 8, 2008
RE:
Cesspool Construction Application
Transmitted herewith is a copy of application No. 3844 for a Cesspool/Septic Tank Construction
Permit submitted by:
Patricia Moore for Domanico Racanelli
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
Date/~$
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 SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
OPERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential ~ $10~_
or Non-Residential ~ $25 __
Owner Name
Owner Mailing Address
Application No. ~ ~ q q
Permit No.
Owner Property Address
Owner Telephone No.
Tax Map No: Section
Cross Street
Please check each that applies:
~.~ Block ~ Lot
New Construction X Fa/-~ ~'~-~
Alteration to E~sting System
Residential Non-Residential
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. (Locate
building and system; give north arrow and approximate distance in feet from system to building
and closest road. New construction may submit c9$~y-ot~survey with SCHD approval.)
Signature
of Applicant
Date
Received by:
87'0.5'00"
SURVEY OF PROPERTY
$ITUATE
GREENPORT
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-45-04-19
SCALE 1":50'
MAY 12, 2008
AREA : 5,505 sq. ff.
0.122 ac.
DOMANICO RACAN ELLI
IRENE RACANELLI
TEST HOLE DATA
Land Surveyor
PHONE (651)727-20g0 Fax (631)727-1727