HomeMy WebLinkAboutWood, Sarah RoseELIZABETH 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.northfork.net
TO:
FROM:
DATED:
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
April 14, 2009
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
APR 14 [1109
BLDG. DEPT.
TOWN OF SOUTHOLD
Transmitted herewith is a copy of application No. 3866
Permit submitted by:
for a Cesspool/Septic Tank ALTERATION
Peter Tokar for Sarah Rose Wood
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
I have reviewed the application and loc~tion map of the project cited above and make the following
recommendations: j
APPROVE
DISAPPROVE
Comments: Maintain.required setbacks from adjacent wells, buildings, property lines and water
Bodies. EX(_AVATI?N INSPECTION REQUIRED.
Datedgg~
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS ~AGEMENT 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 PERMI
CESSPOOL or SEPTIC TANK
APR 2009
Residential @ $10 ~ or Non-Residential ~ $25 __
Application No. _.'5 ,<ff
Permit No.
Applicant Name ' ' ~-~4. -Tr.;F~L-
Applicant Mailing Address '~-/} f,, 5,'t:~or)
tL~ U~_~ ~3, iN,"/,
Septic Tank x or Cesspool
Brief Description of Proposad Construction or Alteration
Location of Proposed Construction/Alteration:
Owner of Property: ~ ;,~- ~:\~
Owner Mailing Address: 9_.'5c
Owner Propeay Address: '2%~
Name and phone number of contact person
Tax Map No: Section ~' Block O
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION ~QUI~S SURVEY WITH HEALTH DEPARTMENT APPROVAL
S~e of Applicant Date
Received by:
N
'TOWN OF SOUT
\
Lo[I
2.4'W
Young & Young
400 Ostr~er A~er~e, R~erhee~d, Ne~u Y~k 11901
631-727-Z303
H~ard W. Yo~, L~ ~
HEALTH DEPART1HENT
SUFFOLK COUNTY DF. PART~ENT OF HF,ALTH
PEE~IIT FOR APPROVAL OF CONS?RUCTION FOR
SINGLE FM41LY RE$1U£NCF. ONLY
,,,P,,o,,,,,
FOR MAXIMUM OF
EXPIRES THREE YEARS FROM DATE OF APPROVAL
[~1~ ~URVIE¥OR '5
A~: E~vle~, To,In oF Coo[hold
%1
A
~,.T. 2~,'
L.P. I 2;2'
L.P. ;2 ~5' ~O'
AOE~;;' ~JILDIN~ PEI~IVlIT DATA
FI[=! m E:~e.V"~f' COHP'LETE~
OCT. O~, 2OO~
JJNE 05, 2¢0~
HAY 02, 2OO~
HAY 02, 200¢
~,C. ALE,
NO.
DI~E~. 2001_014.5_0001._2.00~_02~4_bp
0
IO'
FINISt. E~ ~
4.' 12t^ PV6
PII~ e 2.00~
IOOO ~AL. .~EPTIC, TANK
HYDP, AULIG PF~:~FILE
N'r'5
IOO 5.F~,.I'fl.A.
LEACHIN¢ POOl
EL=I2.q
Your~g & Yo~r~g
400 Ostra~er Av~r~,e, Riverhead, N~ York 11901
~81 - ~27-2803
H~ard F. Y~, La~
NO'rE5
AF~A = 10~,0=16 .E~. FT.
· 5Li~DIVI~ION HAP - "FOt~Tt~',ROOK AT ~A"fVIE~" FILED
IN THE OP'FIC..E OF ~ GL~ OF ~LK ~ ON
~ 15, 2004 A5 FILE ~. III1~.
E:Ot~.VE'dOR'5 C, Et~TIFIOATION
FOR
5ARCH PIOOD
LOt I "FOf~Es'r'ffiROOK AT E~A'CV'IE~"
At. E~jvle~, to~n ot' ¢ouf. holct
5uFt'olk Oounf,~, t,le~ 'fork
Oount~J Tox M~p Dlstrlct I000 Sectlo. '~ Black 02 Lot '~.J
A~DEI~ BLIIL~INE~ PERHIT DATA
ADDED CEETIFIGATION5
5UP, VEY HAP C, OHPLETE~
FIELD .SURVEY COHR.ETED
OCT. O~,
Jflt,~ O~,
HAY 02, 2008,
HAY 02,
5C, ALE~ N.T.~.
JOB NO.
D~. 2001_014.~_0001._200~_02¢¢4_12p
0
0
C,I.E-~OOR 5EATIN~
AEEA
I~ITH 'I'RELLI~ AE~'v'E
Young & Young
400 Ostrander Av~r~e, Riverhead~ New York ~90~
63 ~-727-2303
Howard ~. You~, Land Su~eyor
~ob~ C. T~ Architect
Doug~ E. A~, ~ofes~[ Engi~er
NOTE9
AI~EA = IOq/2q~ ~2. FT.
® .~JBPI¥1¢ION ~IAF' - '~O~¢~OK AT BAWIEH"
~ 15, 2004 A5 FILE ~. Illin.
· ELEMATION5 A~ ~ TH~:
5Ut~VIE¥Ot~'D C, ERTIFICATION
'HOI'qAP. D~ I~I.
survey FoR
SARAH
LOT I "FORESTBt~.OOK AT BAYVIE~I"
A[ Ba~vle~, To~n o~ 5ou[holcl
~,uft'olk C. ounf,~l, Nel,,I York
~,OUI'I~.~ T~X J~1~lp District JO00 S~ction '~¢J Block 02 Lot ~.J
FIE~ ~ ~ HAY 02, 200~