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Home My WebLink AboutHoman, KennethELIZABETH A. NEVILLE, RMC, CMC TOWN CLERK REGISTRAR OF VITAL STATISTICS Ma~RRIAGE 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 April 29, 2009 ~/-APIt 30 2009 BLDG. DEPT. __ TOWN OF SOUTHOLD RE: Cesspool Construction Application Transmitted herewith is a copy of application No. Permit submitted by: Mark Schwartz 3872 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 b~ DISAPPROVE Comments: Signature Datef~/ ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATIgN OFFICER ...v~-r- . ~ - Tow~ oF sou*moL. APPLICATION Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.northfork.net CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential ~ $10 ~or Non-Residential~$2$__ ApplicationNo36q/'2~ Permit No. Applicant Name HAi~i~ ~_ ~.~-*~.--.~-- I~ ~ Applicant Mailing Addrcss ~)~ /~ _~3 C~7~l~l~ Septic Tank V~ or Cesspool Brief Description of Proposed Construction or Alteration ~ Location of Proposed C~st_mction/Alteraio.~' ~ I] OWner o f Property:~~t~~$~ ~;~ Owner Mailing Address: Owner Property Address: Name and phone nlnnber of contact person Tax Map No: Section ~_~__ Cross Street Block 0 / Lot ~/,,, ji~ 7 NOTE: LOCATION MAP MUST BE SUBMITTElr WiTH APPLICATION. NEW CONSTRUCTION m~0ugm~s S~mVEY2I/T}I I~I~E~TME~P~.OV~L Received by:f~~Applicar~ Date* FOUND FOUND // i .~/ / / WOOD STAKE FOUND PIPE FOUN FENCE FouND CONC. MON. wOOD STAKE ~ / '~o ,;.~r 169.9~¥ E MON. ~l oL~J S 44'51'20" MAP · S 44"25 -E FOUND 15' RIGHT poser ~IDE RIGHT OF r~IDE RIGHT OF WAY N/o/F FLORENCE ~IGKS (FARM FIELD)