HomeMy WebLinkAboutTopper, LewisEL~7.&BETH 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.north fork.net
TO:
FROM:
DATED:
OFFICE OF TIlE TOWN CLERK
TOWN OF SOUTHOLD
Southold Town Building Department
Carol Hydell Southold Town Clerk's Office
May 21, 2009
MAY 262009
BLDG. DEPI.
TOWN OT SOLIT}iOLO
Transmitted herewith is a copy of application No. 3876
Permit submitted by:
for a Cesspool/Septic Tank Construction
Lewis Topper
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 peImit.
Please complete the form below and return it to me.
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE ~
DISAPPROVE
Comments:
Signature
Dated
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFOi%MATION OFFICER
OFFICE OF THE TOWN CLERI<
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERI~{IT
CESSPOOL or SEPTIC TANK
.~Town Hall, 53095 Main Pws
P.O, Box 1179
Southold, NewYork 11971
Fax (631) 765-6145
Telephone (681) 765-1800
southoldtown,nor~hfork.ne~
RECEIVED
MM 2 1 ;t)09
$outhold To vn Clerk
l~esidentia! ~ $10 X or Non-Residential ~ $25 __
Application No. ~<~7(,~,
Peanit No.
App!icant Name Lewis Topper
Applicant Mail/ngAddress 220 E 65 St. Apt.19G
Naw York; NY 10065
Scl)tic Tank X or Cesspool
B riel Description of Proposed Construction or Alteration
dwc!!ing and garage
Location of Proposed Construction/Alteration:
Owner of Property: Lewis Topper
Owner MailingAddress: 220 E 65 st. Apt. 1O~
New York, lq'/ 10065
OxxmerPropel~yAddress: l?O T~rry l,a'no (~/1~/~ ~ttqntl c~p M'l.onln ~4)
Mattituek, NY 11952
Name m~d phone mm~ber of contact person Charles R. Cuddy, Esq.
Tax Map No:1000 Section 123 Block 6 Lot 13
Cross Street
construction of single family
at(631) 369-8200
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION, NEW
CONSTRUCTION REQUIRES SURVEY WIT~TH DEPARTMENT APPROVAL
Signat ez Apphcant Date
'~li~VE"d OF= PROPERTY'
51 UATtE, MATTITUGK.
TOPlN: 5~UTHOLD
SUFFOLK, C, OUNT~', N'I'
DATA:
APPROVED BY -,
BOARD OF TRUSTEES ~
TOWN 0~~
DATE /~.//~~ ,/'-
SEPTIC 5¥STEM DETAIL
N
$
E
JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN STR~I~r N.¥.$. LIC. NO. $0202
RIVERHEAD, N.Y. 11901
~--.ALE