HomeMy WebLinkAboutRiccio, Robert & ClaireELIZABETH 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:
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
July 28, 2009
TOWN 0~:'S0I]T~010
RE:
Cesspool Construction Application
Transmitted herewith is a copy of application No. 3886
Permit submitted by:
Frederick Weber for Robert & Claire Rieeio
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.
Carol Hydell
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE ~
DISAPPROVE
Comments: Final approval required from the Suffolk County Health Depatlment,
Signature
Dated
ELIZABETH A. NEVILLE ' '~
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
REGq2)RDS IVlAIqAGEMENqP OFFICER
FREEDOM OF INFOR31ATION OFFICER
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
.~Town Hall, 158095 Main l~$
P.O, Box 1179
Sou~hold, NewYork 11971
Fax (681) 765~614{5
Telephone (681) 761~-1800
sou tholdtown.nor~hfork.ne~
Residential ~ $10.~>~ or Non-Residential ~ $25 __
Applicalion No. ~ ~/' 2 ~
Permit No.
App!icant Name
Applican( Mailing Address ~ ~_..,, ~ ~
Septic Tank..~or Cesspool
Brief Description of Proposed Construction or Alteration
Location of Proposed Construction/Alteration:
Ownero P ope. :
Owner Mailing Address:
O~mer Property Address:
Name m~d phone number of contact person
Tax MapN0: S~tion ~6 Block & ~t I
~oss Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
Si~a~ of~ bate J ~" /
~iv~ ~
SANITARY 5YSTEH
POOL
, ,-o., ~ ..-o.-----~ ......... ;:. 'I ......
rHdl~)
~oo°
TEST HOLE
APPROVED IN ACCU~Um~u~. ~v ~ i n ~,~
REVIEW DETERMINATION DATED q/Z~/O~
Abandor~ment of existing sanitary system must bo in
comformanc¢ with department requirement Submit
completed form .W~..M- O~ ~spmof.
r E,XCAVATION INSPEOTION REQUIRED
// FOR SANITARY SYSTEM
,J,'~ '_ BY H',~ALTH DEPARTMENT
SURVEY IN FoRr~ATION=
PROPERTY O~NER~:
ROBERT I CLAIRE RICCIO
(&$12 INDIAN NECK LANE. L.I.C.)
51TUATE: PECONIC
TOKIN OF $OUTHOLD
SUFFOLK COUNTY. NE~ YORK
LOT AREA: 2&JSO d (O.~.O Acres)
ZONING; R-80
LOT COVERAGE (MAX.):
SITE
C*reenla~n, ~Y IIq~O
September 4. 2008
Revmsed: December 14. 2008
~eVlsed: Januar~ 2~. 2OOfl
NORTH
PLAN
I" ~ 40'-0"