HomeMy WebLinkAboutLandau, AdrienneF. LIZ~.BETH A. NEVH.LE, 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:
RE:
Carol Hydell, Southold Town Clerk's Office
October 22, 2009
Cesspool Construction Application
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Southold Town Building Department
Transmitted herewith is a copy of application No.
Permit submitted by:
Adrienne Landau
3909 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 Department
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTHAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF LNFOP. MATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
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 ~ $25 __
Application No.3 9/~) ~)
Permit No.
Location of Proposed Construction/Alteration:
Owner of Property: ~(", C a ~x ~
Owner Mailing Address: ']~(~ ~AJ0Oa~)
Owner Property Address: ~S-~ ~O,d,~
Name and phone number of contact person
Tax Map No: Section C~ L~
Cross Street 5~.r~~
mock__~ / Lot ~7
NOTE: LOCATION MAP MUST BE SUBMITTED WiTH APPLICATION. NEW
CONSTRUCTION m 0UIm S su ..vg¥'wrr 'fii/ g// m'nv.ym T nePROV
Received by: ~
FAGIN / LANDAU RESI-D. NC
NEW CONSTRUCTION
855 SOUNDVIEW AVE MATTITUCK, NY I 1952
~RV~ PREPARED BY JOSEPH INGEGNO W/NAROFS~ ~CHITECTURE DESIGN 1 = 20~ ZONING
-' ~ s~ND ~ '"'~" -' "' ~
(TEST HOLE DUG BY McDONAL~ GEOSCIENC£ ON OCTOBER 27. 2005)
: a~l~~ YEAR~ FROM DATE OI
No Da~ /
PLUMBING RISER DIAGRAM
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