HomeMy WebLinkAboutAdipietro, RobertELIZABETH A. NEVII,!.E, 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:
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
December 10, 2009
Cesspool Construction Application
Transmitted herewith is a copy of application No.
Permit submitted by:
Robert Adipietro
3918 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 J
DISAPPROVE
Comments: Final approval required from the Suffolk County Health Department,
Signature
Dated
F, LI~,ABETH A. NEV~J,E
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.nor tl'd'ork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD ·
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential ~ $10 ~or Non-Residential ~ $25 __
· Applicant Mailing Address ? q,~ ~.~_O~(
~o. ,Cox I ? x. , /~e.~o~, ~ , ~.~. II
S~fic T~ ~or Cesspool ~
B,~D~p,~. o~P~pos~ Co~=.,on or A~t~.,on ~ ~ y~ ~
Application No. __
Permit No.
Location of Proposed Constmction/Alt~r_~tion: ,,~ / , ,, _~ ',, ' [
Name and phone nUmber ofcontact person.~_//~_,e./7'~ A(~/'~/6/~0 43/' 7(~"'
Z~xUapSo: S~tion -7~P Block 3 ~ot /6
NOTE: LOCATION MAP MUST BE SUBMITTED wITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTIt !~EP&RTMENT APPR_.O, YAL
y: Signature of Applicant f/ Date
Recei
__.:~_ ,I~~ ~ ~ ~ ~b_ . .~ ~ ~ ._ .
~ ~ ~ EXPiReS THREE YEARS FROM DATE ~ APPROVAL
lOx?r*'
NEW SEPTIC SYSTEM ¢7 BEDROOMS)
EXISTING CESSPOOLS TO' FILLED IN OR
REMOVED ;Z~O0 (6 ' Z,~:~,'~' I~, A/cf 4LZ~Oc~ ~I
, NEW -~ GAL. PRECAST SEPTIC TANK
~ LIQUID DEPTH
~ ~.P.s 8'~ ~ I0' DEeP
NOTE CHANGE(S)
OF SECTION 7:Z09 OF THE NEW YORK STATE EDUCATION LAW.
EXCEPT .45 PF__R ~CTION F~09 - SUBDI%qL~K)N :Z. ALL CERTFICA TION$
HEREON ARE VALID FOR TtES MAP ANO COPIES THEREOF ONLY IF
SAID MAP ON COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR
showo I~o~ er, Iroz /I~14 ob~olloo~
o~4 or from d~fo obteln~d from oll~r$.
S. 47°3:Z'00' W.
LONG ISLAND
Z85. 61 '
RAIL ROAD
NOTE'
SUBSURFACE SEWAGE DISPOSAL
SYSTEM DESIGN
JOSEPH FISCHETTI, P.E.
HOBART ROA'D
SOUTHOLD, N.Y. 11971
(631) 765 - .~954
SUR VE Y OF PROPER T Y
A T PECONIC
TO WN OF, SOUTHOLD
SUFFOLK COUNTY, N. Y.
I em fmnlllar w/lb lhe STANDARDS FOR APPRovAL
AND CONSTRUCTION OF SUBSURFACE SEF/AGE
DISPOSAl_ SYSTEMS FOR S~IGLE FAMILY RESIDENCES
ond wBI obide by I&e condiliolts sel fort~ Ihere~l ned o~ tim
permll !o cottslrucl.
B Y McDONALD
1000-74-03-16
SCALE :I"=40'
JAN28, 2008
~.. 49618 - 1797
P. O. BOX 909
1~30 TRAVELER STREET
SOUTHOLD, N.Y: 11971
· 03- 217