HomeMy WebLinkAboutDaversa, RavieroELIZABETH A. NEVILLE, RMC, CMC
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hail, 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:
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
January 29, 2010
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
JAil 2 9 2010
BLDG. DEPI.
TOWN 0F SOUTHOLD
Cesspool Construction Application
Transmitted herewith is a copy of application No.
Permit submitted by:
Raniero Daversa
3928 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 Depax hnent
Dated
TOWN OLRRK
l:tEOlSTl~ OF VITAL STATISTICS
MARRIAGE OFFIOER
REOORDS ~AGE~NT OFFICER
FREEDOM OF INFO~TION OFFICER
..Town Hall, 63096 Main Re
P.O. Box 1179
Sou(hold, New York 119 ?
Fax (631) 765-6146
Telephone (681) 76§~180(
so u thold to~m.northfork.n~
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTEIL&TION PER/?IIT
CESSPOOL or SEPTIC TANK
Residential ~ $10_ ~ or Non-Residential ~ $25 Application NO.
Pennit No.
Applic~tName. ~a ~ jof~ ~ v~SO ~ ~An
~ptic Tamk- or Cesspool~
BnefDescdptmnofPmposed Cens~ction 0r Alteration ~e~ ~, ~lo ~ ~,
Name trod phone number of contact person
TaxMapNo: [oc~o Section Ill
Block b ~ Lol /~'-
Cross Street -%9-7 ,-~ff-. 4')r~. xf'~ruq-rr, at ~r,./
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIILES SUR¥~EY,.,WITlt HEALTH DEPARTMENT APPROVAL
4Y_ '~ ~ 51," - p.z.~,~,~ ~<~,~-,o.. ·
N
TEST HOLE DATA
McDONALD GEOSClENCE
9/~9/o7
LOT NUMBERS REFER TO REVISED SUBDIVISION PROPERTY
OF ALONZO JERSEY BEING PLOT 282 NASSAU POINT CLUB
PROPERTIES, INC. FILED IN THE SUFFOLK COUNTY CLERK'S
OFFICE ON APRIL 28, 19J0 AS FILE NO, 76J.
SURVEY OF PROPERTY
AT NASSAU POINT
TO,tN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
1000-111-03-15
SCALE: I'=40'
SEPTEMBER 26, 2007
NOV. 17, 2008
CERTIFIED TO,
RANIERO DA VERSA
LIDIA DA VERSA
COMMONWEAL TH LAND TITLE
INSURANCE COMPANY
Devotions referenced to on assumed datum. (vACANT)
I om familiar w/th the STANDARDS FOR APPROVAL
AND CONSTRUCTION OF SUBSURFACE SEWAGE
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES
and will ob/de by the conditions set forth therein and on the
permit to construct.
The IocaUon of wells and cesspools shown hereon are
from field observations and or from data obtained from others.
ANY ALTERA~70N OR ADDI~70N TO THIS SURVEY IS A ~IOLA170N
OF SEC17ON 7209 OF THE NEW YORK 5TATS EDUCA170N LAW.
EXCEPT AS PER SEC770N 7209-SUBDIV1510N 2. ALL CER~TFICA~70NS
HEREON ARE VALID FOR THIS MAR AND COPIES THEREOF ONLY IF
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR
V~IOSE SIGNATURE APPEARS HEREON.
· =MONUMENT
· =PIPE p,
AREA--29,078 SO. FT.. ,2Jo
SOUTHOLD, N. Y.
,Y.S. LIC. NO. 4961~
P.O.
(651) 765-1797
STREET
u~7~ 07-194