HomeMy WebLinkAboutEckardt, PatriciaELIZABETH A. NEVILI.~, PJ~IC, 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
March 22, 2010
RE:
Cesspool Construction Application
Transmitted herewith is a copy of application No. 3937 for a Cesspool/Septic Tank Construction
Permit submitted by:
Nancy Dwyer Design Consulting for Patricia Eekardt
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
Dated
ELIZABETH A. NEVILLE
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
southoldWwn.nor~hfork, 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 __ Application No.
Permit No.
Applicant Name ~,J~L~c~ -~,e.~ ~Z~'~
Applic~tMailingAd~ess- ~ ~n
Septic T~or Cesspool_
BdefDescffptiofi of Proposed Com~ction or Alteration ~m'~ ~ '~
~cation of Proposed Co~ctio~Alterafion:
Own omop, y:
Omer Prope~ Address: ~7 ~ ~~e
Nme ~d phone nmber of contact pemon ' ~tkn ~[~
T~ Map No: Section ~ Block ~ ~ ~t
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURV~._Y WIT~ HEALTH DEPARTMENT APPROVAL
~~ /~ Signature o f ~,p_p lic~.~ Date
Received by: ~,..,/[J il ~-J X -
:
-e., -,r SUFFOLK COUN~ DEP~TMENT O~ I~LTH SERVIC~
PERMIT FOR APPROVAL OF
SINGLE FAMILY ~E81[,~E
¢ RECEI ED
SCALE , :30 S SUFF. CO. H*LTH SER~CE8 , TOT* ~;~ ~;~O;A.
OFFICE OF WA~EWATER MGT. ] ~PIRES ~REE ~S FROM DATE
-- CONCRETE CHIMNEY
L~NG COVER AT G~DE ~ MIN. EL. 9.0'
,, X 4"~ 0~8~ 2400 PIPE F ~ BACKFILL AROUND SYSTEM
FINISHED G~DE EL. 11 J ~ ~ ~ '1" IN'HI~ / ~TH ~ARSE ~ND AND G~VEL
.......... , __ I ' FOUR OUTSIDE RINGS, 10 ABOVE BOSOM
Ab~do~ent ;fexla~g sanit~ }~t~ m~t ~ in
mmfomm w~ d~t r~uimmem Submit