HomeMy WebLinkAboutEichacker, PeterELIZABETH 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
Fcc((631) 765-6145
Telephone (631) 765-1800
southoldt own.north fork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO:
FROM:
DATED:
RE:
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
March 26, 2010
Cesspool Construction Application
MAR 2 9 2010
BLDG. DEPT.
TOWN OF SOUTHOLD
Transmitted herewith is a copy of application No.
Permit submitted by:
Mark Schwartz for Peter Eichacker
3939 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 mc. 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
TOWN CLERK
REGISTRAR OF VIT~ ~TATISTI~
~R~OE OFFICER
RE~RDS ~AOE~NT OFFICER
FREEDOM OF INFO~TION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
.~Town Hall, 53095 Main I
P.O. Box 1179
Southold, New YOrk 1
Fax (681) 765-6145
Telephone (681) 765-18
sou tholdtown.nor~hfork.
Residential ~ $10 / or Non-Residential ~ $25__
Appliean~ Mailing Address
Septic T~ or Cesspool~
Brief Description of Propos~ Cons~cfion or Alteration
~cation of Propos~ Const~tioW~t~ration=
Owner of Prope~:
O~er Mai~g Ad.ess:
O~er Prope~ Ad.ess:
Application Noc~'~ ~c:~
Permit No. ~
Name and phone number of contact person .J{4.~5
TaxMapNo: Section /ilo . Block ~'~' Lot
Cross Street
7.Y .4-
NOTE: LOCATION MAP MUST BE SUBMITTED W1TIt., APPLICATION. NEW
CONSTRUCTION REQUIRES SURVE¥,JOfl,~P~H ttE.AI~fl~I~ARTMENT APPROVAL
.,~ ' Iv. tu. REVISIONS:
PROPOSED SEP~C SYSTEM D~AIL
SEPE~TION DIe. CE TO $~AGE DISPOSAL ~
>~~~~~ ............ SCTM~ ~oo0-;;o o5 o8
~m~~ss-.7 . -- ~ PERMIT FOR APPROVAL CO[~5TRU~ioF~ FOR
~ APPRov D
~ FO
- = m ' TEST HOLE DATA ~ -- -~ *~ov~L
~ < ~--n DATA SUPPLIED BY: Mc~N~D GEOSCIENCE S1
~ ~ Box 1~. SO~HO~, NY 11791 (~31) 765-3677
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