HomeMy WebLinkAboutDowling, ThomasELIZABETH A. NEVILI,IZ., 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:
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No.
Permit submitted by:
OFFICE OF THE TOWNCLE~ ~ ~ ~ ~ ~7
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
October 29, 2010
3991 for a Cesspool/Septic Tank Construction
Mark Schwartz for Thomas & Maureen Dowling
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
Signature
Dated
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 53095 Ma~n Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential ~ $10 X/or Non-Residential ~ $25 __
Applicant Mailing Address FO Eft' if ~ ~?
C' W v3° 6
Septic Tank ~ or Cesspool ~(
Brief Description of Proposed Construction or Alteration
Application No. ~ (~ C/ /
Permit No.
Location of Proposed Construction/Alteration:
Owneroferoperty: ~p~, ./'7 _~'f 0t, ,/G//~rt/Yf/f~/fT-~ ~'~'"(--
Owner Mailing Address: (?.~0 /~ ff.- 0',~f'/:, t,o-,~, .o~
Name and phone number of contact person /1~ ~ ~__
Tax Map No: Section l Oa 0 Block
Cross Street
CNg~sE~yRI~cOT5 oA~NI ~Q uIMAP~s sMUI~v~( ~/~T~I~~WIDT~/~R~~A~!/Nho V~,~
Signature of Applicant ~ Dale~
Received by: ~
i ...... ,'"'"'-~-"~,~ / ,'
/~ ~ ~,J,~ ~ J ZOI ~ / ZONE ~.
~,L ~ : :~ ~ SITE DATA J
Re~ , ~
, ~
~ DATA SUPPLIED BY: McDONALD GEOSCIENCE
NORTH POND ROAD ~M~ mo~m4-~q~
~~ ~~~~~ ............... 5CTM~ ~ooo ~o4 o9
~,~ 5 ITE P~N
vance,
---"~~LE: 1"= 50'-0'
Sub ' _. r
~ ~,;(P~ ~)Vo" ,~:"~ ...... ,,
EX. ASPHALT DRIVI~JAY
18
20
MAINTAIN, riO' $EPERATION J
B'E'I'~EEN 'O~TER LINE AND J
SEPTIC AS'~ER SCHDS J
UTIL.
POLE
18
ZONE
EXISTING SEPTIC SYSTEM
X TO BE REMOVED PER
$CHDS REQUIREMENTS
16 14
12
10
ZONE~ ZONE
8 LINE .../ 6 LINE
4
ZONE
AE
EL.
16
B
D
8
ZONE ZONE
LINE 6 ZONE 4
SC-[;JV 1600-104-09-03
SITE PLAN Loc
SCALE: 1" = 20'-0' --
REVISIE, NS:
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