HomeMy WebLinkAboutConlon, VincentELIZABETH 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
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department ]IPR ~. 7 2011
FROM: Carol Hydell, Southold Town Clerk's Office
8LOG. OEP[
DATED: April 26, 2011 TOWN OF S0UT~0LD
RE:
Cesspool Construction Application
Transmitted herewith is a copy of application No. 4009 for a Cesspool/Septic Tank Construction
Permit submitted by:
Mark Schwartz for Vincent & Para Conlon
Please review the application and location map and advise if this office may issue the permit.
Please complete the form below and remm 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: j
APPROVE
DISAPPROVE
Comments: Final approval required from the Suffolk County Health Department
Signature
Dated t~9
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
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 ~""'or Non-Residential ~ $25 __
Applicant Name ~/~
Applicant Mailing Address
Septic Tank a.~or Cesspool ~"~'
Brief Description of Proposed Construction or Alteration
Application No.
Permit No.
Location of Proposed Construction/Alteration:
Own ro, ro y:
Owner Mailing Address:
O~r ~ro?~ Ad~ss:
Name and phone number of contact person
Tax Map No: Section [ ~ 7
Cross Street
Block O0~ Lot /o
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
. i a eo,App?f, Da e
Received by:( '~
c c rto s: SURVEY OF
~ ~._~0 ~ 55 cu. ft / 42.2 = 2 vertical ft. of 8' dia. leaching pool ~qui~d
OF
6~9 aq. ff. X 0.17 = 111 cu. ft. FI~ No. 212 FI~D OCTOSER 5, 1921
~ % ~' TOWN OF SO~THOkD
6s. 0~'~° ~ %~ SUFFOLK COUNTY, NEW YORK
~. s.c. TAX No. 1000-127-08-10
~ ~ NOVEMBER 9, 2010
DESCRIPTION ARF-.A ~ LOT COVERAOi
EXIST. HOUSE 990 sq. ff. 8.2%
PROPOSED ADDITION 649 sq. fl. 5.4%
PROPOSED GARAGE 520 sq. ft 2°7%
TOTAL EXIST. 1,959 sq. ff. 16.5%
Fox {651)727-1727