HomeMy WebLinkAboutJester, RobertELIZABETH 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
TO:
FROM:
DATED:
RE:
Carol Hydell, Southold Town Clerk's Office
May 9, 2011
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SoutholdTownBuildingDepartment 2011
Cesspool Construction Application
Transmitted herewith is a copy of application No.
Permit submitted by:
Robert & Diane Jester
4014 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~lgcation 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 MANAGEMEN~ OFFICER
FREEDOM OF INFORMATION 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 P~oa
P.O. Box 1179
Southold, NewYork 11971
Fax (631) 765-6145
Telephone (681) 765-1800
so u tholdtown.northfork,ne!
Residential ~ $10 or Non-Residential ~ $25
Applicant Maihng Address 5~c{
Septic T~ or Cesspool '~
B fief Description o f Propos~ Cons~cfion or Alteratioa
Application No. H 12)[~
Permit No.
Location of Proposed Construction/Alteration:
Owner of Property: ?-.~5q..*t ~ ~')t_'(X~xc.... c-~q~J[%V'
Owner Mailing Addre~s: .~¼ C ~r~.l>\{~ ~[a~¢ ~'~
Owner PropertyAddress: q tO, %h[~c,,~
Name m~d phone number of contact person
Tax Map No: Section 35 Block. I Lot
Cross Street qg
NOTE: LOCATION MAP MUST BE SUBMITTED WITIt APPLICATION, NEW
CONSTRUCTION REQUIltES SURVEY W1TIt I~,ALTlt DEPARTMENT APPROVAL
l eeoiwd I/y:
, SignatUre ofApphca~z
Of= LOT D
"FINAL PLAT FOR THE PROPERTY OF MICHAEL VERITY"
51~A~ ~NP~T
TO~: ~LP
.St)RVEYED= APRIL 14. 2010
SUFFOLK COtJNT'r' TAX #
IOOO- 35- I - 4_5
ROBE~,.T W.
DIA.,~ O.
LAWYERS ','~.lt'.[,E ~,{SURANCB CORFOF-~'EiON
SOU'~I BAY A~STRACT, hc.
TEST HOLE
NO.I FROh-f
FILED HAP
CLA'f 4-
~AN[?
SAND ~
®RAVEL
EL=2F
VACANT
I?~!ELLIN®
PUBLIC ~IATER
LOT 4
EL=lq'
EASEMENT
,'LOT 2
NOTES:
SUFFOLK COUNTY DEPARTMENT OF ~
~ELOT ¢~OVERA~ERooF I NCLLIDIN®DATA' 2~ LOT 3 ~-~ P[RI41T2 F0~3 APPROVAL 0r C0H ST~CTI F0~ A
HOUSE AREA 2~2l 5.F. OR 8.2 % LOT ~VE~E ]~ ~INGL[ FM4ILY RESIDENCE 0NJ
~ EL=lq' FOE ~,.,Xh B,.
DATE ~PPROVAL
· STAKE SET
EL=20'
OPEN
SPACE
S63003'~/'~' 130.01'
Lond now or rorm¢cl~ oF:
Lond no~ or formcrt~ oF:
JUSTIN h4ATHESON
OH[:LLIN®
PUBLIC HATER
4/
PROPOSED $EPTtC FOR ~iAX. 4 BEDROOhd
HOUSE {2OO ®ALLON SEPTIC TANK AND I2
VERTICAL FEET OF 8' [DIAh4. CE$SPOOL
Areo = 2&,lq2 S. F.
Ar'eo = 0~4-12 Acres
6RAPHIC 5GALE I"= 40'
e
O4o~'r~ ItOAi:))
JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN STREET N.Y.S. LIC. NO. 50202
RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287
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