HomeMy WebLinkAboutBarratt. RobertELIZABETH A. NEVILLE, MMC
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS OF MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, NewYork 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
TO:
FROM:
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
APR - 5 2012
BLDG DEP1,
TOWN OF SOUI'HOLD
DATED: April 3, 2012
RE:
Cesspool Construction Application
Transmitted herewith is a copy of application No. 4076
Permit submitted by:
Robert Barratt for 1240 Village Lane
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.
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 Depas~i~ent
Dated~Signature
ELIZABETH A. NEVILLE ': -- TOWN CLERK
REGISTRAR OF VITAL STATISTIC23
MARRIAGE OFFIOER
RECORDS MANAOEaM~NT OFFICER
FREEDOM OF INFOKMATION OFFICER
.~Town Hell, 6309§ Metn R°e
P.O. Box 1179
Southold, NewYork 119~1
F~ (631) 766-8146
Telephone (631) 765-1800
sou tholdtown.no~hfork,ne~
Residential ~ $10..
OFFICE OF THE TOWN CLERE
TOWN OF $OUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
or Non-Residential~:$25 /
Applicant Name ~ ~ o~.--r ~ ~. ~ ~ ,~'r T'
Application No. q 07 ~
Permit No.
Applican! Mailing Address A~ ~ ~- w ~,~
Septic Tank v" or Cesspool__
Brief Description of Proposed Construction or Alteration
Location of Proposed Construction/Alteration:
Owner0fProperty: I-e.~ 'otw~.. ~,q ~,
Owner Mailing Address: i> o ~,~-r-- t % ~-
OwnerPropertyAddress: '~'2_,~o ~_~ ~t_.~, q ~ t_
Name and phone number of contact person [.
TaxMapNo: I~oo Section %f:, .Block ol Lot
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH I~,ALTH DEPARTMENT APPROVAL
/ / ,
Date
l eceiv d 6r.
API~OVAK STAM~
Suffolk County Department of Health Servicc~;
Approval for Construction-Other Than Single Family
Reference No.~_~i 0---0~~'000~ Desi~ FJov~
The~e pi.ri, have been reviewed for gen~ral conformance with Suffolk
C~mty Depe~nent of Health Services standards, relating to water
supply a~d sewage disposal. Regardless of any emissions,
]imomimm~ or lack of detail, co~tructio?, is required to .bo in
aceoniaaee wi~h the attached permit conditions and ,apphcable
atamlarda, nnl~a specifically waived by the Department. This approval
Approval Date c/- '-~e~ver
;ILePI:iOI/AL I~f WATER ~IJAUTY UNIT
300 ~lx~'me.
Gm~totAmm-O.O64mct~,nowmimnd~,mc. .--_. -- - -
POE = 300 x 0.084 = 25.3 glxl
iI
41
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