HomeMy WebLinkAboutPizzolla, JohnELIZABETH 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
SEP 2012
DATED: September 20, 2012
RE:
Cesspool Construction Application
Transmitted herewith is a copy of application No. 4110 . for a Cesspool/Septic Tank Construction
Permit submitted by:
Mark Schwartz for John & Linda Pizzolla
Please review the application and location map and advise if this office may issue the permit.
Please complete the form below and retum it to me. Thank you.
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
REGISTP~AR OF VITAL STATISTICS
MARRL4.G E 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.north fork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $l(~. or Non-Residential
Applicant Name ~. ~./( .
Applicant Mailing Address
Septic Tank~or Cesspool ~
Brief Descri~ of Proposed Construction or Alteration
Location of Proposed ConstmctioWAlter~tion:
Owner of Prope~y: ,)0~
Owner Mailing Address:
Owner Property Address:
Application No. ~ / [ 0
Permit No.
Name and phone numbcr ofcontact person /~,t:t~/~_~ ~,/-~tT~T'?.-- '~..~ ~
Tax Map No: Section [ l/ Block ~ f ' ~t I( ~/~
Cross Street ~[~~ ~
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUI~S SURVE~H H~~ARTMENT APPROVAL
~ ~ Si~ature of Applic~ Da
Received bY'. ~/~l ~[ ~ /[ ~ ([ ~
N
AREA/46,045 $0. FT. ':
SURVEY OF PROPERTY
AT NASSAU POINT
TO~N OF SOUTHOLD
SUF?OLK COUNTY, N.Y.
I000-111-08-11 & 1R
SCALE: 1'=30'
~NU~ ~2, 20~2
JUNE 15. 2012 (PROPOSED SEPTIC SYSTEM) '
PE~T FOR AP~OVAL OF CONST~UCWON
PROPOSED SEP~C SYS~M (SiX BEDROOMS)
1,500 GALLON PRECAST SEPTIC TANK 8' DIA. 5' LIO. DEPTH
8' DEEP x 8 DIAMETER LEACHING POOLS
EXISTING SANITARY SYSTEM TO BE ABANDONDED
IN ACCORDANCE WITH S.C.D.H,S. STANDARDS
TEST HOLE DATA
BY ~DONALD GEOSCIENCE
~/~/~2
· =MONUMENT
, l, ELEVATIONS ARE REFERENCED TO N.A.V.D.
LOT ~UMBERS REFER TO "AMENDED MAP A OF NASSAU
~ POinT, OWNED BY NASSAU POINT CLUB PROPERTIES,
· INC"!FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE
·: ON, AUGUST 16, 1922 AS FILE NO. 156.
,~NY -AL TERA TION (~ ADDITION TO THIS SUR~'EY I$ A ~OLA TION
OF SECTION 7209OF THE NEt~ YORK STATE EDUCATION LAW.
EXCEPT AS PER SECTION 7209-$USDIVISION 2. ALL CE'~TIFICA71ON$
HEREON ARE VAUD FOR THIS MAP AND COPIES THEREOF ONLY IF
NO. 496~
(651) 765-5020 FAX ~651,) 765-~1797
P.O. BOX 909