HomeMy WebLinkAboutThorp, DeloresELIZABETH 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, New York 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
DEC - 5 20'IZ
BLDG DEPT.
TOWN OF SOUTHOLD
DATED: December 5, 2012
RE:
Cesspool Construction Application
Transmitted herewith is a copy of application No.
Permit submitted by:
Fred Weber for Delores Thorp
4125 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:
APPROVE ~
DISAPPROVE
Comments: Final approval required from the Suffolk County Health Depamnent,
Signature j
TOWN CLERK
REGI~TB,AR OF VITAL STATISTI CS
MARRIAGE OFFICER
RECORDS iV~uNAGEMENT OFFICEE
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERR
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
.~Town Hall, 53095 Main Roa.
P.O. Box 1179
Southold, New York 1197 l
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
Residential@S10 X or Non-Residential@S25__ Application No.
Permit No.
App!ieant Name ~,,~:;,
Applicant Mailing Address q~ ~,
Septic Tank or Cesspool
Brief Description of Proposed Construction or Alteration
Location of Proposed Construction/Alteration: OwnerofProperty: ~::~ '-~
Owner Mailing Address: '~3' .~- F,~',t2~.. ~,_.,. GQ.e)
Owner Property Address: ~3 t).~ [~,&'q~J,~wo, r'~
Name and phone number of contact person
Tax Map No: Section
Cross Street
NOTE: LOCATION MAP ~ST ~ S~ED W~H ~PLICATION. NEW
CONSTRU~ION ~Q~S S~ ~~TH DEP~T~ ~PROV~
Abandonment of ex~stmg samiary system must be.~ N/o/r
TH~ODoR£ C. MARTZ,
comformanc¢ with departm~ ent requirement Submit ~.
~mpleted form WWM-..~.~ as proof, co~ ~
~ N/O/,~
^s~L ASClU'rTO
LOT 1~)
S ,',34 79' 20" ~ 100.00'
u_ ~/o/r
uSgEH d. OgoK~
MAUR~EH £. DECKE~
LOT~
PROPOSED SANITARy 5YETEH
SUBSURFACE SEWAGE DI)I~IPOSAL ~YSTEHS FOR 51NNGLE FAHILY RE~N~E5 AND ~LL
ABIDE BT THE CONDITIOH~ 8ET FORTH THEREIN A~D ON THE P~T ~ CONETR~T.
TANK ~ ~
TEST HOLE DATA
PROPERTY O[tJN ER:
PATTI THORP
82S HAyUlATER5 ROAD
HAHLET: NASSAU POINT
TOWN OF ~OUTHOLD
SUFFOLK COUNTY, NEW YORK/
E~URVEy INPORHATION:
NATHAN COR~IN,
JANEEPORT, NE~ YORK
5URVEYED~ MAT 1, 2012 I
LOT 30fl OF AMENDED MAP A ~ NASSAU POINT
O~NED b~ NASSAU POINT CLUB[PROPERTIES INC.
FfLED N THE SUFFOLK COUNTY~CLERK50FF~CE
~UFFOLK COUNTY
PERIwr FOR l
SiNC_4,.E
DF HEALTH SERVICES
I FOR A
DENCE AND
TOt',v.l[
DATE OF APPROVAL
lEO' Radius
I00' Radius
ABANDON