HomeMy WebLinkAboutDeFiore, PasqualeTO:
FROM:
DATED:
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No.
Permit submitted by:
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
December 12, 2012
4126 for a Cesspool/Septic Tank Construction
Gennaro Paul DeFiore for Pasquale Anthony DeFiore
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 Department
ELIZABETH A. NEVILLE '
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
ld~KRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
,,~Town Hall, 53095 Main Roa,
P.O. Box 1179
Southold, New York 11971
Fax (631) 785-6145
Telephone (631) 765-1800
southoldtown.northfork.net
~ OFFICE OF THE TOWN CLEI~K
TOWN OF SOUTHOLD
TOWN OF SOUTHOLD
BUILDING DEPARTMF-~uTHOLD W
P.O. Box 1179 ASTEWATER DISTRICT
Southold, N.Y. 11971
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Permit No.
Applicant Name C_,..~,.~o_~ ~)f.~.o~._~
Applicant Maihng Address
Septic Tank tl~Cesspool
Brief Description of Proposed Construction~ ~,-~,..~
Location of Proposed Construction/Alteration:
Owner of P~0perty:_ PA,~,o At_~
Owner Mailing Address: ZS c~ ~-'~.t~.c,,,~
Owner Property Address: ¥ ! t.(~ ,~ou,..~NJ,~x
Name ~d phone nmber of conact person
T~MapNo: I~ S~tion Ol~.o~ Block
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION P. eqvnu s sva y wrm q ,A T/ pEP) aT eYr APeaOVAL:
Received I~y: /~Q~ Signature of Applicant Date
.. J
ANY ALTERATION OR AD~TION TO THIS SURVEY IS A VIOLATION
O~ ~ECTION 7209 OF THE NEW YORK STAT~ ED~4TION LAW.
EXCEPT AS PER SECTION 7209 - SU~31VlSIO~ ~. ALL CERTIFICATIONS
HEREON ARE VALID FOR THIS MAP' AND COPIES THEREOF ONLY F
SAD 1~4P OR CQPES ~.AR THE IMPR~.$SED SEAL OF TI~. SURVEYOR
The Iocallons of wells e~l cesspools
shown hereon ore from field o~servaliofl$
and or from dole o~eieed from o~ers.
Therefore their Ioc~l/ow$ ~ ~ existence
F~OSE SI6NA TURE AP~R$ HEREON.
is not guoreMeed.
$CDHS ReL #
2000 col IO'f~ m 4' Llfft~ DepYe SEPTIC TANK
~UFFOU-~ COU~<~'Y ¢ :?PART~,LENT ',~;Y ~ZALTH SERVICES
ADDITIONALLy TO COIV~L Y WITH SAID LAW TERM ' AL TERED BY
~ST ~ U~D BY ANY A~ ALL S~VEY~S UT~IZ~ A C~Y
~ A~T~R S~VEY~P. TE~S S~H ' ~ECT~D
BROUGHT- TO-DATE ARENOT~CO~L,NCE WITH T~LA,.
FIDELITY NA T~NAL TITLE ' C.P'
INSURANCE CO.ANY OF NEW YORK ''
THOR~IKE W[LIAMS ~ g ~.~
DWELLING
well over 150'
WA TER
I
RAIN RUNOFF CONFAINMENT .
HOUSE 2656 $~.fL
GARAGE 610 s~.fL , ~
I~0 s~fl. ~ ~ ~ .
' . ~ ~f¢' ~S' R~E YEAR,.,
W RoAD .......
' ~C ~16~.~ , VF ......
~ PRO~ ' 2 ~ I0'~ eW~ I om fomilior wifh Ihe STANDARDS FOR APPROVAL
'I~'C ~ l-'0¢ ~ AND CONSTRUCTION OF SUBSmFACE SEWAGE
. } LOT 66
~ ~ .... ~ ..... ~ "~P OF ~ BY ~ ~"- ~C~N TWO
~ Li.e~U8~ Be inspect~ ~ I A T O~NT P~NT
K
90.00, [OT ~ ~X.-¢~~~O. 49618
o~LL~ < ~[CON~C ~U~YO~S, P.C.
~ (SSI) 765 - 5020 FAX ¢63O 765 -
~0~~ ~. o. Box ~o~
AREA = 20,794 sq. ft. /zao TRAVELER STREET
/ SOUTHOLD, N.Y. 119~1