HomeMy WebLinkAboutConstantino, RalphELIZABETH A. NEVILLE, MMC
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS OF MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
TO:
OFFICE OF THE TOWN CLERK
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoh tewn.northferk.net
TOWN OF SOUTHOLD
Southold Town Building Department
DEC 1 7 2012
[3[DG DEPI.
TOWN OF
FROM: Carol Hydell, Southold Town Clerk's Office
DATED: December 14, 2012
Transmitted herewith is a copy of application No. 4127 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Amy Martin for Ralph & Carmela Constantino
Please review the application and location map and advise if the project has received Suffolk County
Health Department approval and 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: Maintain required setbacks fi'om adjacent wells, buildings, property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED.
Date/'"~7/~>
SOUT~LD WASTEWATER ruST'CT
Application No.
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
or [] Non-Residential (~ $25
Septic Tank [] or Cesspool []
~e~mi,~o. ~ 1:2-7
Address:
Applicant Mailing
Brief description of Propsed Construction o~~
Location of Proposed Conj~iructi?,n/Alt~.rati°n:
Owner Mailing Address:
Tax Map No.: /tr~0 Section:
Nea~st Cross su~t:
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION I~QUmES SURVEY
'Received by: ~L sil~,(lre ~pplicant
(33' ,~.0 'V'/')
BA~ED ON MAP OF
D~CAIBED PROPERTY
51TUATED AT
ORIENT: T/O 50UTHOLD
$UFFOLK. COUNTY, N.Y.
~.C.T.M. 1000-13- I-6
5Y:PECONIC 5URVEYOR~, F,C.
[_AND SURVEYOR
A~EA = 53.75~ 5.ff.
,_SITE FLAN
SCALE: I" = 40'0'
Excavation
By Health O,e
TO
lired
I
PROPOSED DE?TIC SYSTEM DETAIL
TEST HOLE DATA
BY McDONALD GEOSCIENCE
12/21/11
95 +/
53'
PAlE BROV~N RNE SAND SP
DEC 1 7
l
BLD6 DEFT,
TOV,'h OF ~;OHTt!OLD
RECEIVEB
OCT ~ 9 2012
T ?OR ~ .~a~- .... ........ V~O~ff!ON OFTHE OFFICEJ
......... ''):Si '/ ~AW R ANY PERSON,
........ ~ ..... , ..... lNG UNDER THE
-~ ~:: !ON OF A LICENSED
'1 ..... ~ v~,~c ~P0q DA~ E OF APPROVAk ~
~ RODERT I. DROWN A~ChHTE~%
SUFF. CO. HEALTH SERVt
[E.II/iiTEWATER I
.,.,>,.s ,,.¢ ¢~~''''° CONDYANTINO R. EDIDENCE
~V. i 0/03/20! 2
INC.