HomeMy WebLinkAboutMarino, MargaretELIZABETH A. NEVILLE, MMC
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
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Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax(631)765-6145
Telephone (631) 765-1800
www.southoldtownny.gov
OFFICE OF THE TOWN CLERK _
TOWN OF SOUTHOLD ` r!
TO: Southold Town Building Department f ! APR 3 2015
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t
FROM: Sabrina Born, Southold Town Clerk's Office —
DATED: April 1, 2015
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4302 for a Cesspool/Septic Tank Construction
Permit submitted by:
Mark Schwartz for Margaret Marino Trust
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
d - -
Signature
109 0 7
Dated
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
' SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $104 or
Applicant
Applicant Mailing
Non -Residential @ $25
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Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork. net
Application No. Li.34o2
Permit No.
Septic Tank or Cesspool ✓ .`
Brief Description of Proposed Construction or Alteration W A54t,-'� J"V ✓72%l
Location of Proposed
Owner of Property:
Owner Mailing
Owner Property
Alteration:
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ss: c,� O 6 *ele-at-) /�O/n�1' .4e- -y
V,04 0 &jW ,4 . r ( . -? Z 6
ns: -060 a i oc'-I cit/ "-111� - -- -
Name and phone number of contact person
Tax Map No: Section 6 Block Q Lot
Cross Street F -&L, ,u)&a, �.
NOTE: LOCATION MAP -1V
CONSTRUCTION REQUIRES
Received by:
WITH APPLICATION.
6
SCDHS REF # F?10-14-0008
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For Sanitaryy��T p'# S
By Health Dep;
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SURVEY OF PROPERTY
A T CUTCHOGUE
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NY
1000-109-05-14.18
SCALE: 1 `=40'
JUNE Q, 1995
DECEMBER 15, 2014
Dec. 31, 2014 (ADDITIONS)
Feb. 12, 2015 (revjsions)
LOP 80 Mar. fig 2015 Revisiorl
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