HomeMy WebLinkAboutHill, Ronnie (2) • %gip' SOUI'fo
ELIZABETH A.NEVILLE +" '`� 4 Town Hall, 53095 Main Road
TOWN CLERK * Jill ' P.O. Box 1179
REGISTRAR OF VITAL STATISTICS N
gh o aC Southold, New York 11971
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MARRIAGE OFFICER l �O �1 Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER . ��" Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER Cour( s" southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3396 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : RLH LAND PLANNING SERVICES INC
Address 1: 8595A COX LANE - UNIT# 1
City St Zip CUTCHOGUE NY 11935
Descripton of Proposed Construction or Alteration
-NEW RESIDENTAIL CONSTRUCTION
-FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT
Name Of Owner RONNIE HILL
Mailing Address 1 P 0 BOX 551
City St Zip EAST MARION NY 11939
Property Address 1 745 GOLF VIEW COURT
City St Zip EAST MARION NY 11939
Tax Map No. section 30.00 block 2 lot 13.200
Cross Street ROUTE 25
Building Permit Number Cross Reference:
Issue Date: 12/07/05 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE '`� l0 : Town Hall, 53095 Main Road
TOWN CLERK o 4i
1111 , P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ` G . c Southold, New York 11971
MARRIAGE OFFICER kO? Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER 'VeA�. Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ..court,*�'�� southoldtown.northfork.net
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\)g) 2 2p05 OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
O:
- Southold Town Building Department
FROM: Michelle L. Martocchia, Southold Town Clerk's Office
DATED: December 1, 2005
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 3547 for a Cesspool/Septic Tank
Construction Permit submitted by:
RLH Land Planning Services Inc.
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: ( , Q,
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Signature
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Dated
ELIZABETH A. NEVILLE Town Hall,53095 Main Road
TOWN CLERK k a,! ; P.O. Box 1179
t x Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER tia � Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER y�f ����� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER = �'� 41 #00, southoldtown.northfork.net
to
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT .
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$10 /r Non-Residential @$25 Application NoCj(-/ 7
Permit No.
Applicant Namego, L(..04C,Q,o, ,
Applicant Mailing Address
L74-ty //93S�
Septic Tank or Cesspool At
BriefDesc iption fProposed Construction or Alteration /(eMf R`e_yhc:�
C!. -51Y Ile,troy)
Location of Proposed Construction/Alteration:
Owner of Property: A00'1,6, ,A4 //
Owner Mailing Address: F. 6•61X, 537l 62i fMeue,01, I /1939-c S
Owner Property Address: 7''S QoIP lii etAif ugP
5-f Mai2ici, NI 11939 -05-.5- I
Name and phone number of contact person
Tax Map No:I (OTTO Section/� C (cn 3 v Block • a Lot (3Cross Street IV IS �1tk os- ko )
NOTE: , LOCATION MAP MUST BE SUBMITTED ITH APPLICATION. NEW
CONSTRUCTION REQUIRES SUR ' WITH HEAL " DEPARTMENT APPROVAL
S.gnature of Appl' .,�t Date
Receivedb (/CQ � i
Y �
JFFOLIC COUNTY DEPARTMENT OF HEALTH SERVICES\PEP.MJTFORA1PROVALOFCONSTRUCflONFOR A
GLE FAMILY RESIDENCE UPiLY 30 ei 29 °s " SURVEY OF PR 0 PE ?rn T 1 '� /
TE \ - HS REF.NO. Rio--ro5-- ,0-`19 /
36a. ° A A-r
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R MAXIMUM OF P i F NP pay / \ �: EAST MARION
Fo NI EE
EXPIRES THREE YEARS FROM DATE OF APPROVAL of Ga - ' - c TOWN OF S 0 U T H 0 L D
s� a�� \____/
". `\ N SUFFOLK COUNTY , N. Y.
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�` The locations of wells and cesspools
. 20 . shown hereon are from field observations
o� and or from data obtained from others. ANY ALTERATION OR ADDITION TO THIS SURVEY ISA VIOLATION
OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. 1
,t6 OF NZii, EXCEPT AS PER SECTION 7209 - SUBDIVISION 2. ALL CERTIFICATIONS
* Yr, HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY F
•, SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR
Cr
T WHOSE SIGNATURE APPEARS HEREON.
AO
* 41 13 l am familiar with the STANDARDS FOR APPROVAL ADDITIONALLY TO COMPLY WITH SAID LAW TERM 'ALTERED BY '
*
AND CONSTRUCTION OF SUBSURFACE SEWAGE MUST BE USED BY ANY AND ALL SURVEYORS UTILIZING A COPY
Z V'.:.6:"'. •if
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES OF ANOTHER SURVEYORS MAP. TERMS SUCH 'INSPECTED 'AND
IP. 49618 and will abide by the conditions set forth /herein and on the BROUGHT TO DATE 'ARE NOT IN COMPLIANCE WITH THE LAW.
:� . permit to construct.
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