HomeMy WebLinkAboutAlberto, Donald SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3486 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : DONALD ALBERTO
Address 1: 68 HIGHLAND AVE
City St Zip PORT WASHINGTON NY 11050
Descripton of Proposed Construction or Alteration
-ADDITIONAL (1) 8'X4 ' HIGH LEACHING POOL, OVERFLOW FROM CESSPOOL
Name Of Owner DONALD & ANN ALBERTO
Mailing Address 1 SAME AS ABOVE
City St Zip 0000
Property Address 1 415 BLUE MARLIN DRIVE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 57.00 block 1 lot 2.200
Cross Street DOLPHIN DRIVE
Building Permit Number Cross Reference:
Issue Date: 12/08/06 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
,„„
IIllO�``Or SO lit
1
1
ELIZABETH A. NEVILLE `` O
Town Hall, 53095 Main Road
TOWN CLERK4` P.O. Box 1179
REGISTRAR OF VITAL STATISTICS • G Q$ Southold New York 11971
MARRIAGE OFFICER r Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER lij'`+ ,A
•• Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICERil►l southoldtown.northfork.net
��...
Of
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Francesca Quintieri, Southold Town Clerk's Office
DATED:
Transmitted herewith is a copy of application No. 3642 for a Cesspool/Septic Tank Construction or
Alteration Permit submitted by:
Donald Alberto
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.
Francesca Quintieri
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments:
Signature
//A 6 0TH
Dated
•
,-�sFF ,,,,�;
ELIZABETH A.NEVILLE Town Hall, 53095 Main Road
TOWN CLERK A', P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER : Gy '� 1 Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER Ov���� Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER `' '� 4,.'Isoutholdtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10 (or Non-Residential @$25 Application N•
Permit No.
'41 ei
Applicant Name 1) 0 A/ 6-0 4Li t/v,/0 •
Applicant Mailing Address Ag' c-.4974,29 /e1-(/5"
t U/L/6-7zp-v /'l!! I r oJ'a
Septic Tank or Cesspool ✓ r
Brief escription of Proposed Construction or Alteration 4 (1) Q k
-I-
14IL $ cr f/ PMOL ot/ -/ e,14 - C CE(
Location of Proposed Construction/Alteration: ,
Owner of Property: DO/1-14'6-e ///Vf
/ .41--657-72)
Owner Mailing Address: - 66 9/64-0~
-; per LorhouliC'7 2.1v 1104-7)
Owner Property Address: 4 £ L VS / 4- L "t/ t
(PDcr/WDc-0 ,v
Name and phone number of contact person Edi/ 61-7-0 S7 3-/2-9Y
f
Tax Map No: ///��"��"49 Section PC Block or Lot 2 2
bDCross Street , Pz,/W z)4,...4L
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
/AP i I /D— 2. 2
O '
rature of Applic.M t Date
Received by:/_ .i►
. _,
U Y.
m RTY •
• A71 `A a
TO ': ..$otic r • r . �r-
UP TY
* $ 4 x:57-. 0t- ..
Ow:. i
• A 2 2009
1,.orN BER$ ARE norfteNcea TO "MAR OF
1I.E�1 IN THE OFFICE.0
• THE':S' 'i`OL.k:GOUJ fr CLERK ON AU&IST'2
.:
196ASMAPNO .. 3. ..
'ix.'
AREA =2.0,640a . tt.� • a p� ��W y
.
5 . t.Meme NEW),
Ale AL' AAte. � �.tb� '� ���'
OF S�E r T W Y01#f S A TE:m1CA p 1-t..w.it
EX EP $.P R,SE • 409 }S/ , (CA°' ants I
NE' t7NARS' VALIDP! fJ, y-,,.�, ' / ,' c
. All?mAEA oft 001E°9ArirkOW
RESSEDALS F .1' - "YOR ,�1 �'A va;�• K . e, NO. 49618
'• WHOS`E'Sl6N,APURE A'PIVAR9:. N. &A♦�. .. ..
ijr
ADD/T/ L "Y TQ
..
OMPLY WOTI SA. LAW TEAM. ALT;, o X:, , ! = F�
MUST Ur SIT(AN)4 ISI ALL vEyons•km Y f631I .Tl�r'.j ° � ��'` 1 7fi5 - l l97
OF•A - E-TOR' AP TERMS SUCH '4 ; . -_ .P. O. BO. $A9..
T OR .' `r - re - D41 4 NO'T.IN CIMAM WI :LAw, 1234• TRAVELER STREET
4 7 1