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ELIZABETH A.NEVILLE �� �® * �V_A Town Hall, 53095 Main Road
TOWN CLERK '' ; P.O. Box 1179
� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS : � Fax(631) 765-6145
MARRIAGE OFFICER \�
RECORDS MANAGEMENT OFFICER � ®d EE/ $$- ,i�� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ' �
OFFICE OF THE TOWN CLERK
SOUTHOLD WAVIRMAREIRTRISEEDSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2648 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JOHN MOGLIA
Address 1 : 10 POPLAR STREET
City St Zip SAYVILLE NY 11782
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF # R10-01-0123
Name Of Owner MOGLIA, JOHN
Mailing Address 1 10 POPLAR STREET
City St Zip SAYVILLE NY 11782
Property Address 1 SNUG HARBOR ROAD
City St Zip GREENPORT NY 11944
Tax Map No. section 35.00 block 6 lot 8.000
Cross Street MARINE PLACE
Building Permit Number Cross Reference:
Issue Date: 9/07/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
70,-- .
(X.0C-d:
ELIZABETH A. NEVILLE ���1� T.;-.,, -7.: A ; Town Hall, 53095 Main Road
TOWN CLERK ‘ ;,r.,;:,4,:;".. :' :.: a % P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �� �'` '`.` �, Southold, New York 11971
MARRIAGE OFFICER :: # ' -,V�,11 Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER =__4®� ),,�semJ��{ �� ... Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER LS �O.
OFFICE OF THE TOWN CLERK —� _ --^�,�
TOWN OF SOUTHOLD �- - - ._.
1,�)i 2 fPTO: Southold Town Building Department L i u f :AUG 8 2001 i!
FROM: Linda J. Cooper, Southold Town Clerk's Office I U-9 ^FPT.
-
DATED: August 28, 2001
Transmitted herewith is a copy of application No. 2737 for a Cesspool/Septic Tank Construction
Permit submitted by:
John Moglia
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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations: '
APPROVE V
DISAPPROVE
Comments: C� (4,0.. .....14.
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Signature
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Date
1 '
OFFICE OF THE TOWN CLERK ,'.�CAFF OCK 13
TOWN OF SOUTHOLD ,��Q� COGy Application No. OL
ELIZABETH A.NEVILLE,TOWN CLERK •
P.O.BOX 1179 Construction
SOUTHOLD,NEW YORK 11971 Alteration
tra tit
Tele hone O,f Qi,, ' $10.00 -Residential
P
(63.1) 765-1800 - Ol � '�� $25.00 -Non-Residential
TOWN OF SOUTHOLD •
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL •
Permit No.
Fee .$
DATE
APPLICANT NAME: /k/ /1/1//i
APPLICANT ADDRESS: Ow
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
j/e !/r./ % Q/C9x
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTI N OR ALTERATION: •
• OWNER OF PROPERTY: '//'J
OWNER MAILING ADDRESS: ANd_ie'531--
7,tqui/le,,- 0/ ior..)--.
OWNER PROPERTY ADDRESS: i./?U i M�
e GeiT) / ,
TELEPHONE NUMBER OF CONTA PERSON: ( '/- ci 053
TAX MAP NO. : Section (35Block Lot 0 •
CROSS STREET: 1e,/ve f//6€
BUILDING PERMIT NUMBER CROSS REF" NCE: /
Signature of 1plicant
RECEIVED BY: C •
•- - � 's Office
DATE: V •
1 TEST HOLE
7-13-o I EL. 9G. 9 SURVEY OF LOT 3-7
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,. LISA McQUILKIN
Ar 0 fluauthorized alteration or addition to this survey is a s iolation of section 7209 of the
New York Slate ducation law.
LAND SURVEYING
• �en O Copies of this survey map not bearing the Land Surveyors inked or embussed seal is 102 MAIN ST R E.ET
+ — not considered to be a true valid copy.
Distances shown from property litres to existing structures ore for a specific purpose W. SAy\/I L.LE, ISI`/ 117 9 Co
. and use and arc not intended to guide in the erection of fences or other structures. G 31 -SG3- 4952_
n Certification indicated hereon shall run only to the person for whom the survey is
s M AR-1 I-4 E. P LACE prepared and on his behalf,to the Company or Agencies listed hereon and to the SCALE.: 1 "= 20'
assignees of the lending institution.Certifications are not transferable to additional
410/111k" institutions or subsequent owners. DATE: J 1.1 L1 1c), 200 I .
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Job No. G S43-ol