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Home My WebLink AboutSteidl gifFFOI�' ELIZABETH A. NEVILLE,MMC ®� c® Town Hall,53095 Main Road TOWN CLERK P.O.Box 1179 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS 0 Fax(631)765-6145 MARRIAGE OFFICER ,j. ®�. Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER "�®� �`� www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK D [ECEWE TOWN OF SOUTHOLD D MAR e 8 2017 TO: Southold Town Building Department BUILDING DEPT. FROM: Sabrina Born, Southold Town Clerk's Office TOWN OF SOUTHOLD DATED: March 8, 2017 - Transmitted herewith is a copy of application No. 4468 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Morris Cesspool for Erica Steidl 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 from adjacent wells,buildings,property lines and water Bodies. EXCAVATION INSPECTION REQUIRED. C RECEIVED MAR - 9 2017 Signature Southold Town Clerk Dated, SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 4468 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : MORRIS CESSPOOL SERVICE Address 1: PO BOX 2130 City St zip CUTCHOGUE NY 11935 Descripton of Proposed Construction or Alteration ADDITION TO EXISTING SYSTEM APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. Name Of Owner ERICA STEIDL ------------------------------ Mailing Address 1 11915 MAIN RD ------------------------------ ----------------------- ------ city ----------------------------------------------------------- City St zip EAST MARION NY 11939 -------------------- -- ---------- Property Address 1 11915 MAIN RD ------------------------------ ------------------------------ City St zip EAST MARION NY 11939 -------------------- -- ---------- Tax Map No. section 31.00 block 5 lot 1.001 Cross Street COVE BEACH RD ------------------------------ Building Permit Number Cross Reference: Issue Date: 3/09/17 El'zabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) L ELIZABETH A. NEVILLE, MMC Town Hall, 53095 Main Road TOWN CLERK P.O.Box 1179 Southold,New York 11971 CA REGISTRAR OF VITAL STATISTICS Fax(631)765-6145 MARRIAGE OFFICER Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Sabrina Born, Southold Town Clerk's Office DATED: March 8, 2017 Transmitted herewith is a copy of application No. 4468 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Morris Cesspool for Erica Steidl 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 from adjacent wells buildings property lines and water Bodies EXCAVATION INSPECTION REQUIRED. Signature Dated ��®Surf ELIZABETH A. NEVILLE G Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 W Southold, New York 11971 REGISTRAR OF VITAL STATISTICS W MARRIAGE OFFICER Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER ��f®d ®� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.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 No. Permit No. Applicant Name '� h�� "I Applicant Mailing Address P Q 4j 61< Septic Tank or Cesspool Brief Description of Proposed Construction or Alteration e)IIX14 ("10&> Location of Proposed Construction/Alteration: / Owner of Property: SCA Jl t'_�i 1 Owner Mailing Address: I'm/0 49 &-4,11 Allyl6yl /'z /IY,5 Owner Property Address: Name and phone number of contact person Tax Map No: Section r _Block Lot _ Cross Street kk NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL 1/9 1 ' Signature of Applicant Date Received by: � �ON