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ELIZABETH A. NEVILLE,MMC �y0 �y 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 OFFICERy� Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER �,� `�► www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER
OFFICE OF TOVVN OFE TOWNCLERKLERK D [EgFo'V[�
D
oEC 1 3 2017
TO: Southold Town Building Department
FROM: Sabrina Born, Southold Town Clerk's Office BUILDING DEFT.
TOWN OF SOUTHOLD
DATED: December 11, 2017
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4549 for a Cesspool/Septic Tank Construction
Permit submitted by:
John R. Bracco for Peter & Maria Sheehan
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 ptoject cited above and make the following
recommendations: -
APPROVE
DISAPPROVE
Comments: Final approval required from the Suffolk County Health Department
Signature
fpe)�, D40 /
Dated
ELIZABETH A. NEVILLE,MMC Town Hall,53095 Main Road
TOWN CLERK " �' P.O.Box 1179
co
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS Fax(631)765-6145
MARRIAGE OFFICER �� �" Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER ., '' www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICERxr°°
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Sabrina Born, Southold Town Clerk's Office
DATED: December 11, 2017
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4549 for a Cesspool/Septic Tank Construction
Permit submitted by:
John R. Bracco for Peter & Maria Sheehan
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 a-r.r�ov, l �-eqqllii•ed frorn the Suffolk °t-miltlie aar•tnicnt,
Signature
Dated
a � � Town ll,53095: ain Road
ELIZABETHA.
P.O. Boy: 11.79
TOWN CLERK
.® NSM v
Southold, Nem�(�a�k 11971
�
RAR OFVITAI�STATISTICS
MARREAGE OFFICER Fax(631.) 765-6145
Telephone (631) 766-1800
'
� AI::D ' CSINFORMATIONOFFICER CORDS MANAGEMPNT OFFICER
a out oldt�awn.x�io t fffor ,.Yiet
OFFICE OF THE TO'WN GIJER- K
TOWN OF SOUT11OLD
A1111t WG9k AIN N
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Re
s d. rmt � 10 ...... orNon-Residential,@ ......................... Application o
Applicant �������
Septic Tank ......orCesspool _
Brief Descnpfion of Proposed Construction or Alt ratioii_,_J'.,
jc-
----------
Location of Proposed Construction/Alteration:
Owner: 'ili "kdd r,a„aw 2-1 � � �..�`�. . :xm�� � �_T �.� � p..".��� o"a...� ..�. ...._.
Owner prop rty " r ss' 300,._. . ..... , a
. .. .. ma....m..,,. ..
1l"�� gid.p �'ra � ar contact p °�sa� u w�. �. .,,
TaK Map No: Section Block. .111 5, � Lot �
Cross Street
u �
Nam: LOCATION MAP MUST BE SUBMITTED f '111 kPPLICATION. NEW
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i8il��i��aoawy �6a��ut.
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Cleanout must be installed on the
septic tank inlet waste line. All utilities
require a 5ft minimum separation to
OM
NOW EOMMEMLY EXI511NG WELL the septic system.
I
PETER W.5NEEHAN p NOW 0M rOMMEMI.Y
C CONVEMIIN A TO FWJ IC WATEM) ` / MOr9EMf A.t7/V21N& 0M FORMEMLY
/ GLOMIAA.PARIN
1 C IbWMOVECI> / FOR SANITAIRY SYSTEM
C 12WELLING) LYVIA fALMA50N / XCAVATION
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Site Plan
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PROPOSED SEPTIC SY " "
Scale - 1" -` 40`0 i NORMFOR THE SHEEHAN RESIDENCE
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YOUNG & YOUNG
300 Naugles Drive
LANb 5UINMIZ Mattituck, New York t; A
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LUTHERS ROAD 364 5,�. JOHN R. B RACC
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Registercd Architect,P.C.
3 MINOOM5 17 �street �1
Sayville,Sayville, Y 11782
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WALL # U565 410007072331901 5 53525-. 115 �L�VMON 2.9 fax: (631)589-9889
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