HomeMy WebLinkAboutPagnutti ELIZABETH A.NEVILLE,MMC O` 0 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 ,f, 0�. Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
D INQ20YEE
TO: Southold Town Building Department JUL z zone DD
FROM: Sabrina Born, Southold Town Clerk's Office
DATED: June 28, 2018 B1UDING DEPT,
TOWN OF SOLMOLD
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4620 for a Cesspool/Septic Tank Construction
Permit submitted by:
Valerie Marvin, Esq. for Louis Pagnutti.
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: f
APPROVE t�
DISAPPROVE '
Comments: Final approval required from the Suffolk County Health Department
Signature
D
-711-7
/8
Dated
0
ELIZABETH A.NEVILLE �`Z`� G•y Town Hall, 53095 Main Road
TOWN CLERK p P.O. Box 1179
COD Southold, New York 11971
REGISTRAR,OF VITAL STATISTICS %�s Fax(631) 765-6145
MARRIAGE OFFICER .j. Telephone (631) 765-1800
RECORDS MANAGEMENT OFFICER
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 ky C
Applicant Mailing Address -Pd :E� __�/(o 3
(z►- I[�C
Septic Tank or Cesspool
Brief Description of Proposed Construction or Alteration
S yl cC A) 6-L
Location of Proposed Construction/Alter tion:
Owner of Property: LZLkAS
ni
Owner Mailing Address: 0D ie J�
Owner Property Address: J�7 � V, I 6C
Name and phone number of contact person VtAle4/, C Kkx.,V✓( ✓+ 7-2-�� �'30C�
Tax Map No: Section 444 Block '�i Lot 5^
Cross Street
NOTE: LOCATION MAP MUST BE S MITTED WI APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY TH HEALTH ARTMENT APPROVAL
Signature of Applicant Date
Received bv.
GONER TO GRADE �..
DROP T IS USED
IF
e�"� I.WTTOM Or r OL V4AL.L,re A MINIMIM OF V ADOJC ON IN
A TOTAL OF 4 OMS. IRES FOR eosu CxyPANe1oN of THE LGl.NINe s f INI eRADE TTrIs IAPPRGNID PIPE TODD
�t
2 STORY R-51vENCE ACC.OMMODATIN6 �ePOLWP
IC TO BE I0 0 OPAL. IC TANK 5.lE
N6g WITH (5) 8'OX3' DEEP LEACHING POOL. O q�5'HOW�T�0 Ta eRADC PIT�a »I" a
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ALLOW FOR
P CONSTRUCTION �
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V
ADJACENT
'y RESIDENCE
(IMPROVED) - �, «. a»
am ON PUBLIC,WATER
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ADJACENT
RESIDENCE
Excavation
Inspec io eum°
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6RMWORT,MY 1944
ON PUBLIC WATER y O
Y mor TOWN OF 50UTHOLD
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SEGTION. 44 BLOCK. 2 LOTS 5 r
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Health DepartmentLor sly, �cs4 sa.Pr. Lu l�
UA
M AUBLIG WATER 1--�
' ANLL IRES DENGE ITHIN BOO'
WITHIN 150'RADIUS ON
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Pe
INDIVIDUAL SEPTIC,
HOLE �
MGDTMT ONALC DSGIENGE ABANDON EXISTING SANITARY SYSTEM
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L AteA i TEST HOLE O
EL.10.1 DARK BROWN LOAM � � tM, wt+ µ� a�� µ�" �^^+,
(ou JUN l
PROPERTY LINES �, _ O '�� °I
..�. APROX.WATER LITS .,, ,� �"w
R• v
(SW BROM SILTY SAND 's LOCATION DEC 0 6 ,I ,
HATER
(L.0 PROPOSED IJ=ACHING POOL
'.770C-3^"
T/
MATER IN BROM SILTY'SArm �A fig. PROPOSED SEPTIC,TAMC,
62
AGRE5 \ /1
LMA'Y
d r 1 PROPGSEV 5096 EXPANTION TANK
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES ^
W4TER IN BRONN FINE TO 0
(Sw) GOAR9E SAND A ANDOMWDRY
P
tii R \
re.L " lry ' ROPO��E� WFJI PERMIT FOR APPROVAL OF CONSTRUCTION FOP.
» X. r° lINGcLrz Fp,Pm:( RESIDENCE ONLY
� 'y� PROPOSED DISTRIBUTION BOX\ � Q
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O
�� NEI&HBORIN& PROPERTIES
PLOT PLAN .
tu
SUPPLIED BY PUBLIC WATER EXPIRES�'H :YEARS F 0 DATE F APPROVAL
-- ...... _. __
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