HomeMy WebLinkAboutNewman ELIZABETH A. NEVILLE, MMC m Town Hall,53095 Main Road
TOWN CLERK P.O.Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS " V Fax(631)765-6145
MARRIAGE OFFICER Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER ri t 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: September 27, 2018
RE: Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 4657 for a Cesspool/Septic Tank
Construction Permit submitted by:
Robert Brown for Stuart & Joyce Newman
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:
Signature
Dated
ELIZABETH A. NEVILLE Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER � � 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. b S 1
Permit No.
Applicant Name ? '
Applicant Mailing Address.,) ... �' �. .. ..W
r
m f r IOyt ... _ .. �.
Septic Tank or Cesspool
Brief c ori tion of Proposed Con
p pool -
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1 stru.�ct ,
Location of Proposed Construction/Alteration-
Owner
onstructio AlterationOwner of Pro ert
Owner Mailing Address: .�m�,...._.......m
Owner Property ,ddl ssra�
Name and hone number of contact person
p p
Tax Map No: Section O _:� _, 'Block. m w Lot-_w
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
Sigr atur f qol ant A bate
Received by: __m...m � _ r.... . .....
5A5ED (DN 55URVEY 5: :
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JEFFREY UDALL l ,rg SFR C Onv se
f s REMOVE 125 5F AND NCIGNbOR5
LOT IMPROVED
OF FX 5-N- DE-r, Cleanout must be installed on the
D / IN( 2E `H "�N septic tank inlet Waste line. All utilities
K - _ r require a 5ft minimum separation to
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NOTE:
MAXIMUM DRAINAGE AREA
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SECTION DETAIL
u rvaicxl section Ca)[.exchlne Pools SILT FENCE DETAILS
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SEPTIC CK055-5ECTION
Robert I. Brown 4. NEWMAN RESIDENCE
I
Architect, P.C. 564''-5 ROUTE 48. SOUTHOLD, NY 11071
N , Y N. ),
UN .4S ACTN;_;{€Nn T1 )N t s
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zo5 r"1�' Ave. �srtr'e77port NY 10 24 MAY, 2018
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631-477-9752 n,
SCALE: 1" = 30