HomeMy WebLinkAboutBeinert ELIZABETH A.NEVILLE,MMC Town Hall,53095 Main Road
TOWN CLERK P.O.Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS
'�� �iQ�u� 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: November 20, 2018
RE: Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 4678 for a Cesspool/Septic Tank
Construction Permit submitted by:
Castillo Sca es
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 �x Town Hall, b3096 Main Roa
'T'OWN CLERK _ P.O. Box 1179
REGISTRAR,OF VITAL STATISTICS
Southold, New York 11971
MARRIAGE OFFICER k Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER , Telephone(631)765-1800
FREEDOM OF!NFORMAT ION 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.
ApplicantN,an &CA
Applicant Mailing Address
Septic Tarek, or Cesspool
*iefDescription of Proposed.C6n truction or Alteration,_
Location of Proposed Constructions" Iteration:
Owner of Property: #
Owner Mailing Address:_522 r �
1
Owner Property Address:
Name and phone number of contact person
Tax Map No: Section__ 5 Block Lot ,
. Cross Street NGZAQ ,12D
NOTE: LOCATION MAP MUST'BE SUBNIITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES S77WW_1 _ 1
`II .�al DEPARTMENT APPROVAL
Siguatum ofApplicaa t Date
Received by: I C
STAIRS '
&IMNEY 46
C�
MICHELE BEINERT RESIDENCE
TAX MAP 1-000-75-4-27 ,
--tet 522 SOUTH HARBOR ROAD
l
1000,14 avy I d
STAIR'S 6'"a r 9N Ie oR
......_ .w
FOOTINGS DECK STRAPPED "' l) �i� r a
TO HOUSE
LOWER DECK
1r' FOOTINGS ® -XISTIN'
SEPTIC
NEW
PROPOSED
CESSPOOL
Y
T
FOOTINGS
FCOT-NGS AILRNGS �,
UPPER DECK y
EXISTING
FOOTINGS O O CESSPOOL
s
. .............., � .
I/, CESSPOOL
STAIRS
REMOVED
AND
FILLED IN „
16X37 POOL
I z POOH
' � EOU91
DECK AND POOL DIAGRAM
CREATED BY JOYCE GRIGONIS
PGsL FNE, COMPLETED OCTOBER 5,2018
USING SURVEY TEMPLATE
FROM RODERICK VAN TUYL
6"'
DATED AUGUST 1,1989
OWWELL SCALE:1"—10'