HomeMy WebLinkAboutPranzo, Anthony & Hand KennethOI~IC~ OF ~ TOWN CL~Rg
TOWN OF BOUTHOLD
17ABItTH A. NEVILLE, TOWN CLERK
P.O. BOX I 179
SOUT~OLD, NI~W YORK 11971
Application No.
Construction
Alteration~'~'
$10.00 - Residential I.~
$25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
DATE
APPLICANT NAME: PECONIC CESSPOOL
APPLICANT ADDRESS: ?. O. BOX 972
MATTITUCK, NEW YORK 11952'
SEPTIC CESSPOOL ~/
DESCRIPTION OF PROPOSED CONSTRUCTION OR AL'I~ERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: /~./~//~/C/~, ~_.~/1.~Z~,. ,~/l./~/'~--7~
OWNER MAILING ADDRESS: /~ ~;~ C ~'//~.
OWNER PRopERTY ADDRESS: ~
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO.: Sectio~ 0~ Block O<:~/~
CROSS STREET: ~ ~,~,
BUILDING PERMIT NUMBER CROSS REFERENCE:
RECEIVED BY:
DATE:
Signature o~_.,,Applica nt
Town Clerk's Office
ELI2EZ, BETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
IvLARRIAGE OFFICER
RECORDS MAiqAGEMENT OFFICER
FREEDOM OF INFORMAT. I .QN_OF~FICER
OFFICE OF THE TOWN CI,I~,RK
TOWN OF SOUTHOLD
Town Hail, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fox (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
TO: .....i:~'- ~3t~/~th~°lttT~wn-BUi 1 din g--------- Department
FROM:
Linda J. Cooper, Southold Town Clerk's Office
DATED: February 18, 2004
Transmitted herewith is a copy of application No. 3283
Permit submitted by:
for a Cesspool/Septic Tank ALTERATION
Peconic Cesspool for Anthony Pranzo and Kenneth Hand
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.
I have reviewed the application and loc~on map of the project cited above and make the following
reconunendations: r ~
.APPROVE ~
DISAPPROVE
Comments: Maintain required setbacks from adjacent wells, buildings, property lines and water
Bodies. EXCAVATION INSPECTION REOUIRED.
Dated
O~lCg OF Tfl~ 'fOWN
P~ J~ A. N~V~ ~ .~ TOWN ~
P.O. BOX J 179
SO~O~, ~W YO~ 11971
Telephone
(63t) 765-1800
Application No,~'~'~ ·
Construction _-~_~
Alteration~/
$10,00 -Residential
$25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee '$
APPLICANT NAME:
APPLICANT ADDRESS: '
SEPTIC CESSPOOL
DATE
PE~ONIC CESSPOOL
P. O. BOX 972
MATTITUCK, NEW YORK 11952'
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALT~ERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
.OWNER OF PROPERTY: ~.~/~/l~f~.~_-¢_~/~_~,. A~A/J/F--7~
OWNER MAILING ADDRESS: /~ ~ C6'~/~r
OWNER PROPERTY ADDRESS: ~c~-~
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO.: sectior/~)~Tttg(9 Block
CROSS STREET: ~
BUILDING PERMIT NUMBER GROSS REFERENCE:
Lot _/'~/~7',. ~t:~ ~
RECEIVED BY:
DATE:
Town Clerk's Office