The URL can be used to link to this page

Home My WebLink AboutRichards, James A pF SO(/j�ol ELIZABETH A.NEVILLE,RMC, CMC O Town Hall, 53095 Main Road TOWN CLERK J P.O.Box 1179 REGISTRAR.OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER • �� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICERTelephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER �COU v,��' southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 3869 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : COASTLINE CESSPOOL & DRAIN SVC Address 1: 4225 BRIDGE LANE City St Zip CUTCHOGUE NY 11935 Descripton of Proposed Construction or Alteration ADDITION TO EXISTING SYSTEM. APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION REQUIRED. EXCAVATION INSPECTION REQUIRED Name Of Owner JAMES RICHARDS ------------------------------ Mailing Address 1 P O BOX 395 ------------------------------ ------------------------------ City St Zip MATTITUCK NY 11952 -------------------- -- ---------- Property Address 1 540 TERRY PATH ------------------------------ ------------------------------ City St Zip MATTITUCK NY 11952 -------------------- -- ---------- Tax Map No. section 123.00 block 6 lot 19.000 ------ --- ------ Cross Street OLE JULE LANE ------------------------------ Building Permit Number Cross Reference: ---------------------------------- Issue Date: 7/15/09 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) SOUryo ELIZABETH A.NEVILLE,RMC,CMC h0 l0 Town Hall, 53095 Main Road TOWN CLERK l l P.O.Box 1179 REGISTRAR.OF VITAL STATISTICS Southold, New York 11971 G MARRIAGE OFFICER app Fax(631) 765-6145 �► RECORDS MANAGEMENT OFFICERTelephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER �CDUIV I�e� southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD E ((� D TO: Southold Town Building Department APR 16 2009 FROM: Carol Hydell, Southold Town Clerk's Office MG.DEPT. TOWN OF SOUTHOLO DATED: April 15, 2009 Transmitted herewith is a copy of application No. 3869 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Coastline Cesspool for James Richards 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. Carol Hydell I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE DISAPPROVE Comments: Maintain required setbacks from adjacent wells,buildings,property lines and water Bodies. EXCAVATION INSPECTION REQUIRED. Signature �v e Dated ' oVFO��O ELIZABETH A.NEVILLE h`t` G.y Town Hall, 53095 Main Road TOWN CLERK p P.O.Box 1179 ti 2 Southold, New York 11971 REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER • Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER y�fol �aO� 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. 3 0 0 Permit No. Applicant Name eoa sr� -1 l yy S"J o . Applicant Mailing Address -y�af� 6 E-i cAQ e_ �_a cy— C_t_DA_cl�C- 1 NQa�� Septic Tank or Cesspool_ Brief Description of Proposed Construction or Alteration 3YlSA-Q \\ +t--, a,(nci-e . ki Location of Proposed Construction/Alteration: Owner of Property: ��S R�C-Y�a-c-_ Owner Mailing Address: 'P(� ��)G "-�q5 Owner Property Address: Name and phone number of contact person eq Tax Map No: Section Block Lot _ Cross Street (':)\--- 7)s-n2. �_&C)atT rf)a 1 Nk-YUC_ NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES -R�JEY WITH HEALTH DEPARTMENT APPROVAL ''-Signature of Applicant Date Received by: C41 ��: ''::- ^•-,,in,'G�- i,� � • � � � - .. ,r�� K „�,r ., .,t;'^`v"'i" _<7 L<•: rC M1�M_.� , �, -_�� - _. - ,' `- : - -_..''.•�' ._ a: �� ,- 4�*'' - _ -��-�U�i�/I�7r�is :- - - _ ' � �jj (y'i. pp:�,,}ice' •�`E � ', �' _ •2 _"_�+-::- �_. _' � ! -^-of - - - = � -��- _' - - - - - 'f� -��;� �✓` ;,; +,;�t=�.::..� .fix `fir . . -