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Home My WebLink AboutMagill SO!/ryo ELIZABETH A.NEVILLE ,`O l0 Town Hall, 53095 Main Road TOWN CLERK P.O.Box 1179 REGISTRAR OF VITAL STATISTICS N �t Southold, New York 11971 MARRIAGE OFFICER G Q Fax(631) 765-6145 RECORDS FREEDOM OF MANAGEMENT ION OFFICER �OI�CQU ,� � s utho dtowTelephone n nor hfork.31) n et OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 3589 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : PECONIC CESSPOOL Address 1: PO BOX 972 City St Zip MATTITUCK NY 11952 Descripton of Proposed Construction or Alteration -ADDING ADDITIONAL OVERFLOW TO EXISTING SYSTEM -MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES Name Of Owner RICHARD & LAURA MAGILL ------------------------------ Mailing Address 1 345 BRAY AVENUE ------------------------------ ------------------------------ City St Zip LAUREL NY 11948 -------------------- -- ---------- Property Address 1 SAME AS ABOVE ------------------------------ ------------------------------ City St Zip 0000 -------------------- -- ---------- Tax Map No. section 126.00 block 2 lot 1.400 ------ --- ------ Cross Street MAIN ROAD ------------------------------ Building Permit Number Cross Reference: ---------------------------------- Issue Date: 10/26/07 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) �pF SO(/jy ELIZABETH A.NEVILLE �O� Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold,New York 11971 MARRIAGE OFFICER Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER �Q Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER �li�"Irouff southoldtown.northfork:net i OFFICE OF THE TOWN CLERK s-,;' �;n- — TOWN OF SOUTHOLD i Y V 3 2007 r _S'o hol Town Building Department FROM: Michelle L. Martocchia, Southold Town Clerk's Office DATED: October 1, 2007 RE: Cesspool Construction/Alteration Application Transmitted herewith is a copy of application No. 3747 for a Cesspool/Septic Tank Construction/Alteration Permit submitted by: Peconic Cesspool for Richard & Laura Magill 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 4� DISAPPROVE Comments: , t Signature /0/0 o Dated �'� G'y own Hall, 53095 Main Road ELIZABETH A.NEVILLE T TOWN CLERK o P.O.Box 1179 C* Southold,New.York 11971 REGISTRAR OF VITAL STATISTICS �y► MARRIAGE OFFICER Gy • O�� Fax(631) 765-6145 1) 6 5-1 RECORDS MANAGEMENT OFFICER �IJOl �a Telephone n.no th fork 00 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 'V or Non-Residential @$25 Application N4aq-7 Permit No. , Applicant Name PECONIC CESSPOOL Applicant Mailing Address P. O. BOX 972 MATTITUCK, NEW YORK 11952 Septic Tank or Cesspool /A--*" - Brief Description of Proposed Construction or,Alteration Location of Proposed Construction/Alteration: Owner of Property: Owner Mailing Address: S� 6 d44 J7 yk Owner Property Address: '7 k S' /3-Z4 �v 3 Name and phone number of contact person ) ®► 9�� GS'� Tax Map No: Section / o"2!v Block Lot w Cross Street / -�- NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY H-HEALTH DEPARTMENT APPROVAL" Signature of Applicant U Date Received by: (-D� RICHARD & LAURA MAGILL 4 LAUREL $ f€ C h l x Ar 4 0 r ib-AL,