HomeMy WebLinkAboutDiVello, John r a
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JUDITH T. TERRY :,
Town Hall, 53095 Main Road
TOWN CLERK : o T P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = VO �. Fax (516) 765-1823
MARRIAGE OFFICER .,`' �O �� Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER = of * Il
FREEDOM OF INFORMATION OFFICER �� d���,��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 49 N Residential Non-Residential X
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PECON I C CESSPOOL
Address 1 : P. O. BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
REPLACE OLD CESSPOOL WITH NEW TYPE & ADD OVERFLOW TO EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS
BUILDINGS, PROPERTY LINES, WATER BODIES AND MINIMUM OF 2' ABOVE
GROUND WATER. EXCAVATION INSPECTION REQUIRED.
Name Of Owner DIVELLO, JOHN
Mailing Address 1 MATTITUCK SANITATION
P. O. DRAWER 1402
City St Zip MATTITUCK NY 11952
Property Address 1 305 WICKHAM AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 140.00 block 2 lot 30.000
Cross Street PIKE STREET
Building Permit Number Cross Reference:
Issue Date: 5/26/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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o oc��FFO(KcQGy_
JUDITH T. TERRY ; Z Town Hall, 53095 Main Road
TOWN CLERK z 0 T P.O. BOX 1179,
REGISTRAR OF VITAL STATISTICS VI • � Southold, New York 11971
MARRIAGE OFFICER _ �Q OI' ��, Fax (516) 765-1823
_ 401 4 *1D e. Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK ' E i W r
TOWN OF SOUTHOLD
TO: Southold Town Building Department 20 9
i
FROM: Linda Cooper, Southold Town Clerk's Office r: . DER- —
DATED: May 20, 1994 - ' OF SO'
•
Transmitted herewith is a copy of application No. A1182 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Mattituck Sanitation
•
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 this office.
Thank you.
44--1c-d-
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - DICAVAT1ON INSPECTION
DISAPPROVE - RRED
COMMENTS: no � , j 4 i 7
/ i'�C :1--eZ
71-- dr--Jet./ AtLeZi cgoi
irl'--/714 143 1 ''‘) '
61kelf tdet% --49-a-1
RECEIVED 2....- a , ''''
MAY 2 6 1994 Signature
Town Clerk Souk
Date
,
Y
OFFICE OF THE TOWN CLERK "''--
Town of Southold ,,�'O�j�FFO�K`'OG Application No.`(////
�~
Judith T. Terry, Town Clerk 4,
Town Hall, 53095 Main Road ;� Construction L�
P. 0. Box 1179 ; c t" Alteration
Southold, New York 11971 Vs �
Telephone $10.00 - Residential
(516) 765-1801 ��ljilt
$1) $10.00
$25.00 - Non-Residential c/
,,,,,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 57/1
APPLICANT NAME: /� v
APPLICANT ADDRESS: /`%/ 4171 97 L
-- -7-4 2! S%' //y
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
ei ' 4r i '
•
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR A TE AT JON• _
OWNER OF PROPERTY: ' /0 0 -C-C-
OWNER MAILING ADDRESS: / z /9e L
OWNER PROPERTY ADDRESS: S
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section / 416 Block Lot 3
CROSS STREET: //2,(a, "ifica
BUILDING PERMIT NUMBER CROSS REFERENCE:
/ 4-7
Signature of Applican '
RECEIVED BY:
Town Clerk's Office
DATE:
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