HomeMy WebLinkAboutMattituck Fire Dept OL
JUDITH T. TERRY � yL ; Town Hall, 53095 Main Road
TOWN CLERK : v T • P.O. Box 1179
tri Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = VO r ,p Fax (516) 765-1823
MARRIAGE OFFICER �0 •" Fax
(516) 765-1801
RECORDS MANAGEMENT OFFICER -'V,1 41 IP°.
FREEDOM OF INFORMATION OFFICER iiii,,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 47 N Residential Non-Residential X
Fee $ 25.00 Septic X Cesspool
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
ADDITION OF A NEW OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APRROVED AS SUBMITTED. MAINTAIN REQURIED SETBACKS FROM ADJACENT WELLS
BUILDINGS, AND PROPERTY LINE. PROVIDE MANHOLE AND COVER AS REQUIRED
BY SCHD FOR LOCATION. EXCAVATION INSPECTION REQUIRED.
Name Of Owner MATTITUCK FIRE DEPARTMENT
Mailing Address 1 PIKE STREET
City St Zip MATTITUCK NY 11952
Property Address 1 PIKE STREET
City St Zip MATTITUCK NY 11952
Tax Map No. section 140.00 block 3 lot VVt /l e
Cross Street WICKHAM AVENUE
Building Permit Number Cross Reference:
Issue Date: 4/19/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY :: ..... Town Hall, 53095 Main Road
TOWN CLERK z G T P.O. Box 1179
REGISTRAR OF VITAL STATISTICS to Southold, New York 11971
MARRIAGE OFFICER V. O�' 'l� Fax (516) 765 1823
=_'I�i,1 �1D �s� Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK „ '`
TOWN OF SOUTHOLD -‘t '
TO: Southold Town Building Department �
FROM: Linda Cooper, Southold Town Clerk's Office �trit, s
DATED: April 12, 1994 ..
(o
Transmitted herewith is a copy of application No. A1154 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Mattituck Fire Dept.
•
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.
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - /' EXCAVATION INSPECTION
• . REQUIRED
DISAPPROVE -
V /
COMMENTS: i_ ,,. .��i a_'.- _�,, ..... A`_�
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MOVED -� � . ,
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APR 1 8 1994 ��� ---r
Ton Clerk 6ouWold Date
OFFICE OF THE TOWN CLERK ,,,,,,,,,,,- -- _
Town of Southold , s's' ���FD�KCO Application No. �/3
Judith T. Terry, Town Clerk � Gy
Town Hall, 53095 Main Road . � ; Construction
P. O. Box 1179 'c
=v I-711 Alteration
Southold, New York 11971 ;i
Telephone 40- $10.00 - R- _• .entia
(516) 765-1801 = °1 * ' , ' $25.00 -Non-Residential £
•
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE
APPLICANT NAME:
f �
APPLICANT ADDRESS:
SEPTIC CESSPOOL
DESC' ' ON OF PROPOS . D CONSTRUCTION OR ALTERATION
°IF; ; - i
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION;
OWNER OF PROPERTY:
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section i ,'7/ Block Lot 7
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant d
RECEIVED BY: de
Town lerk!s Office
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