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HomeMy WebLinkAboutMattituck Sanitation 00 ` 111oeloVfFOLit 1� 4% ` y<` JUDITH T.TERRY ,� o Town Hall, 53095 Main Road TOWN CLERK vs x P.O. Box 1179 REGISTRAR OF VITAL STATISTICS 1 111 Southold,New York 11971 MARRIAGE OFFICER Fax(516)765-1823 RECORDS MANAGEMENT OFFICER . 4f ���� _ X1111 Telephone(516)765-1800 - 1 �` FREEDOM OF INFORMATION OFFICER - , ,•s. OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 57 N Residential Non-Residential X Fee $ 25.00 Septic Cesspool X PERMIT ISSUED TO: Name : PECONIC 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 OF CESSPOOL APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION REQUIRED. Name Of Owner MATTITUCK SANITATION Mailing Address 1 P. O. DRAWER 1402 City St Zip MATTITUCK NY 11952 Property Address 1 800 WICKHAM AVENUE City St Zip MATTITUCK NY 11952 Tax Map No. section 140.00 block 2 lot 30.000 Cross Street HILL STREET Building Permit Number Cross Reference: Issue Date: 3/28/95 Judith T. Terry Southold Town Clerk (TOWN SEAL) ,,, c6 &uC ( s /el l 07) CC- , 0004 JUDITH T.TERRY x,10 Town Hall, 53095 Main Road TOWN CLERK y Z P.O.Box 1179 0 ,�� Southold,New York 11971 REGISTRAR OF VITAL STATISTICS 1 Fax(516)765-1823 MARRIAGE OFFICER y� aO�iol RECORDS MANAGEMENT OFFICER c �.� `�►isiI Telephone(516)765-1800 FREEDOM OF INFORMATION OFFICER �� ,•��� 7,, l L' 6 OFFICE OF THE TOWN CLERK ' TOWN OF SOUTHOLD TO: Southold Town Building Department MAR ` FROM: Linda Cooper, Southold Town Clerk's Office DATED: March 27, 1995 Transmitted herewith is a copy of application No. 1357 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. u '�cuL Linda J. Cooper * * * * * * * * * * * * * I have reviewed the application and location map of the project listed above and make the followin commendation: APPROVE - DISAPPROVE - COMMENTS: Maintain required setbacks from adjacent wells, buildings, property lines and water bodies. EXCAVATION INSPECTION REQUIRED. yiee,;„ Signature Dat ( ,FICEF THE TOWN CLERK ��'""""' Town of Southold Application No./3_17 Town Clerk Judith T. Terry, Town Hall, 53095 Main Road _ Construction P. 0. Box 1179 Alteration Southold, New York 11971 ' Telephone 0," �40-/ $10.00 - Residential , i (516) 765-1801 1 , $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 $ DATE 3/ 3/e/--S APPLICANT NAME: / ge,-1', -1— 2�--}-- APPLICANT ADDRESS: '. 0 / --9 7L.__.. SEPTIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION i. A .r LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION : OWNER OF PROPERTY: /ice w<j-1. OWNER MAILING ADDRESS: '8?rd �:,G. /I✓�-+--� lli1�`.." 1)4 C, /;�/L-t'--*.t..�-- -- / Se. ir OWNER PROPERTY ADDRESS: 0�� d! .c-. t �" ` Y 1/ 13 z TELEPHONE NUMBER OF CONTACT PERSON: TAX MAP NO. : Section /. YLC) Block 2— Lot 4) CROSS STREET: Z e-- . BUILDING PERMIT NUMBER CROSS REFERENCE: %/4// ' Ap P SiJ y���nat e olicant RECEIVED BY: a setIV /D Town Clerk's Office DATE: ma 2 4 W95 S9ytfeld Town Clerk ['• F' , .........-....... 0( 0------ ' =-1 p4A.4A,A.1 n fri_ ----- . I C--------- i ,.. I 1 ( [ I i I I i i i-7 i i i • 1 t; - -