The URL can be used to link to this page

Home My WebLink AboutCribben, Thomas / ow iii oII JUDITH T.TERRY �I_� Gyle Town Hall, 53095 Main Road TOWN CLERK ; y i P.O. Box 1179 P 1 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS O Fax(516) 765-1823 MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER 91 *;s' Telephone (516) 765-1800 FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1538 R Residential X Non-Residential Fee $ 10.00 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 ADDITION OF AN OVERFLOW TO AN EXISTING SYSTEM. APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS BUILDINGS, AND PROPERTY LINES. EXCAVATION INSPECTION REQUIRED. Name Of Owner CRIBBEN, THOMAS Mailing Address 1 256 CLINTON AVENUE City St Zip BROOKLYN NY 11205 Property Address 1 175 SECOND STREET City St Zip LAUREL NY 11948 Tax Map No. section 126.00 block 10 lot 2.000 Cross Street BRAY AVENUE Building Permit Number Cross Reference: Issue Date: 9/16/96 Judith T. Terry Southold Town Clerk (TOWN SEAL) I��I�OS�FF��/f'CO ` / S G1 JUDITH T.TERRY � �� y1 Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 �a- �I Southold, New York 11971 REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER �y* 0'1, Fax (516) 765-1823 RECORDS MANAGEMENT OFFICER ! 4 `000' Telephone (516) 765-1800 FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda Cooper, Southold Town Clerk's Office DATED: September 5, 1996 Transmitted herewith is a copy of application No. 1604 for an ALTERATION PERMIT for a cesspool or septic system submitted by Peconic Cesspool for Thomas Cribben 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 - DISAPPROVE - COMMENTS: Maintain required setbacks from adjacent wells, buildings, property lines and water bodies. EXCAVATION INSPECTION REQUIRED. - f Signature Date • 1 OFFICE OF THE TOWN CLERK ,,,, ,,, Town of Southold %. c,�vFE� 6 0 Application No. b Y Judith T. Terry, Town Clerk Gy Town Hall, 53095 Main Road ; Construction P. 0. Box 1179 Southold, New York 11971 to yc Alteration Telephone syO,est � �i' $10.00 - Residential L- (516) 765-1801 y�l $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 f/ APPLICANT NAME: ,,��2%� L� 41-419--frit" APPLICANT ADDRESS: Ai 6/26 972_ SEPTIC CESSPOOL l.'s"— DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION MAj4 , LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSf�CTIO R ALTERATION: OWNER OF PROPERTY: OWNER MAILING ADDRESS:.S a41---1-- /314 . 7/ )- a �-- OWNER PROPERTY ADDRESS: / 7 5" Z TELEPHONE NUMBER OF CONTACT PERSON: psre--Q.G' TAX MAP NO. : Section /24, Block /0 Lot • CROSS STREET: /1) 2 BUILDING PERMIT NUMBER CROSS REFERENCE: /6.(dk Signatu of Applicant RECEIVED BY: Town Clerk's Office DATE: VA Ai I g� efit r ON' --z9 • w.I( 6 734A1