HomeMy WebLinkAboutDaly, Matthew ow iii
,o�OS�FFO�,r
.
G
JUDITH T.TERRY ���_� 'yam Town Hall, 53095 Main Road
TOWN CLERK ; N • P.O. Box 1179
•REGISTRAR OF VITAL STATISTICS O
,� Southold, New York 11971
MARRIAGE OFFICER `�y� 0����' Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER : 49/ 11g *toe 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. 1652 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 CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS
BUILDINGS, PROPERTY LINES, AND WATER BODIES. EXCAVATION INSPECTION
REQUIRED.
Name Of Owner DALY, MATTHEW
Mailing Address 1 P. O. BOX 762
City St Zip MATTITUCK NY 11952
Property Address 1 2505 DEEP HOLE DRIVE
City St Zip MATTITUCK NY 11952
Tax Map No. section 115.00 block 14 lot 12.000
Cross Street THERESA DRIVE
Building Permit Number Cross Reference:
Issue Date: 4/30/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
- .
....- - ,.„ /16,._,, ,,,L,
p�� alp' l
1 a Town Hall, 53095 Main Road
•j ve O� i P.O. Box 1179
,1'1,' __1 ��_ Southold, New York 11971
JUDITH T.TERRY `•%.„�--.- TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD@"',;
TO: Southold Town Building Department , JU Prl
FROM: Linda Cooper, Southold Town Clerk's Office APR 2 2 1897
DATED: April 21, 1997
Transmitted herewith is a copy of application No. 1723 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Matthew Daly .
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 - i/
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
RECEIVED
APR 2 91997 Si natu�i7
S" OId Town Clerk Dat
OFFICE OF THE TOWN CLERK ,,,' -•. l
Town of Southold �,�' „FFDtkc No./ 1013
Judith T. Terry, Town Clerk ,�' � Ol/� Application No.
Town Hall, 53095 Main Road Z Construction
P. O. Box 1179 ; a ,T,
Southold, New York 11971
r , Alteration
Telephone ,�'�Q �� ' , $10.00 - Residential
(516) 765-1801 - 0.
$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/97
APPLICANT NAME:
APPLICANT ADDRESS: 'd 977-SEPTIC CESSPOOL .—
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
/ / g.1 - / -
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 9-101. �L?tii'
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS: 2"5O S— fl
TELEPHONE NUMBER OF CONTACT PERSON: mak, 9s
TAX MAP NO. : Section /Lc Block / 4" Lot 7�
CFFO3S STREET : di
BUILDING PERMIT NUMBER CROSS REFERENCE:
RECEIVED X
Signat of Applicant
RECEIVED BY: APR 21 1997
Town •Clerk's Office
DATE: Southold Town Clerk
4 `
0
.44 '114;7
024
ivts44-t.
sluvoi
D6t5p hole (