HomeMy WebLinkAboutGilbert, Edgar CO -
ELIZABETH A.NEVILLE 'h`1` y Town Hall, 53095 Main Road
TOWNd
TOWN •
P.O.P.O. Box 1179
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Southold, New York 11971
REGISTRAR OF VITAL STATISTICS 471 Fax (516) 765-1823
MARRIAGE OFFICER : 1i
RECORDS MANAGEMENT OFFICER : � ��0 0� Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER - ������
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1898 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
REPLACE OLD CESSPOOL WITH NEW TYPE, FILL OLD WITH SAND.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM WELLS,
BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION
REQUIRED.
Name Of Owner GILBERT, EDGAR
Mailing Address 1 30 KNOLLWOOD ROAD
City St Zip WHIPPANY NJ 7981
Property Address 1 175 GLENWOOD ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. sectio 1�- e- block 4 lot 10.000
Cross Street PEQUASH AVENUE
Building Permit Number Cross Reference:
Issue Date: 7/10/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE P#$ y���` Town Hall, 53095 Main Road
TOWN CLERK ; y , P.O. Box 1179
• Z Southold, New York 11971
•
REGISTRAR OF VITAL STATISTICS4.7 Fax (516) 765-1823
MARRIAGE OFFICER � tfr ����'�� Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER �� a�
••... •
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: July 1, 1998
Transmitted herewith is a copy of application No. 1972 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Edgar Gilbert
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.
4.eyyt_ae-oc-i
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following ecommendation:
APPROVE -
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
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Date
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OFFICE OF THE TOWN •CLERK ,s" '''".,• / 7
Town of Southold �iii,c4VOtk '
Judith T. Terry, _ Application No.
y Town Clerk ��'� 0 Gy,
Town Hall, 53095 Main Road �' Construction ---v'
P. O. Box 11791-...
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Southold, New York 11971 ,tn ��,� Alteration (�/_i
Telephone =y0,��o �����'4 $10.00 - Residential 4_--
(516) 765-1801 - l 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 I 1 p
APPLICANT NAME: ,,�
APPLICANT ADDRESS: ".'D / 97z_._
SEPTIC CESSPOOL lig
DESCRIPTION PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION :
OWNER OF PROPERTY :_____ _ �/ZZ,_J24•2---
OWNER MAILING ADDRESS: \J . 'fit/#44.)-1-12e,/�' iyam+
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OWNER PROPERTY ADDRESS: 7 Lre4__
. eeicie_44,742_,4________ _______
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section /16 Block y Lot /dGilikS
S STREET : Ifr.. ..eit_a - _ -- — -
BUILDING PERMIT NUMBER CROSS REFERENCE:
L
Ci'_r.11'-71-.-,th'I'l(-4/ignature of Applic
RECEIVED BY :
Town Clerk's OfficeDATE:
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