HomeMy WebLinkAboutGilles, Matt 'ELIZABETH A.NEVILLE �,``Z` *��` Town Hall, 53095 Main Road
TOWN CLERK ti - P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
# Fax (516) 765-1823
MARRIAGE OFFICER * �,
RECORDS MANAGEMENT OFFICE %R! ��0��1I 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. 1818 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL
Address 1 : 2760 YENNECOTT DRIVE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITION OF CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM WELLS,
BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION
REQUIRED.
Name Of Owner GILLES, MATT
Mailing Address 1 29925 MAIN ROAD
City St Zip CUTCHOGUE NY 11935
Property Address 1 29925 MAIN ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 102.00 block 2 lot 15.000
Cross Street PEQUASH AVENUE
Building Permit Number Cross Reference:
Issue Date: 3/13/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
ow OW, / V /Aou
ELIZABETH A.NEVILLE • `1` yam►; Town Hall, 53095 Main Road
TOWN CLERK i P.O. Box 1179
y Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS �� Fax (516) 765-1823
MARRIAGE OFFICER 'N * Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER �Ql ‘f).1
FREEDOM OF INFORMATION OFFICER •'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department �v , 1c vYi/
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: March 4, 1998 0/ 11177''
Transmitted herewith is a copy of application No. 1892 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Matt Gilles
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.
iignatu
3 /1 '3 (9 4
Date
'
OFFICE OF THE TOWN CLERK• �' Vgth'
TOWN OF SOUTHOLD
' Q Application No.0
ELIZABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 Construction
SOUTHOLD,NEW YORK 11971
Alteration !/
Telephone `��j'
$10.00 - Residential
61
(516) 765-1801 '
��' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE
APPLICANT NAME: /ZD, S �,0-0d0c:te've
APPLICANT ADDRESS: 2 ' d )4C/I1//12:�o1`t 1°,(
s t,“,ed AY.
SEPTIC CESSPOOL
DESCRIPTION OF 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: /Oar ,Z71-e--0
OWNER MAILING ADDRESS: 2�; 92c ,i7*,
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: O 7 5"--
TAX
[TAX MAP NO. : Section (' Z Block 2 Lot /$
CROSS STREET: (:-11`e "
BUILDING PERMIT NUMBER CROSS REFERENCE:
oSId-1
Signature of Applicant
RECEIVED BY:
E'(! erk's Office
DATE: 10995
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