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ELIZABETH A.NEVII.LE
c - Town Hall, 53095 Main Road
TOWN CLERK y Z P.O. Box 1179
�1� Southold,New York 11971
REGISTRAR OF VITAL STATISTICS �� y ����� Fax(516) 765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER Ol �a,d• Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER "" -'i�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 83 N Residential Non-Residential X
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 WELLS,
BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION
REQUIRED.
Name Of Owner INTERREAL N.Y. LAND III L.P.
Mailing Address 1 NEW SUFFOLK SHIPYARD
NEW SUFFOLK ROAD
City St Zip NEW SUFFOLK NY 11956
Property Address 1 6775 NEW SUFFOLK ROAD
City St Zip NEW SUFFOLK NY 11956
Tax Map No. section 117.00 block 5 lot 29.001
Cross Street FANNING ROAD
Building Permit Number Cross Reference:
Issue Date:6 /17/98 Elizabeth A. Neville
ylz�ltiy Southold Town Clerk
(TOWN SEAL)
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kLIZABTH A.NEVILLE t',f t; Town Hall, 53095 Main Road
TOWN CLERK y :'� , P.O. Box 1179
2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS v'
Fax (516) 765-1823
MARRIAGE OFFICER :` y' **oil
�1 Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER O( ** l�
FREEDOM OF INFORMATION OFFICER
aro
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: August 12, 1998
Transmitted herewith is a copy of application No. NR 1992 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for New Suffolk Shipyard
•
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.
S' natu
Date
OFFICE OF THE TOWN .CLERK ,,'",
Tow ��
Town of Southold �' �FFD�K�'
�'J DI' Application No./_
Judith T. Terry, Town Clerk ' Gym L
Town Hall, 53095 Main Road ;� • Construction
P. O. Box 1179 : v rn ; Alteration
Southold, New York 11971 ��
Telephone =04„. �� .�'' $10.00 - Residential
(516) 765-1801 1 4 , ' $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
igh,EC
DATE
APPLICANT NAME: ✓r/tf
eb.„414/114/
APPLICANT ADDRESS:
SEPTIC CESSPOOL`
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: /
OWNER OF PROPERTY:��A /1 4/19
OWNER MAILING ADDRESS: 6775 . _
OWNER PROPERTY ADDRESS: 4 ,,GL(e/ /_�� _. ;�-
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section /I7 Block S Lot Z �• 96 /
CR8SS STREET :
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Appl' nt
•
RECEIVED
RECEIVED BY :
Town466erik s lighice
DATE:
Southold Town CLerk
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