HomeMy WebLinkAboutKreiling, George #,II/i
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JUDITH T.TERRY �� � y1 Town Hall, 53095 Main Road
TOWN CLERK ` y Z $ P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER '-?/� � �1 Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER - �l * `�a,��� 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. 1499 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, PROPERTY LINES AND WATER BODIES. EXCAVATION
INSPECTION REQUIRED. MAINTAIN REQUIRED HEIGHT ABOVE GROUNDWATER.
Name Of Owner KREILING, GEORGE
Mailing Address 1 LUPTON'S POINT
City St Zip MATTITUCK NY 11952
Property Address 1 P. O. BOX 757
City St Zip MATTITUCK NY 11952
Tax Map No. section 115.00 block 11 lot 5.000
Cross Street MARRATOOKA ROAD
Building Permit Number Cross Reference:
Issue Date: 6/28/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
,segVFFO(�io
,� may',
JUDITH T.TERRY .o L Town Hall, 53095 Main Road
TOWN CLERK ; y i P.O. Box 1179
� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
�• �1� Fax (516) 765-1823
MARRIAGE OFFICER �j0 *006 Telephone Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER 1 �` �
,
FREEDOM OF INFORMATION OFFICER ���„ .0011° -
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OFFICE OF THE TOWN CLERK - /4
TOWN OF SOUTHOLD \�
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: June 21 , 1996
Transmitted herewith is a copy of application No. 1564 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for George Kreilinq
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 an•+ water bodies. EXCAVATION INSPECTION
R E,U I R E D. A60,11._,, r _��
Signature
1V2-834
Date
OFFICE OF THE TOWN CLERK ,�''
� '.,,,,,,,•-
Town o1 Southold ''l, �F �KC
f� - C(C C/1
Judith T. Terry, Town Clerk ,e�� �l/y Application No.
Town Hall, 53095 Main Road ;iConstruction L—
P. O. Box 1179 . = rn ; Alteration
Southold, New York 11971 ��
Tele hone ..:...02b.
y0 O�.,i, $10.00 - Residential /-`-
P 'b
(516) 765-1801 �'y01 * ';, ' $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 44A 014 ---_---
APPLICANT NAME: -ife--0-21.0"� ' / 1 ii'
i
A
APPLICANT ADDRESS: �/ 4 . ..... 7
Ail, te` I // --
SEPTIC CESSPOOL 1/.
DESCRIPTION OF PROPOSED CONSTRUCTION OR A TERATION
- 17 °-'-INd '
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY : - f
OWNER MAILING ADDRESS: 1 A /
7. 7 '
OWNER PROPERTY ADDRESS: /? A' . // 1-2--
_
TELEPHONE NUMBER OF CONTACT PERSON:` dark= 44, 3f
TAX MAP NO. : Section ll Block /7 Lot .c.---
CROSS STREET: ."37�-t.�r.,. 4 ,„ -- _.E5+(
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of A ca t —
RECEIVED BY :
r ��,,R
Townr�c ffice
DATE: %;LIIV 2 L1996_ __
Lawn Clerk Southold
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