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HomeMy WebLinkAboutO'Neill, Tom �,O��g�FFO(��o JUDITH T.TERRY Town Hall, 53095 Main Road TOWN CLERK ; y i P.O. Box 1179 rr1 $ Southold, New York 11971 REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER \yif' 0� 1�, Fax (516) 765-1823 RECORDS MANAGEMENT OFFICER �l ��•�� 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. 1450 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 A 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 O'N E I LL, TOM Mailing Address 1 2470 SIGSBEE ROAD City St Zip MATTITUCK NY 1952 Property Address 1 2470 SIGSBEE ROAD City St Zip MATTITUCK NY 11952 Tax Map No. section 144.00 block 1 lot 22.000 Cross Street PECONIC BAY BLVD. Building Permit Number Cross Reference: Issue Date: 4/09/96 Judith T. Terry Southold Town Clerk (TOWN SEAL) •,#Of 11[11 j 014- 0° 0.• COGy, `� JUDITH T.TERRY �� _ Town Hall, 53095 Main Road TOWN CLERK ; y Z P.O. Box 1179 REGISTRAR OF VITAL STATISTICS O 1�, Southold, New York 11971 MARRIAGE OFFICER : y ' Fax (516) 765-1823 RECORDS MANAGEMENT OFFICER �� Q��1� �1 `t►� �� Telephone (516) 765-1800 FREEDOM OF INFORMATION OFFICER ����,,,•••//I, OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda Cooper, Southold Town Clerk's Office DATED: March 21 , 1996 Transmitted herewith is a copy of application No. 1509 for an ALTERATION PERMIT for a cesspool or septic system submitted by Peconic Cesspool for Tom 0' Neill • 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 - f/ DISAPPROVE - COMMENTS: Maintain required setbacks from adjacent wells, buildings, property lines and water bodies. EXCAVATION INSPECTION REQUIRED. RECEIVED 49 �-� APR 9 1996 signatu (A'AC. Town Clerk Southold Dat OFFICE OF THE TOWN CLERK ,,,-""' Towr. of Southold5.014 UL/r .•-_ Judith T. Terry, Town Clerk ;'' cl/y=. Application No. Town Hall, 53095 Main Road ;'s"'" Construction P. O. Box 1179 Southold, New York 11971 s� W Alteration Telephone O,y,4, ���'o! ,` $10.00 - Residential 1� (516) 765-1801 _ Ol44 �� • � $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 3/2.0(9 APPLICANT NAME: / APPLICANT ADDRESS: ,4 d SEPTIC CESSPOOL C� 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: OWNER MAILING ADDRESS: a5L71.) - y /11 OWNER PROPERTY ADDRESS: TELEPHONE NUMBER OF CONTACT PERSON: x©191 TAX MAP NO. : Section /`/IY Block / Lot CROSS STREET : ..how BUILDING PERMIT NUMBER CROSS REFERENCE: .41 Signatur- of Applican, RECEIVED BY: Town Clerk's Office DATE: /1,f / c • . a • 61P2-46— oIe Le65p6-1-4 L.� 5.,e>yArze- „,14