HomeMy WebLinkAboutPignota, John 1 ilii
,I ,o�OStF FOL,�-cO
G`
JUDITH T.TERRY ���� yt Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
��
MARRIAGE OFFICER \ Southold, New York 11971
REGISTRAR OF VITAL STATISTICS O . 1�
41 �1 Fax (516) 765-1823
�
RECORDS MANAGEMENT OFFICER 49 _s..4711
1 'j ,d� 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. 1485 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
ADDITON 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.
Name Of Owner PIGNOTA, JOHN
Mailing Address 1 2405 MARRATOOKA ROAD
City St Zip MATTITUCK NY 11952
Property Address 1 21405 MARRATOOKA ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 123.00 block 2 lot 6.000
Cross Street CENTER STREET
Building Permit Number Cross Reference:
Issue Date: 5/214/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
• ....
#10 oFFO(,t •
JUDITH T.TERRYTown Hall, 53095 Main Road
TOWN CLERK y Z P.O.Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER `y ��+'1�� Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER •. �l 4 *Psi" Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER 44w.w, ,•��
r
OFFICE OF THE TOWN CLERK D U tS
TOWN OF SOUTHOLD
" MAY 2 1 1996 >!
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office BLDG.DEPT. a
TOWN OF SOIJTHOLD j
DATED: May 21, 1996
Transmitted herewith is a copy of application No. A1547 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
PECONIC CESSPOOL FOR JOHN PIGNOTA
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 - C '
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
Signatur: ,,
it
Date
•
OFFICE OF THE TOWN' CLERK ,tt
Town of Southold ���' c��FFIKI' '�'
Judith T. Terry, Dy Application No. V 7
Town Clerk �' � G �� ,/
Town Hall, 53095 Main Road ; Construction
P. O. Box 1179 : v ac Alteration
Southold, New York 11971 to
Telephone `y�,��0 0/ $10.00$10.00 - ResidentialJ� V
(516) 765-1801
•_ 1 1 '
$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:
APPLICANT ADDRESS: .01 '-x 9,Z__
-
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONST UCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALT A7VON:
OWNER OF PROPERTY: `�/ . aM.
OWNER MAILING ADDRESS: 4:2N4.69
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: ' -9 9‘ Jr J_
TAX MAP NO. : Section J Block ), Lot , -__
CROSS STREET: �_��� ^, -
BUILDING PERMIT NUMBER CROSS REFERENCE/& . )
J 'Jill/ /
Signature of ellant
RECEIVED BY 4 i Q_ i
Q_—
T. CT-rk's Office
DATE: �� ,�Zl7
a '
t‘l r .01
_ I
W
Sofr
q�' 7
D or