HomeMy WebLinkAboutRichards, George I‘,��\,0 co
JUDITH T.TERRY O% Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
ui Southold, New York 11971
REGISTRAR OF VITAL STATISTICS 11� Fax (516) 765-1823
MARRIAGE OFFICER y 1
RECORDS MANAGEMENT OFFICER :��.. I *.O 111 Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER •, ,101,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1682 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 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 RICHARDS, GEORGE
Mailing Address 1 P. O. BOX 1434
City St Zip MATTITUCK NY 11952
Property Address 1 1335 MARRATOOKA ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 115.00 block 11 lot 26.000
Cross Street NEW SUFFOLK AVENUE
Building Permit Number Cross Reference:
Issue Date: 6/04/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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i# f Town Ha11, 51095 Main Road
Ij �+� i P. Box 1179
1I ' Ol �� Southold, New York 11971
JUDITH T.TERRY •��%%woo'. TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
May 15, 1997
Transmitted herewith is a copy of application No. 1748 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for George Richards
Please . v c,w the application and location map and advise if this office may
issue al : 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.
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O.FFICE`OF THE TOWN CLERK ,,,'""",,,,,,
Town of Southold01iCi
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Judith T. Terry, Town Clerk ;' l/ Application Klo.
Town Hall, 53095 Main Road _ Construction t
_-
P. O. Box 11794=3 rn Alteration
Southold, New York 11971 Ifs
Telephone jO,j�o �0 �, 1 $10.00 - Residential
(516) 765-1801 141
��,, $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 /// 1 • ' •
APPLICANT NAME:
APPLICANT ADDRESS: P.e /r 972
'V,7 // S Z
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: :
OWNER MAILING ADDRESS: !�"��, / V3 3 c
OWNER PROPERTY ADDRESS: / c". yYjij `
TELEPHONE NUMBER OF CONTACT PERSON: n-C- "liter
TAX MAP NO. : Section 7/ 5 Block / / Lot Z6
CROSS STREET: J?/,G-11 g�
BUILDING PERMIT NUMBER CROSS REFERENCE:
64(% .,•ei
RECEIVED Signature of Applic nt
RECEIVED BY : MAY 1 5 1997
Town Clerk's Office —
DATE: Southold Town Clerk
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