HomeMy WebLinkAboutStott, Robert Jr •
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JUDITH T.TERRY ����S ..01, • Town Hall, 53095 Main Road
TOWN CLERK y Z P.O. Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS �� ,�� Fax (516) 765-1823
MARRIAGE OFFICER = �01 �s ��� Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER - l ��l
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. 1518 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, AND PROPERTY LINES. EXCAVATION INSPECTION REQUIRED.
Name Of Owner STOTT, ROBERT L. JR.
Mailing Address 1 1755 PARADISE POINT ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 1755 PARADISE POINT ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 81 .00 block 3 lot 24.000
Cross Street NORTH BAYVIEW ROAD
Building Permit Number Cross Reference:
Issue Date: 8/06/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY ; o Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
ti ,�� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS `L �y ����� Fax (516) 765-1823
MARRIAGE OFFICER �01 �,0�I� Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER J ���
011
FREEDOM OF INFORMATION OFFICER t .,"
OFFICE OF THE TOWN CLERK �;
TOWN OF SOUTHOLD t, l
i
TO: Southold Town Building Department p JUL ? 9
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: July 29, 1996t.
t TrY r
Transmitted herewith is a copy of application No. 1583 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cessp000l for Robert L. Stott Jr.
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 - e_....-------
DISAPPROVE
.�DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
Signature- /'
/s
Date
A /S-/
OFFICE OF THE TOWN CLERK � ,,,,,,,,,,- _
Town of Southold .'� 15\\F�01 /S -))
Kco Application No. `
Judith T. Terry, Town Clerk fConstruction
� � GyTown Hall, 53095 Main Road
P. O. Box 1179 Alteration
Southold, New York 11971 u
Telephone �� ���•� $10.00 - Residential
(516) 765-1801 = $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: 40-9-13,1-7
APPLICANT ADDRESS: e) i' t
l/9 S.
SEPTIC CESSPOOL LV
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
Ateie
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Mit - 44e-e --
OWNER MAILING ADDRESS: /755 p .. 12-
OWNER PROPERTY ADDRESS: �-----
TELEPHONE NUMBER OF CONTACT PERSON: �`�1��- (,' 5y
TAX MAP NO. : Section 'f Block 3 —Lot 9.4'
CROSS STREET :
BUILDING PERMIT NUMBER CROSS REFERENCE:
0444‘'Llfi'Signature of Atile icant
RECEIVED BY:
Town Clerk's Office
DATE:
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