HomeMy WebLinkAboutViviani, Michael oft egF04
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JUDITH T.TERRY �� yl Town Hall, 53095 Main Road
TOWN CLERK y Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS •`Oy � Fax(516) 765-1823
����, Southold,New York 11971
MARRIAGE OFFICER CJD 40/1.0O �
RECORDS MANAGEMENT OFFICER I � 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. 1745 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 WELLS,
BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION
REQUIRED.
Name Of Owner VIVIANI, MICHAEL
Mailing Address 1 1825 DEEP HOLE DRIVE
City St Zip MATTITUCK NY 11952
Property Address 1 1825 DEEP HOLE DRIVE
City St Zip MATTITUCK NY 11952
Tax Map No. section 115.00 block 14 lot 18.000
Cross Street RICHARD LANE
Building Permit Number Cross Reference:
Issue Date: 10/09/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY ;4. ' 8 Town Hall, 53095 Main Road
TOWN CLERK ` y = ; P.O. Box 1179
�r Southold,New York 11971
REGISTRAR OF VITAL STATISTICS O 0MARRIAGE OFFICER
‘.%3b
. �� Fax(516)765-1823
y �
RECORDS MANAGEMENT OFFICER = 0.( i ��0111 Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER , ,,s°,I
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: October 6, 1997
Transmitted herewith is a copy of application No. 1822 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Michael Viviani
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 followin recommendation:
APPROVE -
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
RECEIVED
4 CZ 81997 Signature
Southold Town Clerk101 &/
Sp Date
OFFICE OF THE TOWN CLERK ,,,,'","
Town of Southold �.' Utko;
Judith T. Terry, Town Clerk ;' .\0 �l/y Application No.
Town Hall, 53095 Main Road �� Construction
P. 0. Box 1179T Alteration
Southold, New York 11971
Telephone 0400, � ��' $10.00 - Residential
(516) 765-1801 ----5441 ,, � $25.00 -Non-Residential
-- ,,_ X11
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE /0;:rf 7
APPLICANT NAME:
APPLICANT ADDRESS: 477
r // 95z
SEPTIC CESSPOOL
DESCRIPTION OFPROOPOSSED 'CONSTRUCT
ION
OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION :
OWNER OF PROPERTY: /11; ,¢. 7 , ; `i//,r- /
OWNER MAILING ADDRESS: /rd-f" /)d6r,
OWNER PROPERTY ADDRESS: CA-fr 54-
TELEPHONE NUMBER OF CONTACT PERSON: c)295--- S(F,
TAX MAP NO. : Section /15 Block / Lot /g
0R*9-S& STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
c‘rAf-4"( //1/f
Signature of Ap can
RECEIVED BY: RECEIVED
Town Clerk's Office
DATE: OCT 61997
Southold Town Clerk
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