HomeMy WebLinkAboutTuthill, Ralph ,,...
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JUDITH T.TERRY Q� y1� Town Hall, 53095 Main Road
TOWN CLERK Q y 2 % P.O. Box 1179
• 1.3.' I Southold, New York 11971
REGISTRAR OF VITAL STATISTICS • Oy N.
Fax(516) 765-1823
MARRIAGE OFFICER .�J O
RECORDS MANAGEMENT OFFICER el',i `�`;00 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. 1768 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 TUTH I LL, RALPH AND SUAN
Mailing Address 1 P. O. BOX 306
City St Zip MATTITUCK NY 11952
Property Address 1 1045 WAGON WHEEL LANE
City St Zip MATTITUCK NY 11952
Tax Map No. section 108.00 block 3 lot 12.007
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 11/14/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
/ 7
oil OF F04
JUDITH T.TERRY t _ 'fJ► � Town Hall, 53095 Main Road
TOWN CLERK ; y 4 P.O. Box 1179
v. ft, C Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax (516) 765-1823
MARRIAGE OFFICER w /RECORDS MANAGEMENT OFFICER = ,( ilk 4%00 Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ,011
0
OFFICE OF THE TOWN CLERK i 121997
TOWN OF SOUTHOLD
BLDG.DEPT.
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: November 10, 1997
Transmitted herewith is a copy of application No. 1842 for a Cesspool/
Septic Tank Construction Permit submitted by:
Peconic Cesspool for Ralph and Susan Tuthill
Please review the application and location map and advise if the project
has received Suffolk County Health Department approval and if this office
may issue the permit.
Please complete the form below and return it to me.
Thank you.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recoommmendations:
APPROVE ✓
DISAPPROVE
Comments:
ignat r
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Dated
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OFFICE OF THE TOWN, CLERK ,s' III"
Town of Southold �'��5� KCO - Application No. `d
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Juditri T. Terry, Town Clerk GyJ� ------
Town Hall, 53095 Main Road Construction t-�P. O. Box 1179 Alteration
Southold, New York 11971 s
Telephone = ,y�o ��O!'�� $10.00 - Residential
(516) 765-1801 1 4 , $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: tee.-01-1-0-G.--e•__.__----- -------_--------
APPLICANT ADDRESS: 7
SEPTI C 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:1O1 _ 1444.v6_
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: S/
TAX MAP NO. : Section f O r Block Lot 02._7
CROSS STREET :
BUILDING PERMIT NUMBER CROSS REFERENCE:
‘,./7/&- Z6(
�r~V�Sign ire of Applicant
RECEIVED BY : RECEIVED
Town Clerk's Office
DATE: NOV 10 19-97
Southold Town Mei
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