HomeMy WebLinkAboutCatapano, Karen (2) � � �oS�FFot,��
ELIZABETH A.NEVILLE ��O OGy� Town Hall, 53095 Main Road
TOWN CLERK � Z P.O. Box 1179
ftEGISTRAR OF VITAL STATISTICS � � Southold, New York 11971
MAftRIAGE OFFICER y� � ��� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER 0,� � .�� Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICEft southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPaSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CFSSPOOL
Permit No. 3167 R Residential x ►van-Residential
�ee $ 10.00 septic x cesspool
;,ERMTT ISSUED Tt9:
i�d�1e : PEtONIC CESSPOOL
a�dress l: Po Box 972
City St Zip MATTI7UCK NY 11952
DesCripton of Proposed Construction or Alteration
ADDITION TO EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM AD)ACENT WELLS,
B�ILDINGS, PRQPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTINO REQUIRED.
h�ame �f Own?r CATAPANO, KAREN
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�railing Address 1 PO BOx 579
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Clty St Zip SOUTHAMPTON hY 11958
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property Address 1 3985 SOUND AVENUE
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City St Zip MATTITUCK NY 11952
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�'ax Map No. section 12Z.00 block 1 lot 2.000
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Cross Street BERGEN AVENUE
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Building Permit tvumber cross Reference:
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zssue �ate: 4/15/04 Elizabeth A. Neville
-------- S�uthold T��vn Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE ��� Gy Town Hall, 53095 Main Road
TOWN CLERK o � P.O. Box 1179
y Southold, New York 11971
REGISTRAR,OF VITAL STATISTICS � �
MARRIAGE OFFICER ,f, � �� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER �Q! �a� Telephone(631) 765-1800
FR,EEDOM OF INFORMATION OFFICER � southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
�K ` 4 �� TOWN OF SOUTHOLD
TO: Southold Toy�n Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: April 14, 2004
Transmitted herewith is a copy of application No. 3305 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Peconic Cesspool for Karen Catapano
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.
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: Maintain required setbacks from adjacent wells, buildin�s, propertv lines and water
Bodies. EXCAVATION INSPECTION REQUIRED.
Signature /
.
�S � �
Dated �
� �
� , .
. � .
, OFF1Ci�OF 1U8 TOWN CL�AK
mwNo�eovrxoLo _Q�J�����K��G Appiication No:330�'
EIIZABBTH A.NBVWB,TOWN CLLItIE ��T � �---�—
P.o.HOX It'ro � ..C�nstr uction--�.�
sotmtot�,NBW YORK l 197 G � � A I te ra t i o n d�
Tele hone ,yO,j � O�' $10.OU - e �/
(G31) 7 5-1800 ��l' ��� $25.00 - Non-Residential
TOWN OF SOUTHOLD
` SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCT ION or ALTERAT ION PERMIT
SEPT I C TAN K or CESSPOO L
Permit No.
Fee �$
DATE � ��13�� �C
� APPLICANT NAME: 1'EGONIC CESSPOOL
APPLICANT ADDRESS: P. o. Box 972
MATTITUCK, NEW YORK 11952 '
SEPTIC CESSPOOL �
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
�
� �� �Gcfi� o�� _G��--�-
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
' . OWNER OF PROPERTY: /'�'�-/r�� �,��'�g,p�,v�
OWNER MAILING ADDRESS: �D< /�JOjC S3�'9
� .���;�� ��S' !! g SB'
OWNER PROPERTY ADDRESS:���- �� ��
� .�/��. L/9 Sz�
TELEPHONE NUMBER OF CONTACT PERSON:
��3 a���
TAX MAP NO. : Section �y�� Baock f — Lot Z
-f��G& ST R EET: j� ' � ��c., �
BUILDINC PERMIT NUMBER CROSS REFERENCE:
�
, � Signature p licant .
RECElVEp BY: /�
Tow�rk's Office ..._ �
DATE: / v �
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' Southold, NY 11971
* * * RECEIPT * * *
Date: 04/14/04 Receipt#: 7900
Transaction(s): Subtotal
1 Septic Permit- Construct- Resid. $10.00
Check#: 7900 Total Paid: $10.00
Name: Peconic, Cesspool
P O Box 972
Mattituck, NY 11952
Clerk ID: LINDAC Internal ID:92299