HomeMy WebLinkAboutKnight, Stan �"e, FfO��►C
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ELIZABETH A.NEVILLE 1�'�h,10 1 Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
z ; Southold,New York 11971
REGISTRAR OF VITAL STATISTICS lAb
MARRIAGE OFFICER `� ,f, 1� �, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER *Q! 4.�se Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER - �0� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3217 R Residential x Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : PECONIC CESSPOOL
Address 1: PD BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
REPLACE OLD POOL WITH NEW ONE
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS,
BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTINO REQUIRED.
Name of Owner KNIGHT, STAN
Mailing Address 1 75 MARK ROAD
City St Zip MATTITUCK NY 11952
Property Address 1 75 MARK ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 114.00 block 10 lot 14.000
Cross Street DEER DRIVE
Building Permit Number Cross Reference:
Issue Date: 9/02/04 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE �� � Town Hall, 53095 Main Road
TOWN CLERK y Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �O PPP t Southold, New York 11971
MARRIAGE OFFICER * 0.01 Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER = .( jig �a,i�� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER .,, . "### southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD RECEIVED
JUL 3 4
TO: Southold Town Building Department AUG 2 6 2004
FROM: Linda J. Cooper, Southold Town Clerk's Office Southold Town Clerk
DATED: July 29, 2004
Transmitted herewith is a copy of application No. 3358 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Peconic Cesspool for Stan Knight
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,buildings, property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED.
r77/44--'4,
Signature d'
Dated
OFRCEOfTHE TOWN CLERIC 11� � I/►► ►....��.
TOWN OFBOUIIIOLD ���► ;��F�OIK�+�G '� Application No. ��7d
1?UZADIB11 A.NBV1LLL,TOWN CLERK R+ . .
P.O.BOX 1179 ., ' Construction "
SOU(11OLD.NEW YORK 11911
gt
Iteration s/
Telephone :...odj �,a� r�,i' $ 10. -- esi •ntial
(631) 765-1800 = �l' ,;�r'. $25.00 -- Non-Residential
.►ii
TOWN OF SOUTIIOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERAT ION I'LRM I F
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$ /60
17/DATE Q•
APPLICANT NAME: PECONIC CESSPOOL
APPLICANT ADDRESS: P. 0. BOX 972
MATTITUCK, NEW YORK 11952 '
SEPTIC CESSPOOL 1- '
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before hermit may lie issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
. OWNER OF PROPERTY: 37'-
OWNER MAILING ADDRESS: 'S re--se
A/4.
OWNER PROPERTY ADDRESS: .
TELEPHONE NUMBER 0'= CONTACT PERSON:
TAX MAP NO. : Section j/V. Block JO Lot
09465-STREET: et
BUILDING PERMIT NU NBER CROSS REFERENCE:
Signature of plicant
RECEIVED BY:
.4 ____
To n C earl 's Office
DATE: 7/29 dam
1 A
. ,.-
STAN KNIGHT
75 MARK ROAD
MATTI TUCK
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