HomeMy WebLinkAboutMahares, Thomas (2) S11FfU�
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ELIZABETH A.NEVILLE ' 1 ; Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
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REGISTRAR.OF VITAL STATISTICS � vs. � � Southold, New York 11971
MARRIAGE OFFICER
a�7����, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER = Q �i� Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER _ .,'� 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. 3230 R Residential x Non-Residential
Fee $ 10.00 Septic x Cesspool
PERMIT ISSUED TO:
Name : PECONIC CESSPOOL
Address 1: PO BOX 972
City St zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION TO EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS,
BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTINO REQUIRED.
Name of Owner MAHARES, THOMAS
Mailing Address 1 235 SOUND BEACH DRIVE
City St Zip MATTITUCK NY 11952
Property Address 1 235 SOUND BEACH DRIVE
City St Zip MATTITUCK NY 11952
Tax Map No. section 99.00 block 1 lot 17.000
Cross Street INLET DRIVE
Building Permit Number Cross Reference:
Issue Date: 10/01/04 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE ', y,d` TovVn Hall, 53095 Main Road
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TOWN CLERK ; \, P.O. Box 1179
10 Pr1
REGISTRAR OF VITAL STATISTICS O Southold, New York 11971
L
MARRIAGE OFFICER y,, ���, Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER '_ �l * Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER .#" southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SEP 7 2004
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: September 3, 2004
Transmitted herewith is a copy of application No. 3372 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Peconic Cesspool for Thomas Mahares
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
v
DISAPPROVE
Comments: Maintain required setbacks from adjacent wells, buildings, property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED.
Signature
Dated
''III►►►►►p,,►►,I'
• OFFICE OF THE TOWN CLERIC .� c % UL1� 3 .3 J
TOWN OF SOUTHOLD '����� Wire; Application No. 7
RLIZALIT 11 A.NBVU111.TOWN CLERK � Construction 1�^
P.O.BOX 1179 � 1
SOUlii01D,NM YORK 11971
4=1 :at 3 Alteration
to
Telephone 4°° _, 4 •"‘",/ : $10.00 - Residential
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(631) 765-1800 = O1' JI +%►�'�r $25.00 - NOn-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERAT ION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee •$
DATE
• APPLICANT NAME: PECONIC CESSPOOL
APPLICANT ADDRESS: P. O. BOX 972
MATTITUCK, NEW YORK 11952 '
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before hermit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
. OWNER OF PROPERTY: Th b (flAh Ftres
OWNER MAILING ADDRESS: x.35 S� (1„, c_j, DA_,
10,if 1 '5 Z.
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER Or: CONTACT PERSON:__ ,6-55r
TAX MAP NO. : Section q q Block / Lot / 7
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
•
• RECEIVED Signature O Applicant
RECEIVED BY: 7667-1,
To8'CI(SIC®Qtpffice
DATE:
Southold Town Clerk
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Thomas Mahares
235 Sound Beach Drive
Mattituck