HomeMy WebLinkAboutKrill, William c
.ELIZABETH A.NEVILLE te �` Town Hall, 53095 Main Road
TOWN CLERK y 2 ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
�Oy� �l���',, Fax (631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER . O( jig 14.00 Telephone 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. 3263 R Residential X Non-Residential
Fee $ 100.00 septic x Cesspool
PERMIT ISSUED TO:
Name : PECONIC CESSPOOL
Address 1: P 0 BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
REPLACE PARTLY CAVED IN CESSPOOL WITH NEW TYPE
MAINTAINED REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY
LINES, AND WATER BODIES. EXACAVATION INSPECTION REQUIRED
Name Of Owner KRILL, WILLIAM
Mailing Address 1 3330 EUGENE ROAD
city St zip CUTCHOGUE NY 11935
Property Address 1 SAME
city st zip 0000
-ax Map No. section 970.00 block 8 lot 901
cross Street BAY AVENUE
Building Permit Number Cross Reference:
f"t f2 e EP
':slue Date: 1/27/05 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
3a63
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k:LIZABETH A. NEVILLE t` ; Town Hall, 53095 Main Road
TOWN CLERK t vaZ ; P.O. Box 1179
v' % Southold, New York 11971
REGISTRAR OF VITAL STATISTICS :0 l* * # Fax(631) 765-6145
MARRIAGE OFFICER /f' Q
RECORDS MANAGEMENT OFFICER --- O! 41 *;81.° Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER .. .•.9" southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: December 6, 2004
Transmitted herewith is a copy of application No. 3406 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Peconic Cesspool for William Krill
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. .
2/74149
Signature
/ //3/of
Dated
•
ISI,, ,,,,,,,,,, .
OFFICE OF THE TOWN CLERK �I I '
TOWNOTSOUiHOLD 1446 / F�ULII��QG Application No. V66ELZABETHA,�NBVALB,TOWN CLERK I •
. P.o.BOX 1179 �� % Construction
SOUI710LD,NBW YORK 11971 a
3 Alteration
Telephone ��,Q��'� $10.00 - Residential V�
(631) 765-1800 `- 1' � ',,rlll $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 IL n p
APPLICANT NAME: PECONIC CESSPOOL
APPLICANT ADDRESS: P. 0. BOX 972
MATTITUCK, NEW YORK 11952 '
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before hfmrmit way lie issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
• . OWNER OF PROPERTY: ti/ 1
OWNER MAILING ADDRESS: 1
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 0•-ik- 9'G S j
TAX MAP NO. : Section 7 L3lock _ Lot /. /
•
CROSS STREET: ' 6-711
BUILDING PERMIT NUMBER CROSS REFER] ICL-::
Signature of Niplicant
RECEIVED BY: y
To n C rk's Office
DATE: / Z ' 6 .
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WILLIAM KRILL
3330 EUGENES ROAD
CUTCHOGUE _
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