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Home My WebLink AboutMorris, Melvin •fi • , ,�O�pF SO(/Ty®l ELIZABETH A.NEVILLE,RMC,CMC I O Town Hall, 53095 Main Road TOWN CLERK * P.O. Box 1179 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS N MARRIAGE OFFICER Fax�O /�� Fax (631) 765-6145 RECORDS MANAGEMENT OFFICERlo1 Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER =yeOUNTY ��al southoldtown.northfork.net �... .•ei OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 3907 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : PECONIC CESSPOOL Address 1: P 0 BOX 487 City St Zip LAUREL NY 11948 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 INSPECTION REQUIRED. Name Of Owner MELVYN MORRIS Mailing Address 1 272 PARK AVENUE City St Zip MATTITUCK NY 11952 Property Address 1 272 PARK AVENUE City St Zip MATTITUCK NY 11952 Tax Map No. section 123.00 block 7 lot 6 Cross Street MARATOOKA ROAD Building Permit Number Cross Reference: Issue Date: 10/09/09 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) ----. - . .0,,i q S0!/ryo ELIZABETH A.NEVILLE,RMC,CMC 0 •` 1l0 : Town Hall, 53095 Main Road TOWN CLERK it it, P.O. Box 1179 u, y� Southold,New York 11971 REGISTRAR OF VITAL STATISTICS % G @ ,� MARRIAGE OFFICER a0 ° Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER /.1 Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER =y�'oU ,�II��i southoldtown.northfork.net ... ,,' OFFICE OF THE TOWN CLERK • TOWN OF SOUTHOLD R,---, TO: Southold Town Building Department OCT 7 2009 FROM: Carol Hydell, Southold Town Clerk's Office BLDG DEPT. TOWN OF SOUTHOLD DATED: October 7,2009 Transmitted herewith is a copy of application No. 3907 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Peconic Cesspool for Melvyn Morris 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 Carol Hydell * * * * * * * * * * * * I have reviewed the application and 1 tion 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. . Signature /v a 1:3. o S Dated ' 9 11, SUFFot,r- ELIZABETH A.NEVILLE �',�`1` 4 Town Hall,53095 Main Road TOWN CLERK ' o . P.O.Box 1179 REGISTRAR OF VITAL STATISTICS : yj. Southold,New York 11971 MARRIAGE OFFICER G `� 1` Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER s.`�W a0. i Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER =_'� * ,.. southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @$10 l.0 _or Non-Residential @$25 Application No. 3 11'7 Permit No. Applicant Name PECONIC CESSPOOL Applicant Mailing Address P• O. BOX _ 487 LAUREL, NEW YORK 11948_ Septic Tank 't or Cesspool Brief Description AfproPosed Construction or A eration Kt S tl/ ,C6-159 2 Location of Proposed&nstruc p hon/Alteption: Meit ,v Owner of Property: MO r1 S` I Owner Mailing Address: - Owner Property Address: 7-(e ea Y.k OA - • Mr, -ft -ruck NV,r� 1I (f' 5 , Name and phone number of contact person 51 Q I J.S. Les+et Tax Map No: Se tion 3 Block 7 Lot Cross Street H 0.TO1/4- no Q R cf . NOTE: LOCATION MAP MUST BE SUBMI ED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WIT EALTH DEPART I NT APP OVAL Aa - ,... to 770 Signature gn e of Applicant Dat Received by: -6 ?ovfL 04 t i iki •___ ,____ t,4 P I I I 1 i 4 '-7c=. 1 61-led- 1,4161joi i 1 L. 4, dt5r -► o< o 11 ce-510, A. r