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HomeMy WebLinkAboutCondron, Ron (2) ', • o��pF SO�jyol ELIZABETH A.NEVILLE '` O Town Hall, 53095 Main Road TOWN CLERK 1�L � P.O. Box 1179 REGISTRAR OF VITAL STATISTICS G � Southold, New York 11971 MARRIAGE OFFICER � • �O Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER �l�C �mI �� Telephone (631) 765-1800 FREEDOM OF INFORMA-�EdI�T OFFICER �Un 1�, southoldtown.northfork.net _ .;- �;�' � _ _ _ `,; ��� �� '' �5 ' OFFICE OF THE TOWN CLERK ` � 2� TOWN OF SOUTHOLD 4��'•.; ! r�:: , _ _; TO: �''`Y " S�outhold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: October 31, 2005 Transmitted herewith is a copy of application No. 3536 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Peconic Cesspool (Ron Condron) 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. Linda J. Cooper * * � * * * * * * * * * 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_gs, property lines and water Bodies. EXCAVATION INSPECTION REQUIRED. Signature /O 3� �-- Dated � �'.;'�' j�' �ry'� 5 rt a`��` a.'e :�� �;; � �'' �� �� .,.._-i����` ri. . _ �. . . . ' � � � *ti,. . � 0,�•��i��+►e�R��+M+�• 1'Q QRN��TI'1�OL� � A�)�l��Cet�Otl No��� BLlZABB'1�i�NBV1�1,8,TOWN CUi "'"l�o:8oX1179 Constructlon �� SOUT!lOLD,NBW YORK 11971 ---- ----_ , /1ltaratioti _ . _ ____ ___. __-- Telephone � �' � i�►•ou Itesidentlal___(/ _ _ (63t) 765-1800 �' � E25.o0 Nr.�n-Residential TOWN OF SOUI�IIOI U SOUTHOLD WASTEWATER UISI't_)Snl I�IS l ltlt; i APF'LICAI'IvtJ for CONSTRUC�i'(ON or AL"! EItA i lc►P! I't:ItA11 1 SEPTIC TANK or CESSI'c�(�l. ��� Permit No.����� �e� �S U A'(-C: /0/10%S" __._ . ------ r � APPLICANT NAME: t'cCoNic ccss��ooL APPLlCANT ADDRESS: P. o. sox 9�2 MA'PTITUCK, NEW YORK 11��51 SE�'�.�G C�SSPOOL t/ .1 �r, ----» �r- � OE�,S��IPTION OF P�tOPOSED CONSTRUCTION Olt ALTEftA�r ION ,, ,�:�.. �� ` - --- . --- - ,: . ��_./.J ' '„',.;�.,Rxl��L-.-s� �� �.-�✓_-'__- ---L C�d-�u-t ' . - �� - .,,,,—, � fi�L. �`u�t ;. ----__ _ - --_ . _ __ _ __ _-------- �,�•'Y��;��"� � ,�,. F, , .. . .___------�---__._.---_._ , __ __"'.___'..__.__" r � • 1.���!►TIG��l.�MAP: MUst be ettached hereto before ��ermit niay I.,e issue�l. ����,�� > t� �,;.,, LQ .* '�'� . �V QF. PROPOS�D CONSTRUCTION OR AL�1'l:ftAl'ION: .�� �i. . . . . � R ' ;,`OW���t�QF PROPERTY: �,o� p���.,�� ,, ; ,,� � . „ .k --- `°OWNER MAILING ADDRESS: /7C�D_ (ti'�,sq�-��� /fil�'7Z�� L�- /La� ,� , �-,�f'-� %�'_-'''�' _`�---���5 z� OWNER PROPERTY ADDRESS: J'�Z,_e -___._. ___-- ._._ _..__-_.___._-_- <'�'�L.�QHONE NUMBER OF CONTACT PEftSON : G3/ p--q�,t �� __ ___._ ._ . .__.�_ �l , r ,, � � � � f�� AP O. • S ction ���- �- �S M N . @ Bloc.lc t.ut � , . � ; . . . _ _ _ __ �� ��, _ . ; 4����5.STRE�T: /��A f�'S' /�_ i __-- � . _ . _ _ . BUII:DINC PERMIT NUMBER CROSS REFt�f�� i�'i � .� -- -- i . _ . _ . _ _ . . _. _._ ___.w_ . Siy�iatura of A lica �t RECElVED 8Y: �� Town GTerk s ffice DATE: __L11�,� _ . . ai�i4 � ��� . � i�O�U ���� �oN � , � ` ��G o e�,`,� �l.c��eo-�- � `�Z''��G��r.lL �t/,t- � � ��� � �� n�� I N�"' i' `, ,�I"�'"'��'' � A� .��ti G�,,,'�t' ; ���-�- ���o ; s� �� ��""wP /�riv.eo[� ,�,L. � ��� !�-�� S . s