HomeMy WebLinkAboutMarkham, Fred (2) SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3497 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : PECONIC CESSPOOL
Address 1: P.O. BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
-REPLACE OLF BLOCK POOL WITH NEW TYPE
-MAINTAIN REQUIRED SETBACKS FROM ADJACENT PROPERTY LINES, BUILDINGS,
WELLS, AND WATER BODIES.
Name Of Owner FRED MORKHAM
Mailing Address 1 875 MASON DRIVE
City St Zip CUTCHOGUE NY 11935
Property Address 1 SAME AS ABOVE
City St Zip 0000
Tax Map No. section 104.00 block 5 lot 3.700
Cross Street HAYWATERS ROAD
Building Permit Number Cross Reference:
Issue Date: 2/01/07 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE , ,`O� Ol0 Town Hall, 53095 Main Road
TOWN CLERK 4 4; P.O. Box 1179
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1 REGISTRAR OF VITAL STATISTICS
Southold, New York 11971
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MARRIAGE OFFICER G �Q'g Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER %(),,�, ``,.a Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER COUNTOV-1.19 southoldtown.northfork.net
' OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
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TO: Southold Town Building Department
FROM: Francesca Quintieri, Southold Town Clerk's Office
DATED:
Transmitted herewith is a copy of application No. 3653 for a Cesspool/Septic Tank Construction or
Alteration Permit submitted by:
Peconic Cesspool
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.
Francesca Quintieri
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
•
Comments: _ --- -
Signature//
Dated
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ELIZABETH A.NEVILLE O/4`t` Gy`` Town Hall, 53095 Main Road
TOWN CLERK p P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER �� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER 0v���� Telephone(631) 765-1800
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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 or Non-Residential @$25 _ Applicatio ► • 3
Permit N.Wie
Applicant Name PECONIC CESSPOOL
Applicant Mailing Address P. O. BOX 972
MATTITUCK, NEW YORK 11952
Septic Tank or Cesspool V' ,� ,�
Brief Description of Proposed Construction or Alteration Oti
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Location of Proposed Construction/Alteration:
Owner of Property: 4 74744.4
Owner Mailing Address: 2”7S" int.,Lirh.
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Owner Property Address: S s.
Name and phone number of contact person 'te - e.Z 63' -02-S�r�i4Sls'
Tax Map No: Section /O 44 Block OS Lot 37
Cross Street /9°1
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
/ 7-1/ /
Si' ature of Applicant / Date
Received by: •lX
....
FRED MARKHAM
875 MASON DRIVE
CUTCHOGUE
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