HomeMy WebLinkAboutPilles Holding Corp (2) SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3511 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : PILLES HOLDING CORP
Address 1: PO BOX 1309
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
INSTALLATION OF CONFORMING MINIMUM GRADE COMMERCIAL SANITARY SYSTEM
FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT
Name Of Owner PILLES HOLDING CORP
Mailing Address 1 PO BOX 1309
City St Zip SOUTHOLD NY 11971
Property Address 1 56275 MAIN RD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 63.00 block 3 lot 1.200
Cross Street COTTAGE PLACE
Building Permit Number Cross Reference:
Issue Date: 3/15/07 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE O 4
%� Town Hall, 53095 Main Road
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TOWN CLERK 4 4 P.O. Box 1179
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Southold New York 11971
REGISTRAR OF VITAL STATISTICS ; G 1
MARRIAGE OFFICER •• ( Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER `._li�'`+oUN�'� ��1�� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
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'%•... I���
_----,OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: " &mold Town Building Department
FROM: Michelle L. Martoe'chia, Southold Town Clerk's Office
DATED: February 21, 2007
RE: Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 3668 for a Cesspool/Septic Tank
Construction/Alteration Permit submitted by:
Pilles Holding Corp. .
Please review the application and location map and advise if this office may issue the permit.
Please complete the form below and return it to me. Thank you.
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: ^� ��.. _�_._ ���
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Signature
Dated
4FFOL4. .�y\
ELIZABETH A.NEVILLE ,'�`Z` ` Town Hall, 53095 Main Road
TOWN CLERK ; p ; P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS Southold,New York 11971
MARRIAGE OFFICER : G `F 1 Fax(631) 765-6145
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RECORDS MANAGEMENT OFFICER " Oi'� Telephone(631) 765-1800
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FREEDOM OF INFORMATION OFFICER 'O� a0. 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 @$252( Application No. D
Permit No.� / '
Applicant Name p► l , Cc,C p
Applicant Mailing Address 6 Qclx. 3 39
Silt, o ��
Septic Tank or Cesspool ) /
Brief Description of Proposed Construction or Alteration ._h5rC,t/u f ,
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Location of Proposed Construction/Alteration:
Owner of Property: 17,11r S N, ,!d,r Ce,f p
Owner Mailing Address: Q \ c?
sof1o% 1 /9r7(
Owner Property Address: 5C all zc 50,145 4,/ A) 057P /
Name and phone number of contact person -•(-‘ pA1QS Sly 6 (} A') b'3
Tax Map No: 100(5 Section <-`j Block 3 Lot
Cross Street CvC[A.rJ,C
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY ITH HEALTH DEPARTMENT APPROVAL
Signature of p icant •ate
Received by:
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.SCDHS Rel. # CI 0-06-0006
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SURVEY OF PROPERTY
AT SOUTHOLD
\il / TOWN OF SOUTHOLD
/ !.\ SUFFOLK COUNTY, N. Y.
1000-63-03-12
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ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION "ECONIC S Plr.7 OR .11W 11,
OF SECTION 72090F THE NEW YORK STATE EDUCATION LAW. (631) 765-56 '��`' 7. 797
EXCEPT AS PER SEC770N 7209-SUBDIVISION 2. ALL CERTIF1CA770NS P.O. BOX 909 Nb. '-°'�•.
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF
SAID MAP OR COPIES BEAR THE
WHOSE SIGNATURE APPEARS HEREON.IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER -)4'? A• .1 324
SOUTHOLD, N. Y. 119