HomeMy WebLinkAboutConnelly, Joseph If,, .
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JUDITH T.TERRY o= 1 ' Town Hall,53095 Main Road
TOWN CLERK ti Z P.O.Box 1179
REGISTRAR OF VITAL STATISTICS %,0 � Southold,New York 11971
MARRIAGE OFFICER yifJ Q'
RECORDS MANAGEMENT OFFICER �.( `�►a � TelFax(516)ephone(516)765 1800
FREEDOM OF INFORMATION OFFICER � ,,��'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1202 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PECONIC CESSPOOL
Address 1 : P. O. BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION OF AN OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS
BUILDINGS, PROPERTY LINES, AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner CONNELLY, JOSEPH
Mailing Address 1 4950 PECONIC BAY BLVD.
City St Zip LAUREL NY 11948
Property Address 1 4950 PECONIC BAY BLVD.
City St Zip LAUREL NY 11948
Tax Map No. section 128.00 block 4 lot 2.000
Cross Street DELMAR DRIVE
Building Permit Number Cross Reference:
Issue Date: 9/15/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY :,, L , Town Hall, 53095 Main Road
TOWN CLERK t o r= P.O. Box 1179
VI Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ‘V64, �� Fax (516) 765-1823
MARRIAGE OFFICER /�� �O ,�� Fax
(516) 765-1801
RECORDS MANAGEMENT OFFICER =��'�f(/` r•
FREEDOM OF INFORMATION OFFICER =���„���ii,��'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: September 6, 1994
Transmitted herewith is a copy of application No. A1247 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Joseph Connelly .
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 this office.
Thank you.
Se,..i,Lc;ecc-
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - L/ .<.
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DISAPPROVE - - c a.,
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Date
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OFFICE OF THE TOWN CLERK ,
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Town of Southold �''
Judith T. Terry, Town Clerk ',N04 �/ Application No. ./c, y7
Town Hall, 53095 Main Road � � Construction
P. O. Box 1179 ; c n+ ; Alteration
Southold, New York 11971 to
Telephone ����',� $10.00 - Residential
(516) 765-1801 _ 1 '��
,, $25.00 - Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. / `Z�7
Fee $ /f . -�
DATE 9-6
APPLICANT NAME: 0,..a.e...z/-frz.e..:
APPLICANT ADDRESS: /re ,f) /97
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUC ON OR ALTE TION:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS: ,
OWNER PROPERTY ADDRESS: '6
TELEPHONE NUMBER OF CONTACT PERSON: 099 `— 6...52
TAX MAP NO. : Section /c7`-(r Block j Lot
CPS STREET: ,191--/,417/0-,r.. 4`Z .
BUILDING PERMIT NUMBER CROSS REFERENCE:
4e/1400,
Signature of A,•i, icafit
RECEIVED BY: ( b l
Town Clerk's Office
DATE: 9\//2A-V
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Peconic eepooe 40e-/ ,a.t -
SEWER& DRAIN SERVICE
P 0. BOX 972 BRAY AVENUE MATTITUCK, NEW YORK 119.2
(516) 298-9658
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