Loading...
HomeMy WebLinkAboutPasca, Anthony SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 4289 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : PECONIC CESSPOOL Address 1: PO 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. Name Of Owner ANTHONY PASCA Mailing Address 1 18900 MAIN RD City St Zip MATTITUCK NY 11952 Property Address 1 18900 MAIN RD City St Zip MATTITUCK NY 11952 Tax Map No. section 115.00 block 6 lot 6.000 Cross Street CARDINAL DR Building Permit Number Cross Reference: Issue Date: 1/30/15 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) ,l,%ig)FFOL4 ELIZABETH A. NEVILLE,MMC �''h•�0 �(f \ Town Hall,53095 Main Road 4 TOWN CLERK % cz - I P.O. Box 1179 1 H Z 1 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS • 00 �' Q Fax(631)765-6145 MARRIAGE OFFICER ` y� te- / Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER e.( '�►a.�'' www.southoldtownn ov FREEDOM OF INFORMATION OFFICER --- ,.�' y.g es....., OFFICE OF THE TOWN CLERK = TOWN OF SOUTHOLD ilr i 1 JAN 2015 TO: Southold Town Building Department , 2 6 FROM: Sabrina Born, Southold Town Clerk's Office L_____ I DATED: January 26, 2015 RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4289 for a Cesspool/Septic Tank Construction Permit submitted by: Peconic Cesspool for Anthony Pasca . 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: • . . f)//1"'rri. ' , 4101. ,.. ....• 4211V5.01..r.,2C A ,,a2 , / ?) , ‘-/j'i _ •, e e,t,-..- _,_,g-,d._L. i / Signature / z -- Dated ELIZABETH A. NEVILLE,MMC Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 Southold, New York 11971 REGISTRAR OF VITAL STATISTICS Fax (631)765-6145 MARRIAGE OFFICER Telephone (631) 765-1800 RECORDS MANAGEMENT OFFICER www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD January 30, 2015 Peconic Cesspool P.O. Box 487 Laurel, NY 11948 RE: 115.-6-6(Pasca) Dear Sir/Madam: enclosed herewith is the Construction, Alteration or Modification Permit for a Septic Tank/Cesspool System for which you applied. AFTER the system is installed but prior to being used, an OPERATION PERMIT IS REQUIRED. The operation Permit is issued by the Southold Town Clerk's Office. The fee is Ten Dotars ($10.00) for,a residential system and twenty-five dollars ($25.00) for a non- residential.system. Your check should be made payable to the "Southold Town Clerk". An application form is enclosed. Please complete the requested information and return the application, proper fee, and LOCATION MAP (map must indicate the location of the cesspool(s)/septic-tank(s), giving approximate distances in feet from any buildings to the pools and distances between the pools. Should you have any questions concerning this matter, please do not hesitate to contact this office. Very truly yours, cSagizi,za n ,ozuz Clerk Typist Enclosures << A.NEVILLE ;' Town Hall,53093 Main Road TOWN'CLERK P.O.Box 1179 REGISTRAR OF VITAL.STATISTICS ; y ; Southold,New York 11971 MARRIAGEoniont� Fax(631)765-6145 RECORDS OFFICER =_ ,�' Telephone(631)765.1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net OFFICE OF TSE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT • APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential�;a $10 V or Non-Residential©$25 Application No. 4'C Permit No. Applicant Name PECONIC CESSPOOL Applicant Mailing Address P. 0. BOX 487 LAUREL, NEW YORK 11948 Septic Tari _ or Cesspool _ Brief Desi tion ofo Construction or Alt tion (er�zw�& cesro( Location of Proposed Construction/ teration: Owner of Property: AnTheaSCCt Owner Mailing Address: - Owner Property Address: 18 900 Maki, 1G ( . ivigy 1 ( ��� p Name and phone number of contact person �C.'1' S l°Z_4 30e Tax Map No: Section II5 Block Lot Co Cross Street &roix,ttai ])f' NOTE: LOCATION' MAP MUST BE SUBMITTED +' = APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY ` :1 AL w: EPAR I` APPR VAL Signature of Applicant Date Received by: tibtie r ii I S 1ggoo hve, c.est-fat el) o ce55 o•oL ooe4P,04A► aj(ale I I