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Home My WebLink AboutKing, Daren SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 4331 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool 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 SUBMI'riED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. Name Of Owner KAREN & ERIC PAPKIN (KING) Mailing Address 1 1515 SIGSBEE RD City St Zip MATTITUCK NY 11952 Property Address 1 1515 SIGSBEE RD City St Zip MATTITUCK NY 11952 Tax Map No. section 144.00 block 2 lot 10.000 Cross Street PECONIC BAY BLVD Building Permit Number Cross Reference: Issue Date: 7/21/15 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) ,,� g�FFOI��; ELIZABETH A. NEVILLE,MMC �may. Town Hall,53095 Main Road TOWN CLERK P.O. Box 1179 ae ; Southold,New York 11971 REGISTRAR OF VITAL STATISTICS 0 ��Pro � Fax(631)765-6145 MARRIAGE OFFICER y sI RECORDS MANAGEMENT OFFICER =0�/t * i' .'� Telephone(631)765-1800nny.go � www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Carol Hydell, Southold Town Clerk's Office DATED: July 17, 2015 Transmitted herewith is a copy of application No. 4331 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Peconic Cesspool for Daren King 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. Thank you * * * * * * * * * * * * 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, buildings,property lines and water Bodies. EXCAVATION INSPECTION REQUIRED. Signature 07/77/S— Dated ELIZABETH A.NEVILLE,MMC op �, Gy Town Hall,53095 Main Road TOWN CLERK o P.O. Box 1179 H = Southold,New York 11971 REGISTRAR OF VITAL STATISTICS p .fie r Fax(631)765-6145 MARRIAGE OFFICER :�#4 Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER 1 Y.g OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD July 21, 2015 Peconic Cesspool PO Box 487 Laurel,NY 11948 RE: 144.-2-10(Papkin/King) 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 Dollars ($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, • Sabrina Born Clerk Typist Enclosures }�/ A.NEVI LE ;,' ' i �. Town�/�,58095 Main TOW 1�i\ "'rka'- • ; P.O.Box 1179 9 REGISTRAR OF VITAL STATISTICS • Southold,New York 11971 Me 1aTAt O5 ,,�.- t%� Fat(68D 765.6145 PECO MAITAt�',ME4' ''`- ,.' Telephone(631)765-1800 POM OF Il�BMAT1ON OFFTCBR , r%'' $OUtholdtown.nort�sfork.net OFFICE OF THE TOWN CLERK • TOWN OP winnow solimoLD W.�A WATER DISTRICT APPLICATION CONSTRUCITON or ALTERATION P R1flT CESSPOOL or SEPTIC TANK t Residential @$14•__„ or Non-Res @$25 Application No. 1-4 33) .. Ptit No. Applicant Name PIC CESSPOOL Applicant Mailing Address P•. 0. BOX _487 IAIBIEL, liEW YORK 11948 Septic Tar:- or Cesspoi V Brief Descl.ption of Proposed ,_;-v,..c tion or Action YeAA,0k,1e P ceSSA, Location of Proposed Coir ictiontAlteaation:r ' r of Kate') , Erc c . ra k V Gln Owner Pri�pezty` OwIler Mailing Address: 15-15 $'(:Se Mak--1- 1!-I,cc/k1 i 950, Owner Property Address: 1515 Sc k MOOF6'6.C, NtY 1( qsA Name and phone number of contact person - L&i 51.1-—03,2 Tax Map No: Section 1 Block Lot / C) CYC Street 2QYLLC' ' . 8-Q-4A-9/ NOTE: LOCATION.MAP MUST BE :$ Mtl i ZD WrIH APPLICATION. NEW CONSTRUCTION REQUIRES SURNEY WITH HEALTH P A ARTNIEi T , 7 (( /5- c..... i sing=of Applicant Date Received by: 061 %root Cmy001 t►1. 4 m 4eset a04, JR9L