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HomeMy WebLinkAboutCogen, Morton SOUTHOLD WASTEWAWR DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 4326 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 SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. Name Of Owner MORTON COGEN Mailing Address 1 1395 FLEETWOOD RD City St Zip CUTCHOGUE NY 11935 Property Address 1 1395 FLEETWOOD RD City St Zip CUTCHOGUE NY 11935 Tax Map No. section 137.00 block 4 lot 31.000 Cross Street EAST ROAD Building Permit Number Cross Reference: Issue Date: 6/24/15 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) ,•',N, FFot,��o ELIZABETH A. NEVILLE,MMC ,���.�.� �(f,`; Town Hall,53095 Main Road TOWN CLERK 1 P.O. Box 1179 ar ; Southold,New York 11971 REGISTRAR OF VITAL STATISTICS p ��� Fax(631)765-6145 MARRIAGE OFFICER = if �� RECORDS MANAGEMENT OFFICER =_'"01 * '�►a�i'� Telephone(631) nny.gov �,.' www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER _,,,,,,,,,•I OFFICE OF THE TOWN CLERK]1 ��-..__— �- --.= 1 TOWN OF SOUTHOLD 111 ' ,:1,< a d �' ��i JUN 17 2015 ll i'" � TO: Southold Town Building Department j- .. , FROM: Carol Hydell, Southold Town Clerk's Office I DATED: June 17, 2015 Transmitted herewith is a copy of application No. 4326 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Peconic Cesspool for Morton Cogen 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 1 cation 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. (7,,,,,,,,.......,_,„ F g Si nature f4 /p /� Dated ••,iii.,,, , 4F -. ELIZABETH A.NEVILLE,MMC s,ay. �y Town Hall,53095 Main Road TOWN CLERK ; § P.O. Box 1179 ` Southold,New York 11971 REGISTRAR OF VITAL STATISTICS ; p .F �� Fax(631)765-6145 MARRIAGE OFFICER �;_'*4 aQ�,,,1 Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER -: Ol 4 'i .' www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER ,.,,,.•• OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD June 24,2015 Peconic Cesspool P.O. Box 487 Laurel,NY 11948 RE: 137.-4-31 (Cogen) 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 7„1.ABETS A.NEVI LE ,', y : Town Hall,53095 Main Road TOWN CLERK c P.O.Box 1179 REGISTRAR OF VITAL STATISTICS : moi• Southold,New York 11971 MARRIAGE OFFICER 42,4 t�' Fax(631)765-6145 RECORDS MANAGEMENT OFFICER =_ ' � 0�,�' Telephone(631)765-1800 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 V or Non-Residential @$25 Application No. 4 L/ 3 Permit No. • Applicant Name PECONIC CESSPOOL Applicant Mailing Address P O BOX LAUREL, NEW YORK 11948 Septic Tom- or Cesspool Brief Desc ption • 1.0.1,osedCoction or Alteration t• ( d& C P. ,O Location of Proposed Construction/Alteration: Owner of Property: �=oViV 1 � r Mo -rov) Owner Mailing Address: B 'te OO 4 ec( CtiOtcrt1_,ALAP,/Ower PropertyAddress: I3900 . C�,(1 Name and phone number of contact person L: / 1 3 Tax Map No: ection 7. Block -(- Lot '3 Cross Street F-4/ NOTE: LOCATION-MAP MUST BE SUB ' D WITH APPLICATION. W CONSTRUCTION REQUIRES SURVEY '. ." 4: TH DEPAR T • ` v WV I (0 17 l Signature of Applicant Date CyReceived by: IV N A :,-;‘,... E.1 • 1 als•Al t....--- •- — -— ....-.— — , .. .60 4?-?&/L- • 1 • P-"' (3 •C . (0. 1 I - , . •