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Home My WebLink AboutMuntner, Eryk s SCUTHCLD VIASTEVIATER DI SPOSAL PERM T CC STRUCTI CN CR ALTERATI CN PERM T SEPTI C TANK or CESSPOOL Per rri t No. 4234 R Fesi dent i al X Isbn-Rlesi dent i al Fee $ 10. 00 Septic X Cesspool PERM T I SSt.ED TO Name : PECCN C CESSPCCL Address 1: P O ECK 487 a t y St Zip LALAEL NY 11948 Descr i pt on of Pr oposed Const r uct i on or Al t er at i on ADDI TI CN TO EXI STI NG SYSTEM APPRCAIED AS SUBM TIED NAI NTAI N REGU FED SETBACKS FROM ADJACENT VELLS, BU LII NGS, PROPERTY LI NES AND MATER BCD ES. EXCAVATI CN I i SPECTI CN REGU FED Nane a Omer ERYK M.NTNER Mai I i ng Address 1 4210 CLE J ULE LANE a t y St Zi p NATTI TUCK NY 11952 Property Address 1 4210 CLE J ULE LANE a ty St Zi p MUI TUCK NY 11952 Tax Map Nb. sect i on 122. 00 bI ock 4 I of 28. 000 Cross Street KRAUS ROAD Bui I di ng Per m t Number Cr oss Ref er ence: I ssue L1at e: 4/28/ 14 El i zabet h A Nevi I I e Southold Tow a er k (TOl'4J SEAL) ,,iii,.. ,Of�o��gUFFO�,�-0 ELIZABETH A. NEVILLE,MMC Town Hall, 53095 Main Road TOWN CLERK ' p P.O.Box 1179 Z Southold,New York 11971 REGISTRAR OF VITAL STATISTICS p 41$ Fax(631)765-6145 MARRIAGE OFFICER `�42. Q / Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER * � �►a 0 � 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: April 28, 2014 RE: Cesspool Construction/Alteration Application Transmitted herewith is a copy of application No. 4234 for a Cesspool/Septic Tank Construction Permit submitted by: Peconic Cesspool for Eryk Muntner 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: Signature Dated ELIZABETH A.N EVB.IX S Gy Town Hall,53095 Main Road f TOWN CLERKCAP.O.Box 1179 REGISTRAR OF VITAL STATISTICS Southold,New York 11971 MARRIAGE OFFICER `� G �!' Fax(631) 765-6145 RECORDS MAIIAGEMENT OFFICER1 � ,s' Telephone(631)765-1800 FREEDOM OF SNFORMATION OFFICER = •• southoldtown.northfork.net OFFICE OF TEE TOWN CLERK • TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @$10 V or Nan-Residential @$25 Application No. a-3 Permit No. Applicant Name PECONIC CESSPOOL Applicant Mailing Address P. 0. BOX 487 LAUREL, NEW YORK 11948 Septic The: or Cesspool Brief Desc :ptio of osed Co ction or Alteration p c4�� p�yy�.ei c.� o�� Location of Proposed Construction/A1 tion: „ Owner of Property: Er,t Owner Mailing Address: V Lio, Of 0(e,f el 14e -w0e-- Mt Owner Property Address: z • J/C � C•cc 41 ll Name and phone number of contact person Wo 5°Z — $i7 Tax Map No: Section to Block 'f Lot a Cross Street NOTE: LOCATION MAP MUST BE SUBMITTED APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HE• DEPARTME • OVAL SignatureofApplicant Date Received by: . Oite 1)(.(1,e, 0 :yin if\f, S 4o9\ ( 0 60` O– — -s 064 ce6srd(, SS ` cyt&L.