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Home My WebLink AboutDeReeder, John 1 \ /_ow JUDITH T.TERRY :t • Town Hall, 53095 Main Road TOWN CLERK H Z • P.O.Box 1179 REGISTRAR OF VITAL STATISTICS � Southold,New York 11971 MARRIAGE OFFICER '1iJJ Q`'�� Fax(516)765-1823 RECORDS MANAGEMENT OFFICER : .( t► se� Telephone(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. 1337 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 MATTTIUCK NY 11952 Descripton of Proposed Construction or Alteration ADDITION OF AN OVERFLOW 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 DEREEDER, JOHN Mailing Address 1 525 NEW SUFFOLK AVENUE City St Zip MATTITUCK NY 11952 Property Address 1 525 NEW SUFFOLK AVENUE City St Zip MATTITUCK NY 11952 Tax Map No. section 1114.00 block 11 lot 19.000 Cross Street MAIN ROAD Building Permit Number Cross Reference: Issue Date: 5/19/95 Judith T. Terry Southold Town Clerk (TOWN SEAL) o��FFO�K�oGy ••, X337 JUDITH T. TERRY : L L Town Hall, 53095 Main Road TOWN CLERK : o T P.O. Box 1179 c!'i � Southold, New York 11971 REGISTRAR OF VITAL STATISTICS = �Ya �� Fax (516) 765-1823 MARRIAGE OFFICER //./ AV�� Telephone (516) 765-1801 RECORDS MANAGEMENT OFFICER =7�'�/,� 4 " �� FREEDOM OF INFORMATION OFFICER iiiii.�� OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department °A, 1995 FROM: Linda Cooper, Southold Town Clerk's Office DATED: May 17, 1995 Transmitted herewith is a copy of application No. A138 for an ALTERATION PERMIT for a cesspool or septic system su mitted by Peconic Cesspool for John DeReeder 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. Linda J. Cooper * * * * * * * * * * * * * I have reviewed the application and location map of the project listed above and make the following recommendation: APPROVE - DISAPPROVE - COMMENTS: Maintain required setbacks from adjacent wells, buildings, property lines and water bodies. EXCAVATION INSPECTION REQUIRED. Imre ,9z4t' Signature Date OFFICE OF THE TOWN CLERK ,, •. Town of Southoldgl.k • Judith T. Terry, ; � COQ Town Clerk Application No. P� ��`�, �' � G - Town Hall, 53095 Main Road = Construction • P. O. Box 1179 z Southold, New York 11971 �fit r'l Alteration Telephone � D,A, � � $10.00 - Residential (516) 765-1801 Ol �� $25.00 - Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ DATE trial 17 /995 APPLICANT NAME: / APPLICANT ADDRESS: &fie 97 SEPTIC CESSPOOL DESCRIPTION OF PROPO ED CONSTRUCTION OR ALTERATION LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONST CTION OR ALT ATION: OWNER OF PROPERTY: OWNER MAILING ADDRES : 5 2-S' Witt, Ate, �e OWNER PROPERTY ADDRESS: ,-- TELEPHONE NUMBER OF CONTACT PERSON: c=` �� 16-5-S TAX MAP NO. : Section 1/9- Block /f Lot /7 CROSS STREET: BUILDING PERMIT NUMBER CROSS REFERENCE: Signature of ;0 p i cant RECEIVED BY: /41 'l T wn Clerk's Office DATE: 3//'"? 9.5 r i /77/4. /Lc K 04 alt166vtn-f# s�