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HomeMy WebLinkAboutDrobet, Jack �� �0 Gy . JUDITH T.TERRY Town Hall,53095 Main Road %TOWN CLERK y Z ; P.O.Box 1179 REGISTRAR OF VITAL STATISTICS %O �, Southold,New York 11971 MARRIAGE OFFICER � • ��� Fax(516)765-1823 RECORDS MANAGEMENT OFFICER � * 1.-es •.• 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. 1428 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 MATTITUCK NY 11952 Descripton of Proposed Construction or Alteration REPLACE EXISTING CESSPOOL WITH A NEW TYPE. APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION REQUIRED. Name Of Owner DROBET, JACK Mailing Address 1 BOX 965 City St Zip MATTITUCK NY 11952 Property Address 1 LUPTON'S POINT City St Zip MATTITUCK NY 11952 Tax Map No. section 115.00 block 11 lot 4.001 Cross Street MARATOOKA ROAD Building Permit Number Cross Reference: Issue Date: 12/15/95 Judith T. Terry Southold Town Clerk (TOWN SEAL) 41.6 **EMERGENCY - CAVE IN /°1,���SOFFO(, ,o • ,� y0 G : JUDITH T.TERRY � yet Town Hall, 53095 Main Road TOWN CLERK ; y = P.O. Box 1179 T Southold, New York 11971 REGISTRAR OF VITAL STATISTICS : O � �'V' Fax (516) 765-1823 MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER l [l .k' ��/ Telephone(516) 765-1800 - /, FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda Cooper, Southold Town Clerk's Office DATED: December 15, 1995 Transmitted herewith is a copy of application No. A1485 for an ALTERATION PERMIT for a cesspool or septic system submitted by Peconic Cesspool for Jack Drobet 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. .#Sig atu r� /"VI f c Date OFFICE OF THE TOWN CLERK ,,•,""' Town of Southold � Judith T. Terry, Town Clerk %`' Ol/ : Application No./Yu Town Hall, 53095 Main Road = Construction L� P. O. Box 1179 Southold, New York 11971 Alteration O� Telephone ,� � i $10.00 - Residential (516) 765-1801 = 01i �, �'� $25.00 -Non-Residential L TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ DATE APPLICANT NAME: of, APPLICANT ADDRESS: Z. SEPTIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: OWNER MAILING ADDRESS: 4 9c s- I s OWNER PROPERTY ADDRESS: ---�— TELEPHONE NUMBER OF CONTACT PERSON: (77-9Y---- TAX 29 -TAX MAP NO. : Section %/ c Block // Lot / CROSS STREET: BUILDING PERMIT NUMBER CROSS REFERENCE: , c-- Signature f Applicant RECEIVED BY: Town Clerk's Office DATE: 4 • 4 ,• -.- / I.'"C' 41144iitt'' ."--'-' , )"I /, / , / I' ) AA) 41! .‘-------• tetril44 / N1 itel Al - 1 -----„,- WO tr s 0.4.4••• • AI ( 4,,,Atte......./...„.