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HomeMy WebLinkAboutLey, Charles //� , 11'l°,o��gtFFO(�6OG- "� A% JUDITH T.TERRY o= .Town Hall,53095 Main Road %TOWN CLERK • y Z% P.O.Box 1179 0 ,,� Southold,New York 11971 REGISTRAR OF VITAL STATISTICS 1 Fax(516)765-1823 MARRIAGE OFFICER :**� .i./. le RECORDS MANAGEMENT OFFICER .( * `t►l�,, 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. 1361 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 ADDITION OF A CESSPOOL 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 LEY, CHARLES A. Mailing Address 1 640 MAYFLOWER ROAD City St Zip NATTITUCK NY 11952 Property Address 1 640 MAYFLOWER ROAD City St Zip MATTITUCK NY 11952 Tax Map No. section 107.00 block 8 lot 26.000 Cross Street WOODCLIFF DRIVE Building Permit Number Cross Reference: Issue Date: 7/26/95 Judith T. Terry Southold Town Clerk (TOWN SEAL) /3 6 11. 4�/ � 4 JUDITH T.TERRY �= d •• Town Hall,53095 Main Road TOWN CLERK k y Z P.O.Box 1179 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS 4 �1 Fax(516)765-1823 MARRIAGE OFFICER ,_�� a��l� Telephone(516)765-1800 RECORDS MANAGEMENT OFFICER I 'sr �►fe. FREEDOM OF INFORMATION OFFICER �� ,�•"� OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD JUL 8 1995 TO: Southold Town Building Department FROM: Linda Cooper, Southold Town Clerk's Office DATED: July 17, 1995 Transmitted herewith is a copy of application No. A1413 for an ALTERATION PERMIT for a cesspool or septic system submitted by Peconic cesspool for Charles Ley 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. 4u 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. RECEIVED / r / Sig ature JUL 241995 Town Clerk Southold Dat OFFICE ')F THE TOWN CLERK ,,,,,,,,,��� �j�� Town of Southold , � CORILxe'0 Application No. Judith T. Terry, Town Clerk •' �� Gy Town Hall, 53095 Main Road •� Construction P. O. Box 1179 • Alteration Southold, New York 11971 ••� Telephone �Q •�• $10.00 - Residential 1/ (516) 765-1801 1 1 ' $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 7/i7/ qs APPLICANT NAME: 05 /297--A-*/7 APPLICANT ADDRESS: SEPTIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION 1 LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTI N OR LTERAT101: OWNER OF PROPERTY: L h x/65 A- �] OWNER MAILING ADDRESS: 6 5f';1 /144"F`OGl/C. —1L- r��� 1/9c?--- OWNER /95 ZOWNER PROPERTY ADDRESS: TELEPHONE NUMBER OF CONTACT PERSON: - "6.55' TAX MAP NO. : Section /6 ? Block cr Lot .9"-cj CROSS STREET: / BUILDING PERMIT NUMBER CROSS REFERENCE: Signature of Applic 't RECEIVED BY: 7/To n Clerk's Office DATE: 7) 1 ___________\ , , .,„,,,,,„,„‘„,.._, . 7 1 , ,, #r� IA © _ old �' $7°°f