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HomeMy WebLinkAboutMcCall, Adrian o JUDITH T. TERRY • yL Town Hall, 53095 Main Road TOWN CLERK v T • • P.O. Box 1179 CP �� Southold, New York 11971 REGISTRAR OF VITAL STATISTICS = VO Fax 0° Fax Fax (516) 765-1823 MARRIAGE OFFICER .%, • Telephone (516) 765-1801 RECORDS MANAGEMENT OFFICER '.'t/ 4iore. 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. 1235 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 NEW TYPE. APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION REQUIRED. Name Of Owner MCCALL, ADRIAN Mailing Address 1 P. O. BOX 271 City St Zip CUTCHOGUE NY 11935 Property Address 1 10230 NEW SUFFOLK AVENUE City St Zip CUTCHOGUE NY 11935 Tax Map No. section 116.00 block 6 lot 3.000 Cross Street MOORES LANE Building Permit Number Cross Reference: Issue Date: 10/27/94 Judith T. Terry Southold Town Clerk (TOWN SEAL) \\MIL// ,'gip OGy JUDITH T. TERRY � = z Town Hall, 53095 Main Road TOWN CLERK . p rT P.O. Box 1179 cls w � Southold, New York 11971 REGISTRAR OF VITAL STATISTICS = VO ,' Fax (516) 765-1823 MARRIAGE OFFICER _ ��jj�� .a� �.' Telephone (516) 765-1801 RECORDS MANAGEMENT OFFICER `'��/1 �I���� FREEDOM OF INFORMATION OFFICER „„�i OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda Cooper, Southold Town Clerk's Office l 4 1994 DATED: October 21, 1994 _ Transmitted herewith is a copy of application No. A1280 for an ALTERATION PERMIT for a cesspool or septic system submitted by Peconic Cesspool for Adrian McCall . 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 - EXCAVATION INSPECTION DISAPPROVE - REQUIRED COMMENTS: Maintain required setbacks from adjacent wells, buildings, property lines and water bodies. EXCAVATION INSPECTION REQUIRED. Signature ! /6/06— Date aDate /71.. r OFFICE OF THE TOWN CLERK 1� ,,''' '''-- Town of Southold �� olK`+-y 0 Application No./ Judith T. Terry, Town Clerk + Town Hall, 53095 Main Road L ; Construction Ar--, P. O. Box 1179 o am Southold, New York 11971 us W$ Alteration Telephone O,l �Q �� $10.00 - Residential (516) 765-1801 = Ol 11 ,, ' $25.00 -Non-Residential • TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICAT ION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ DATE /OA/ '✓ APPLICANT NAME:_frie2fiz, - APPLICANT ADDRESS: /� Air 97 — SEPTIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION ,_ ,i...ii.. .� �.r LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRU TION OR ALTERATION OWNER OF PROPERTY: gibie/,9/4' /4Z t �� OWNER MAILING ADDRESS: A D ?7/ OWNER PROPERTY ADDRESS: /40 2- ay NArit S ' � I/r3s' TELEPHONE NUMBER OF CONTACT PERSON: did - 9�o,ft TAX MAP NO. : Section //( Block Lot 3 CRS-STREET: BUILDING PERMIT NUMBER CROSS REFERENCE: Signature • Ap licant RECEIVED BY: Tc.vn Clerk's Office DATE: -41g, • • • -44' .." i-_____. ......i ; J - a If 1 .1 I i 1 • ' I 1 1 , , ,., . ...... 1„, i..10 r ) „ 1 ! 1 \ tMirV --- 1 A'1,• ' \'-':,,h, N i tj0 ,. \i, f 4\ e, ,--- 1 , . , . . . ee e , Ti ;:f 1 . ) \4 ' I 'k...:V \