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Home My WebLink AboutJerry Shulman Produce Shipperx ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER O�oSUFFO(,�co� o - co Z Oy � O�P" Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 85 N Residential Non -Residential X Fee $ 25.00 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 OLD CESSPOOL WITH NEW TYPE APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION REQUIRED. Name Of Owner JERRY SHULMAN PRODUCE SHIPPER Mailing Address 1 DEPOT LANE ------------- ------------------------------ City St Zip CUTCHOGUE NY 11935 -------------------- -- ---------- Property Address 1 DEPOT LANE ------------------------------ ------------------------------ City St Zip CUTCHOGUE NY 11935 -------------------- ------------ Tax Map No. section 96.00 block 2 lot 3.000 Cross Street ------------------------------ Building Permit Number Cross Reference: Issue Date: 12/15/98 ---------------------------------- Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) FO(,��,G� ELIZABETH A. NEVILLE " y� TOWN CLERK c -� N 2 REGISTRAR OF VITAL STATISTICS �y MARRIAGE OFFICER • O RECORDS MANAGEMENT OFFICER 4,, 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 10, 1998 v /C f- S Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax(516)765-1823 Telephone (516) 765-1800 Transmitted herewith is a copy of application No. 2059 for an ALTERATION PERMIT for a cesspool or septic system submitted by Peconic Cesspool for Jerry Shulman Produce Shipper , 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. 4c- ce E� Linda J. Cooper I have reviewed the application and location map of the project listed above and make the foll7", recommendation: APPROVE - DISAPPROVE - COMMENTS: Maintain required setbacks from adjacent wells, buildings, property lines and water bodies. EXCAVATION INSPECTION REQUIRED. 4 nature Date OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD ELIZABETH A. NEVRI E, TOWN CLERK P.O. BOX 1179 SOUTHOLD, NEW YORK 11971 Telephone (516) 765-1801 �vFFOIK�� v Ol jj1L TOWN OF SOUTHOLD Application No.,?0,51� Constructiony Alteration $10.00 -Residential [/ $25.00 -Non-Residential SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ DATE APPLICANT NAME: APPLICANT ADDRESS: OHO 6e,,�e- 7 SEPTIC CESSPOOL I -- DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATIO LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUTION OR OWNER OF PROPERTY: OWNER MAILING ADDR' TERAT ION: OWNER PROPERTY ADDRESS: TELEPHONE NUMBER OF CONTACT PERSON: TAX MAP NO.: Section 7(e Block 0 Z CROSS STREET: Lot 3 BUILDING PERMIT NUMBER CROSS REFERENCE:�,�,� n Signa ure of plicant RECEIVED BY: Town Clerk's Office DATE: 144leAl m carsSPn W s N F