HomeMy WebLinkAboutRyan, Michael (2) ELIZABETH A. NEVILLE �� yA: Town Hall, 53095 Main Road
TOWN CLERK ; co) 2 ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �t Southold, New York 11971
MARRIAGE OFFICER �� y l�,1� Fax(631) 765 6145
RECORDS MANAGEMENT OFFICER = �O? i41,101� Telephone (631) 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. 2421 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MICHAEL RYAN
Address 1 : PO BOX 1686
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION OF SEPTIC TANK TO EXISTING SYSTEM.
APPLICATION APPROVED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner RYAN, MICHAEL
Mailing Address 1 PO BOX 1686
City St Zip MATTTITUCK NY 11952
Property Address 1 1077 CRESENT WAY
City St Zip MATTITUCK NY 11952
Tax Map No. section 121 .00 block 4 lot 25.000
Cross Street LAUREL LAKE ROAD
Building Permit Number Cross Reference:
Issue Date: 10/10/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NE' YLLE' 7n.l'' i"" ;tO� � Town Hall, 53095 Main Road
TOWN CLERK_.w.��......___....r. `Y y Z % P.O. Box 1179
'`' "' �' i Southold, New York 11971
REGISTRAR OF VITAIATA jOt Ho O #
RECORDS MANAGEMENT OFFICER y-go 5
*a01�'�� Telephone (631Fax(631) )5-61
FREEDOM OF INFORMATION OFFICER �,�����
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: October 4, 2000
Transmitted herewith is a copy of application No. 2509 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Michael Ryan
Please review the application and location map and advise if the project has received Suffolk County
Health Department approval and if this office may issue the permit.
Please complete the form below and return it to me.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations: /
APPROVE v
DISAPPROVE
Comments: Maintain required setbacks from adjacent wells,buildings,property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED. .
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Dated
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OFFICE OF THE TOWN CLERIC s' �FOjK ��.J l/
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TOWN OF SOUTHOLD 0.. 1 (.
�G Application No.
(95-0,A.NEVILLE,TOWN CLERK �7 4.1
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P.O.BOX 1179 `tO Construction
SOUTHOLD,NEW YORK 11971 O '47
Alteration
Telephone 0,� � ,
$10.00 - Residential
(631) 765-1800 _ Ol 11:1:0' $25.00 -Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE /0 C0
APPLICANT NAME: f \ QJ\aQ ( u0.r
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APPLICANT ADDRESS:R O ?d)( J(28(e /079 Crescg ,nf L
a•k--kAActc (\)Y I 196-02
SEPTIC X CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
• OWNER OF PROPERTY: ; Clel R0.P `AG2 „E
OWNER MAILING ADDRESS: -PO jOX 1(,94)(.f
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OWNER PROPERTY ADDRESS: 109 r? Cre nt- LL)&u\
NQ 4;4-1A.ck 1\/ 11Q
TELEPHONE NUMBER OF CONTACT PERSON: o29 cel- v' /O
TAX MAP NO. : Section 19\ 1 Block / Lot c2-5-
CROSS
2-SCROSS STREET: /ire( l a De X__
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applic1
RECEIVED BY:
Town Clerk's Office
DATE:
v9 TE: i0-2 - 2000
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