HomeMy WebLinkAboutDePetris, Larry ,/� O�OSUFFO(,�00
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ELIZABETH A. NEVILLE ���_ 11: Town Hall, 53095 Main Road
TOWN CLERK ; y Z P.O.Box 1179
Vie.
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS O 4 ,1
MARRIAGE OFFICER � y 0 Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER ,',� 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. 2433 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PECONIC CESSPOOL
Address 1 : PO BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION OF OVERFLOW TO EXISTING SYSTEM.
APPLICATION APPROVED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner DEPETRIS, LARRY
Mailing Address 1 100 OLD PASTURE ROAD
City St Zip CUTCHOGUE NY 11935
Property Address 1 100 OLD PASTURE ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 103.00 block 11 lot 18.000
Cross Street PEQUASH AVENUE
Building Permit Number Cross Reference:
Issue Date: 10/13/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE �,�1_ 'y� Town Hall, 53095 Main Road
TOWN CLERK $ o - •
P.O. Box 1179
ti Z
� v„ n� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS • Q . $ Fax(631) 765-6145
MARRIAGE OFFICER . # •�
RECORDS MANAGEMENT OFFICER =_�pl �a�i1� Telephone (631) 765 1800
4.
FREEDOM OF INFORMATION OFFICER _ ��
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: October 11, 2000
Transmitted herewith is a copy of application No. 2521 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Larry DePetris .
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.
4-44e-4-.)--
Linda J. Cooper
* * * * * * * * * * * * * .
I have reviewed the application and location map of the project listed
above and make the followi recommendation:
APPROVE -
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
ignature
52
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Date
I
FFICE OF THE TOWN CLERK
Town of Southold .' C)��F'Ai�' " A {
Judith T. Terry, Town Clerk Application NoQ��
Town Hall 53095 Main Road `= Construction _
P. O. Box 1179 ; * Alteration
Southold, New York 11971 ,•` �'- ' j
�� $10. 00 - Residential v _
Telephone !fjr„ ,
(516) 765-1801 l •, $25. 00 - Non Residential
TOWN OF SOUT11O1. fl
SOUTHOLD WASTEWATER DISPOSAL DISTRICT •
APPLICATION
for
CONSTRUCTION or ALTERAT II) 4 PERMIT
SEPTIC TANK or CESSf3COL
Permit No.
Fee $ i
DATE /�- it0Q
APPLICANT NAME :
APPLICANT ADDRESS: AO.,_.4.294-
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION _____
4/444-
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LOCATION MAP: Must be attached hereto before permit may be Issued.
LOCATION OF PROPOSED CONSTRUCTION OR A'_TERATION:
OWNER OF PROPERTY : ge•Z
OWNER MAILING ADDRESS: ! (Vie--F =1.--
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OWNER PROPERTY ADDRESS: '
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TELEPHONE NUMBER OF CONTACT PEKtSON: oXte- f605V
TAX MAP NO. : Section_ -/0 3 Block /1 Lot ' g
CROSS STREET: a
BUILDINC PERMIT NUMBE CROSS REFEREdCE :
:Signature o , Ap- t
RECEIVED BY: '
town Clerk's Office Witte: -- it
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