HomeMy WebLinkAboutArin, Risa (2) ' S�fFO�,rco
ELIZABETH A. NEVILLE �4 0 G •
?J► Town Hall, 53095 Main Road
TOWN CLERK 1
ti P.O. Box 1179
REGISTRAR OF VITAL STATISTICS v t Southold, New York 11971
MARRIAGE OFFICER :� y �1 Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER �__��! jig $ ,�i 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. 2447 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
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 ARIN, RISA
Mailing Address 1 145 EAST 16TH STREET
APT 4N
City St Zip NEW YORK NY 10003
Property Address 1 18 SOUND AVENUE
City St Zip PECONIC NY 11958
Tax Map No. section 67.00 block 1 lot 900
Cross Street MILL LANE
Building Permit Number Cross Reference:
Issue Date: 10/30/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE �4�= yi: Town Hall, 53095 Main Road
1 \ jNFLPRK % y Z P.O. Box 1179
REGISTRAR OF'VITAL-WAJTISTICS V 6 477? Southold, New York 11971
RRIAGE OFF E t y toN'/ Fax(631) 765-6145
RECO ENT OFFICER x,_-70:1 iNg *a 101 Telephone (631) 765-1800
FREEDOM OF IN .ATION OFFICER _ ,a�
'%. . ./1I
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: October 24, 2000
5
Transmitted herewith is a copy of application No. 2531 for a Cesspool/Septic Tank
CONSTRUCTION/ALTERATION Permit submitted by:
Peconic Cesspool for Arin
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
DISAPPROVE
Comments: Maintain required setbacks from adjacent wells, buildings, property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED. .
Signature
ID / v '1 o
Dated
OFFICE OF TUE TOWN CLERK uFF OLKe33-
TOWN OFSOtJTHOLD � QV-; Application No. �
ELIZABETH A.NEW 1 P.,TOWN CLERK
P.O.BOX 1179IO .4.
SOUTHOLD,NEW YORK 11971
Iteration
Telephone ,j� zbQ�i�,, $10.00 - Residential L-
(631) 765-1800 ='L' 4 ,.'�� $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE 01/T-2-d/f-)‘
APPLICANT NAME:
APPLICANT ADDRESS: /?v 6il ! '72
SEPTIC CESSPOOL?/
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
,may,•, er41e--
71",41rei,
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ,1 , j
OWNER MAILING ADDRESS: /4's /62X Jr
%ziG ' • /,bile jeoe23
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: ' 'J 96-$.4e
TAX MAP NO. : Section ('•7 Block 0/ Lot Qfj
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
eertel.,/ e
Signature of Appli nt
RECEIVED BY: i •
Town e k s O ice
DATE:
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