HomeMy WebLinkAboutGannon, Dorothy ,/ o��stfFO(4-co
ELIZABETH A. NEVILLE ���� 1`: Town Hall, 53095 Main Road
TOWN CLERK y Z • P.O. Box 1179
REGISTRAR OF VITAL STATISTICS V g 4"
y 1
Southold, New York 11971
MARRIAGE OFFICER � y � Fax (631) 765-6145
*a
RECORDS MANAGEMENT OFFICER S. .ON' Fax
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. 21431 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 GANNON, DOROTHY
Mailing Address 1 PO BOX 1625
City St Zip MATTITUCK NY 11952
Property Address 1 350 MACDONALD CROSSING
City St Zip LAUREL NY 11948
Tax Map No. section 145.00 block 4 lot 18.000
Cross Street PECONIC BAY BLVD
Building Permit Number Cross Reference:
Issue Date: 10/13/00 Elizabeth A. Neville
- Southold Town Clerk
(TOWN SEAL)
•
at-1 I
ELIZABETH A. NEVILLE �� yA: Town Hall, 53095 Main Road
TOWN CLERK k, o ti P.O. Box 1179
Z •
REGISTRAR OF VITAL STATISTICS
nti Southold, New York 11971
MARRIAGE OFFICER 4 . ,1� FaX (631) 765-6145
RECORDS MANAGEMENT OFFICER ;��l 4j so. Telephone (631) 765-1800
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: October 6, 2000
Transmitted herewith is a copy of application No. 2513 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Dorothy Gannon •
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 followi recommendation:
APPROVE
�
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
gnatur
to //, /a0
Date
Tr ..•A '' '
OFFICE OF THE TOWN •CLERK
'" -TPwn of Southold ,.' stfOttrAt--- .,,‘
Judith T. terry, Town Clerk .'' -- -- Application Nof:?‘573 ',
Town Hall, 53095 Main Road Construction -
P. 0. Box 1179
•
Southold, New York 11971 '*., Alteration______
Telephone -....tie2, s6;ri/ $10.00 - Residential go/
(516) 765-1801 40/ 41 i‘ , $25.00 - Non-Residential
-.. • •
, ------
. TOWIs OF SOUTHOLD
SOUTHOLD WAC-I I WATER DISPOSAL DISTRICT
1
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT I
.._,1SEPTIC TANK or CESSPOOL
Pet mit No,______.__
.. .
Fee $--- ------ --. -_
DATE /12h/0-1) ____
APPLICANT NAME:__,
APPLICANT -ADDRESS'
- ' 7_
SEPTIC CESSPOOL 1.,•*
• , DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
-------- _
_ - -
.4..,.L271<lel ---e.cif042 ,16...a, ,
. ,
LOCATION MAP: Must. be attacilei hereto t)ercle pe-mit may be issued.
LOCATION OF PROPOSED CONSTItUCT1ON OR At. IE ATION .
OWNER OF PROPERTY , ,
OWNER MAILING ADDREf. ., : Aapl /401:775
___ _____71reteeZtreteaCALJ
OWNER PROPERTY ADDRESS . 3 5() rict.g. II , ' L..
_ _
or
IMF g-,7
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section /411,5 Block .49_ Lot ir
-
tailikoiS' STREET . laseir,„,s..ed _,4404‘,
Ai,
__ _ _ _
dr.
BUILDING PERMIT NUMBER :ROSS REFERENCE :
, I
Signature of Ap 'cant
RECEIVED BY :
— To—vvn Cie-rk's --Office
DATE:
---------- . _
- •
/ • -
,
�' .lk:. Y.w
? E
).
....t,az, L.____' . , -.,,,,,,,'',,,,,i,,,,i,7.,..,1,1',,i,,,,
/
y_
i livw,-. 1
I
}
9. , ar- Id/44145 4.4,Cs-
a-E.7'4- 11' WO it 1
0l�'M -eli +11
.----irog,) .
J Vit
1