HomeMy WebLinkAboutKing, Stephen .�,�o��sUFFO�,�e
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ELIZABETH A. NEVILLE ���� G'y� Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
H Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER ‘b344 � ', 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. 2393 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JEAN KING
Address 1 : PO BOX 863
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
REPLACE BROKEN COVER AND UPGRADE SYSTEM.
APPLICATION APPROVED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner STEPHEN & JEAN KING
Mailing Address 1 PO BOX 863
City St Zip MATTITUCK NY 11952
Property Address 1 525 FRANKLINVILLE ROAD
City St Zip LAUREL NY 11948
Tax Map No. section 125.00 block 2 lot 7.000
Cross Street ALDRICH LANE
Building Permit Number Cross Reference:
Issue Date: 9/08/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
••,O�OS�FFO(,��;;
ELIZABETH A. NEVILLE ��= OG'f� •
Town Hall, 53095 Main Road,c) 3
TOWN CLERK C - P.O. Box 1179
ti Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
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���, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER �__*Ol �a�i1� Telephone (631) 765-1800
jig
FREEDOM OF INFORMATION OFFICER rs��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: August 24, 2000
Transmitted herewith is a copy of application No. 2482 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Jean King, 2290 Deep Hole Dr. , Mattituck, 11952 ,
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 following recommendation:
APPROVE -
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
Signature
sl z-t �L
Date
,,,•,,......,,,,
OFFICE OF THE TOWN CLERK .1.114f
TOWN OFSOUTHOLD ��'Q�'J CQG Application No02 q a�
ELIZABETH A.NEW SOUTHOLD
CLERK i '�1
P.O.BOX1179 ;4Construction
SOUTHOLD,NEW YORK 11971 0 T
• Ul Alteration
Telephone ,y, ��i� $10.00 - Residential
(631) 765-1800 = l. �;,0'� $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 c 6-
APPLICANT NAME: J A9N let A(C)
APPLICANT ADDRESS: 22 ?O DEEP F/oLE DR.
111/9- TT( Tui-lam
SEPTIC CESSPOOL g/
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
eed /dc_e hrOk�f-7 c ver- arid lilorrtde 5VS74em j
Pr / C_e_.. &1 15?/i1lc !t'DQt-c� 3
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
• OWNER OF PROPERTY: 67"EfWE/J Q. jE,41N 116 C
OWNER MAILING ADDRESS: tO /66K e622
/77 i-r-( , c K ,L( ( (q cc71--
OWNER PROPERTY ADDRESS: $a' Fe/9WKL,n'(J/ LLL ,firs .
/ -u 2 c L-- ti-'
TELEPHONE NUMBER OF CONTACT PERSON: (.2j/)a9 0r- 4"//7
TAX MAP NO. : Section /ate. Block Lot "7
CROSS STREET: gi.DP(C H /,g A/c.=
BUILDING PERMIT NUMBER CROSS REFERENCE:
gnature of Applica
RECEIVED BY:
Tow'er 's Office
DATE: • r
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Licensed L4rtd $ �� /rnK4�
Greerifrort, N. Y. et Fr►od . 0
fcr�ey�'g$y
-60 I` �$'10. UNAUTHORIZED ALTERATION OR ADDITION
i L•$,�7 DA n TO THIS SURVEY IS A VIOLATION OF T,
4b ow
SECTION 7209 OF THE NEW YORK TAE'I
EDUCATION LAW:, '; �
.---- ' e p4r COPIES OF THIS SURVEY MAP NOT• ARING t;
THE LAID SURVEYOR'S INKED SEALbR
EMBOSSED SEAL SHALL NOT BE CONSIDERED .,,,
TO BEA VALID TRUE COPY. itt-
. GUARANTEES,INDICATED HEREON SIIALL,IWN
{{{++y�� •ONLY TO THE'PE$SON FOR$1V(:CMI E SUfc IY
1J- 9 / 1S PREP/IAED,AND ON HIS{I HALF IHE;
TITLE COMPANY,GOVERNMN r�l A cNCY
LENDING INSTITUTION LISTED H RLOP(,AND•" !
TO THE ASSIGNEES OF THE LENDING NSTI•
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TUTION.GUARANTEES ARE NOT TRANSFERABLE
A me Hole to = g JO, /97S - TO AGauIGNALITIS ILIT,oNO-ORANSr kA
OWNERS.