HomeMy WebLinkAboutPerini, Dominick SUFFO4cOG`\
ELIZABETH A. NEVILLEt _ y� Town Hall, 53095 Main Road
TOWN CLERK - • P.O. Box 1179
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v n� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax (631) 765-6145
MARRIAGE OFFICER �•�,iL `��1�,
RECORDS MANAGEMENT OFFICER � �Q1 •Vv 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. 2279 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 PERINI, DOMINICK & WINIFRED
Mailing Address 1 PO BOX 1252
City St Zip MATTITCUK NY 11952
Property Address 1 7213 PECONIC BAY BLVD
City St Zip MATTITUCK NY 11952
Tax Map No. section 126.00 block 10 lot 1 .002
Cross Street
Building Permit Number Cross Reference:
Issue Date: 3/24/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE 1,�=�0 OGZ� Town Hall, 53095 Main Road
TOWN CLERK p _ P.O. Box 1179
REGISTRAR OF VITAL STATISTICS y Z Southold, New York 11971
O Fax(516) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICERy�fO _O�I'II Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER '�Il '��.'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: March 22, 2000
Transmitted herewith is a copy of application No. 2367 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Dominick Perini
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.
Signatu
Date
OFliCB OF THE TOWN CLBRIC
,,FFOtk
TOWN OF SOUTHOLD ,�� �
OLA*-___ Application No.a3(or)
ELIZABETH A.NEVILLE,TOWN CLERK -
P.O.BOX 1179 Construction ✓
SOUTHOLD,NEW YORK 11971 : 9 Alteration
Telephone 0,� Q $10.00 - Residential L/
(516) 765-1801 �l �,I $25.00 -Non-Residential
• - ,,..ori .
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT 4 E C E i V E D
MAR 2 2 2000
APPLICATION akuotheici Town Clerk
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee '$
DATE a3 aid
APPLICANT NAME: "1-r-°0-121.c..._d
APPLICANT ADDRESS:
SEPTIC CESSPOOL
Ni
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: D/`ji1i4J/<<-k ,l/, ,4- -a/
OWNER MAILING ADDRESS: A )
,T7n-77;ry c-i-
OWNER PROPERTY ADDRESS: 7 , 3 .. 4i,,y 41L —
TELEPHONE NUMBER OF CONTACT PERSON: c9-ffi ç '
TAX MAP NO. : Section /)4, Block /0 ` Lot I
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applic nt
RECEIVED BY:
Town Clerk's Office
DATE:
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