HomeMy WebLinkAboutMoore, George •
• ill 0004 A
•0'
•
ELIZABETH A. NEVILLE ����0 Gyp Town Hall, 53095 Main Road
TOWN CLERK o P.O. Box 1179
REGISTRAR OF VITAL STATISTICS V' Southold, New York 11971
MARRIAGE OFFICER :O?i . ���, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER "Api $ ••' 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. 2288 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 MOORE, GEORGE & EILEEN
Mailing Address 1 5420 MAIN BAYVIEW ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 5420 MAIN BAYVIEW ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 78.00 block 4 lot 35.000
Cross Street
Building Permit Number Cross Reference:
Issue Date: 4/14/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
•
•„011(\ FFOLt a ,<
• to
ELIZABETH A.NEVILLE %/_ 'y Town Hall, 53095 Main Road
TOWN CLERK ; y i ; P.O. Box 1179
Pry
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ��
O Fax (631) 765-6145
MARRIAGE OFFICER s” y� ��/ Telephone (631) 765-1800
RECORDS MANAGEMENT OFFICER of *
a
FREEDOM OF INFORMATION OFFICER .00'��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: April 4, 2000
Transmitted herewith is a copy of application No. 2376 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for George & Eileen Moore
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
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.
Signal e
1 -S
Date
wOtK��,
OFFICE OF THE TOWN CLERK �'
, 'CFF
TOWN OF SOUTHOLD � CO Application No. 23
FTI7ABETH A.NEVILLE,TOWN CLERK '
P.O.BOX 1179 r� Construction [�
SOUTHOLD,NEW YORK 11971
v ^' Alteration
Telephone yO.j,� % $10.00 - Residential (--
(516) 765-1801 -v4 * ,''�, $25.00 -Non-Residential
•
-- '
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 3/7-1/0"1)
APPLICANT NAME: 11.r
APPLICANT ADDRESS: l/' /3r7.. ?72i
•
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
S
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ,�v.,G-y-7 .o.
OWNER MAILING ADDRESS: Sa-D nt-iiGs�, A-17 A C,
'�
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: QV fast
TAX MAP NO. : Section 7, Block Lot 3
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Z4Z-2Z4/
Signature of A pli nt
VECEIV En
RECEIVED BY:
nrn 1�r!(1fk's Office
DATE:
l
Southold Town c
S
N
Vcoill- 4%#
(k/Cfs-*
/''4-
IOoo r.�