HomeMy WebLinkAboutWiederman, Alicia 001(NOFFOL/(00
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ELIZABETH A. NEVILLE = G* ; Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
y Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER ` ?,iL ����, Fax (631) 765 6145
RECORDS MANAGEMENT OFFICER '/Ql * *a�.1� 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. 2310 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 MATTITCUK 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 WIEDERMAN, ALICIA
Mailing Address 1 77 COUNTRY VILLAGE LANE
City St Zip MANHASSET NY 11040
Property Address 1 450 CEDAR POINT ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 90.00 block 2 lot 15.000
Cross Street BAYV I EW ROAD
Building Permit Number Cross Reference:
Issue Date: 5/08/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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to
ELIZABETH A. NEVILLE �%I_ y�; Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS v' t
Southold, New York 11971
Fax (631) 765-6145
MARRIAGE OFFICER •fi • �1
RECORDS MANAGEMENT OFFICER � �01 �a0 i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ,00
•I,•��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: May 2, 2000
Transmitted herewith is a copy of application No. 2398 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic for Alice Wiederman .
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 g recommendation:
APPROVE -
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
Si-gnat
Date
OFFICE OF THE TOWN CLERK �``�F01� —
TOWN OF SOUTHOLD �% �l � Application No
�3
F.I J7ABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 Construction
SOUTHOLD,NEW YORK 11971 p MI • Alteration�.
: off �
Telephone j%,� ��0r�►'' $10.00 - Residential 4/(516) 765-1801 : 1 � $25.00 -Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE i'0//
APPLICANT NAME: 16-,?&-ri,
APPLICANT ADDRESS: ,/ /61, 972..-
SEPTIC
7ZSEPTIC CESSPOOL L/-
DESCRIPTION
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
1*--4e _-
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ,
OWNER MAILING ADDRESS: 77
OWNER PROPERTY ADDRESS: 15.D ,-z ArAgia I/e "/'
TELEPHONE NUMBER OF CONTACT PERSON: G72�9av-$-r
TAX MAP NO. : Section Block Lot /5—
CROSS—STREET:
5CROSSSTREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of p.pllcant
RECEIVED BY:
Town Clerk's Office
DATE: `i7L/04
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