HomeMy WebLinkAboutKilkenny, James •'_&0 Co
O� OGS Town Hall, 53095 Main Road
ELIZABETH A.NEVILLE
TOWN CLERK %
.c P.O. Box 1179
ti Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ; ; Fax (516) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER 15i* Ow �� Telephone (516) 765-1800
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FREEDOM OF INFORMATION OFFICER N.. ' . ,���
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2181 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PECONIC CESPOOL
Address 1 : P.O. BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION OF CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM WELLS,
BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION
REQUIRED.
Name Of Owner KILKENNY, JAMES
Mailing Address 1 300 KNOLLWOOD ROAD
City St Zip MATTITUCK NY 11952
Property Address 1 300 KNOLLWOOD ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 107.00 block 1 lot 20.000
Cross Street
Building Permit Number Cross Reference:
Issue Date: 10/25/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
'i//// II
��,�Og�FFO(,�Cp ••ELIZABETH A.NEVILLE �1 S. 4 ; Town Hall, 53095 Main Road
TOWN CLERK t p P.O. Box 1179
REGISTRAR OF VITAL STATISTICS %� Southold, New York 11971
y
O Fax Fax (516) 765-6145
MARRIAGE OFFICER ` Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER ---_-'0i
Wig O of P
FREEDOM OF INFORMATION OFFICER :O!'4 /-0.11
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: October 22, 1999
Transmitted herewith is a copy of application No. 2270 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for James Kilkenny .
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.
4""4 "--
Linda
.mLinda 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.
nature
9ige
Date
OFFICE OF THE TOWN(LERl: �4'' s�Ff�l�(`► " Application No��
TOWN OF SOUTHOLD ; Q 6
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JF TOWN • rUCtl
F117� A.�pv7s T • Const
P.O.BOX 1179 _
SOUTHOLD.NEW YORK I!9'.1 L=7 T • I to ra t i o.-_____
` cr.: $10.00 - Resl•ential —
Telephone
-- gi '0„.' $25.00 - Non-Residential
1801
+
516) 765 ,
TOWN OF SOUTHOLI)
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERAT ON PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
.
Fee $_ /
DATE_- Z0l 9 __ _._
APPLICANT NAME: -4',..” ,,P / --
APPLICANT ADDRESS: ,:),d
_PTIC CESSPOOL I
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
/
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,,,.6,0422. .i_ ...,:3_,. _ ______ ____________
ii
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUC ION OR ALTERATION :
OWNER OF PROPERTY : / _
OWNER MAILING ADDRESS: �3 ) - __
.
'!r — —=!ii!- - A _______. __ ___
+ OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON :
TAX MAP NO. : Section /07 Block Lot a v
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFEREVCE:
. iii.F
- --/&/
Signature of Ap• 1 ant
i
,I RECEIVED B al ��
Town Clerks Office
DATE: 17fa2 v
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James Kilkenny
300 Knollwood Road
Mattituck, New York 11952
107-1-20