HomeMy WebLinkAboutVail, Floyd I -
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ELIZABETH A. NEVILLE t$h`l`O �*4; Town Hall, 53095 Main Road
TOWN CLERK p - P.O. Box 1179
ti Z % Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ; ; Fax(516) 765-6145
MARRIAGE OFFICER ` Telehone (516) 765 1800
RECORDS MANAGEMENT OFFICER `N41* �0�/ P
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FREEDOM OF INFORMATION OFFICER - i * r 1•�
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2183 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PECONIC CESSPOOL
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 VAIL, FLOYD AND AUDREY
Mailing Address 1 685 BUNGALOW LANE
City St Zip MATTITUCK NY 11952
Property Address 1 685 BUNGALOW LANE
City St Zip MATTITUCK NY 11952
Tax Map No. section 123.00 block 3 lot 9.000
Cross Street MARRATOOKA ROAD
Building Permit Number Cross Reference:
Issue Date: 10/25/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE `t$ Town Hall, 53095 Main Road
TOWN CLERK p P.O. Box 1179
y Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS O (516) 765 1800 Fax(516) 765-6145
4'
MARRIAGE OFFICER `
RECORDS MANAGEMENT OFFICER `. ' 40��1�� Telephone
FREEDOM OF INFORMATION OFFICER * se�
osts
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: October 19, 1999
Transmitted herewith is a copy of application No. 2268 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Floyd & Audrey Vail
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 - J
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
5iignatu
Date
OFFICE OF THE TOWN CLERK I ir0rrrrrrrr•••',*,,_
TOWN OF SOUTHOLD 5' OCKID = Application No. ON/44)
FI I7ABETH A NEVIL E,TOWN CLERKil
1.
P.O.BOX 1179 !� Construction 2 —�
SOGTHOLD,NEW YORK 11971 ; 1� WI
to *', Alteration
Telephone ..1›,� s0/ $10.00 - Residential. -
(516) 765-1801 ----lie,/ f
- � »� � �' $25.00 - Non-Residential
>rr''�
TOWN OF SOUTHOL)
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
is
t`!
SEPTIC TANK or CESSPOOL !'
Permit No.
Fee $
DATE O'L - / ‘,/,7
APPLICANT NAME: ! .�..c i! �;�// _ ___.__..____ _._ � _ _ __
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APPLICANT ADDRESS: __ _27/Z__�
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
_ ' ...c_..__. .LwV
LOCATION MAP: Must be attached hereto before permit may be isued. ;
LOCATION OF PROPOSED CONSTRUCTION OR A _TERATION :
OWNER OF PROPERTY: C/7/ ,a _ _ _.__ ,�!^ .._._-________
OWNER MAILING ADDRESS: ..416 4
�'4'c-4_.?___•
pier , -.i < 'L'= 1C 95
N
OWER PROPERTY ADDRESS: ..f _____
TELEPHONE NUMBER OF CONTACT PERSON : C.9/1 9/s4'
TAX MAP NO. : Section `?,3 Block -3 Lot
GRO-SS STREET : C� -- 52..3...,4,-, -.2-4.,.,44- .._
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signa ure of ,. pp scat
RECEIVED BY: _
— 's Offi e
DATE:
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