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ELIZABETH A. NEVILLE it�`Z`� Ot%1 Town Hall, 53095 Main Road
TOWN CLERK c 1 P.O. Box 1179
% C13Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER 1 Fax(516) 765-6145
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RECORDS MANAGEMENT OFFICER
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� O� '1� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER : ' Il
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2062 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
RENOVATION 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 MANNING, MARY
Mailing Address 1 700 TERRY LANE
City St Zip SOUTHOLD NY 11971
Property Address 1 700 TERRY LANE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 65.00 block 1 lot 12.000
Cross Street HOBART ROAD
Building Permit Number Cross Reference:
Issue Date: 5/05/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE �,h�0 r/y�y Town Hall, 53095 Main Road
TOWN CLERK c 1 P.O. Box 1179
Z N Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS �' Fax (516) 765-1823
MARRIAGE OFFICER Z RECORDS y Tele hone (516) 765-1800
FREEDOM OF INFORMATIONAGEMENT OOFF CER FFICER `='/°I * #2 § p
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: May 3, 1999
Transmitted herewith is a copy of application No. 2148 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Mary Manning .
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.
4e )(-1 `;
LindaCooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the followin recommendation:
APPROVE
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
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