HomeMy WebLinkAboutMillman, Charles (2) ',0 ,IAPO
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ELIZABETH A. NEVILLE �4 �y�,`; Town Hall, 53095 Main Road
TOWN CLERK p _'� P.O. Box 1179
REGISTRAR OF VITAL STATISTICS • v. • Southold, New York 11971
O � Fax(516) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER * Telephonel (516) 765-1800
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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. 2072 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 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 MILLMAN, CHARLES
Mailing Address 1 11427 SUTTON PLACE DRIVE E.
City St Zip CARMEL IN 46032
Property Address 1 2760 DEEP HOLE DRIVE
City St Zip MATTITUCK NY 11952
Tax Map No. section 123.00 block 4 lot 10.000
Cross Street NEW SUFFOLK AVENUE
Building Permit Number Cross Reference:
Issue Date: 5/25/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
'Ili �SUFFO[,�C-X
•
ELIZABETH A.NEVILLE % �� l/y Town Hall, 53095 Main Road
• TOWN CLERK P.O. Box 1179
�3 ti x Southold, New York 11971
REGISTRAR OF VITAL STATISTICS 1 Fax (516) 765-1823
MRIAGE OFFICER
RECORDS�MANAGEMENT OFFICER \4% 0O'���� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER �,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: May 11, 1999
Transmitted herewith is a copy of application No. 2158 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Charles Millman
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 applica 'on and location map of the project listed
above and make the follow' g recommendation:
APPROVE -
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
Signa k
Date
(AWE OF THE TOWN CLERK .0"c0 Wire;
• ',TOWN OFSOUTHOLD G Application No&/
4 �
• F1.J7ABETH A.NEVILLE,TOWN CLERK s
P.O.BOX 1179 ��, Construction 4/
SOUTHOLD,NEW YORK 11971
=o ^_' Alteration
• cts ;
TelephoneQ �i� $10.00 - Residential tf
(516) 765-1801 =_41 1 � �'� $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 020 -] o�
Fee $
DATE S7//h9
APPLICANT NAME: --",..-ge i e..4-4--G"7ZGG
APPLICANT ADDRESS: /4?
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRU TION OR ALTERA ION:
OWNER OF PROPERTY: �/
OWNER MAILING ADDRESS: //Vc 7 _ e
OWNER PROPERTY ADDRESS: x'760
TELEPHONE NUMBER OF CONTACT PERSON: (91,--76 Sr
TAX MAP NO. : Section la' Block / Lot f.
CRO:a STREET: #197e/c.. 441 --t,
BUILDING PERMIT NUMBER CROSS REFERENCE:
AZe-‘,44/iKel
Signature of glicant
RECEIVED BY: ,�„
Tow
liiffice
DATE:
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