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ELIZABETH A.NEVILLE �ti`1` Town Hall, 53095 Main Road
TOWN CLERK ; p r4 •, P.O. Box 1179
REGISTRAR OF VITAL STATISTICS vy Southold, New York 11971
MARRIAGE OFFICER
O Fax (516) 765-6145
RECORDS MANAGEMENT OFFICER #4, �0�111 Telephone (516) 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. 2090 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : PECONIC CESSPOOL
Address 1 : PO BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
REPLACEMENT OF EXISTING CESSPOOL WITH NEW CESSPOOL.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM WELLS,
BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION
REQUIRED.
Name Of Owner PETTIT, ROBERT
Mailing Address 1 515 MAPLE LANE
City St Zip SOUTHOLD NY 11971
Property Address 1 1280 E CEDAR BEACH ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 90.00 block 2 lot 22.000
Cross Street CEDAR BEACH ROAD
Building Permit Number Cross Reference:
Issue Date: 6/18/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE of�� Gy4 1 Town Hall, 53095 Main Road
TOWN CLERK I p :'� P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Pr,
Fax Fax (516) 765-6145
RECORDS MANAGEMENT OFFICER
MARRIAGE OFFICER :� -*� •)-��� Telephone (516) 765-1800
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FREEDOM OF INFORMATION OFFICER = '4 � ���0
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 2, 1999
a09O
Transmitted herewith is a copy of application No. 2178 for a Cesspool/
Septic Tank Construction Permit submitted by:
Peconic Cesspool for Robert Pettit
Please review the application and location map and advise if the project
has received Suffolk County Health Department approval and if this office
may issue the permit.
Please complete the form below and return it to me.
Thank you.
E��X-ctw
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following reco endations:
APPROVE
DISAPPROVE
Comments:
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Dated
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