HomeMy WebLinkAboutPeeling, Dennis I_,04'4',.°011OSUf F04 -
ELIZABETH A. NEVILLE ���0 t; Town Hall, 53095 Main Road
TOWN CLERK ; p :'� P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS v. MI
MARRIAGE OFFICER ‘
O Fax(516) 765-6145
RECORDS MANAGEMENT OFFICER ‘‘.#11/ �0$1/ Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER el * d
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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. 2117 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : DENNIS PEELING
Address 1 : 63-10 LONG TREE LANE
City St Zip MORICHES NY 11955
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-99-0125
Name Of Owner PEELING, DENNIS & BARBARA
Mailing Address 1 63-10 LONG TREE LANE
City St Zip MORICHES NY 11955
Property Address 1 7500 NEW SUFFOLK AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 115.00 block 17 lot 17.026
Cross Street MEADOW BEACH LANE
Building Permit Number Cross Reference:
Issue Date: 7/28/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILI.F4 _',t% wit Town Hall, 53095 Main Road
TOWN CLERK % p :‘ , P.O. Box 1179
REGISTRAR OF VITAL STATISTICS % W T Southold, New York 11971
MARRIAGE OFFICER ** 1 Fax (516) 765-6145
RECORDS MANAGEMENT OFFICER ` 4 0*iTele hone (516) 765-1800
FREEDOM OF INFORMATION OFFICER �. • ..6 P
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: July 12, 1999
Transmitted herewith is a copy of application No. 2205 for a Cesspool/
Septic Tank Construction Permit submitted by:
Dennis Peelink .
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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following r ommendations:
APPROVE
DISAPPROVE
Comments:
ignatur
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Dated
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OFFICE OF THE TOWN CLERK '.'� �I CQ"FFQL/� ,
TOWNOFSOUTHOLD ,s 44*
Application No. 4 a6
FT I7ABETH A.NEVILLE,TOWN CLERK �'
P.O.BOX 1179 ;'� ; Construction I—
SOUTHOLD,NEW YORK 11971
Alteration
Telephone A �Qiri/ . $10.00 - Residential
(516) 765-1801 �l
' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION •
for
R �'EAIr�„
CONSTRUCTION or ALTERATION PERMIT JUL 9 1999
SEPTIC TANK or CESSPOOL fUwn CIerK Southold
Permit No.
Fee $
DATE 7//
APPLICANT NAME: 3*1//1)lSL(�G—
APPLICANT ADDRESS: 63-/O La,JG (✓Qev-- L1,4-
Pviz4. a-4_5 (-/y
SEPTIC CESSPOOL
DESCRI TION OF PROPOSED CONSTRUCTION OR ALTERATION
05w s1M i L r-AM IL-f raus►D GkV,I
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: S 1/6/12wi/c' - Pyr-L iA}C__
OWNER MAILING ADDRESS: 6 - /e L04)6- Li-
)
OWNER PROPERTY ADDRESS: 150c, .kJ .I- dtri,_
,,cry 11 5'Z
TELEPHONE NUMBER OF CONTA,T PERSON: 3-1 G '77 `` a-a -") (7
Ivo� _� vo
TAX MAP NO. : Section Block / 7. 00 Lot /
CROSS STREET: a 1(0 -6:4- L�A/e"--
BUILDING PERMIT NUMBER CROSS REFERENCE:
_ - of Applicant
RECEIVED BY:
Town Cler Office
DATE: 7/9/9,
ISTALLATION OF _ ;i_.� ` 1`�
THE APPROVED 5� ----
"ROPOC,CD 6A5 MAN E./
SANITARY SYS. �RO�oSED WATER _.` rfI = ' _ - - 2 '`
SHALL SE MADE I' -g
UNDER THE •p' 8f° Q" - _ --
SUPERVISION OF / z ,.-2 21,
THE DESIGN
EASEMENT FOR WATER MAIN
ENC I NEER OR ,........�,i_c•, %'
ARCHITECT _ _ ._
ENGINEER OR ` () c' r
ARCHITECT SHALL 1 I `, -
FURNISH A LETTER
CERTIFYING THE ..... -
SYS. HAS SEEN \. `
• V ALAN- �' _ '
CONSTRUCTED IN
ACCORDANCE W/ �'
.____\______ ,
THE DESICN(s.li?r ,, .t' •,\ N 84°13' „ fw,
IPEK''rr h}7 t At i•;'' ' , . ' - C r V
....___...__ t.. r r ' \ VAGAN_
SITS PLAN
IIate: TAX MAP*, P.3`
f b-�8-q4 R� DISTRICT, IOOG PROPOSED RE�'
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