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ELIZABETH A. NEVILLE y. y Town Hall, 53095 Main Road
TOWN CLERK ,� <c P.O. Box 1179
REGISTRAR OF VITAL STATISTICS N Z Southold, New York 11971
MARRIAGE OFFICER
� Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER ).. Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER
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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. 1980 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
REPLACE EXISTING CESSPOOL WITH NEW TYPE.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM WELLS,
BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION
REQUIRED.
Name Of Owner AIELLO, MARIE & MURPHY, MARY
Mailing Address 1 445 EAST LEGION
City St Zip MATTITUCK NY 11952
Property Address 1 445 EAST LEGION
City St Zip MATTITUCK NY 11952
Tax Map No. section 143.00 block 4 lot 1 .000
Cross Street BAY AVENUE
Building Permit Number Cross Reference:
Issue Date: 12/15/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE 4P1 Town Hall, 53095 Main Road
TOWN CLERK t o •-e• P.O. Box 1179
t ti Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS % rr,3 Fax (516) 765-1823
MARRIAGE OFFICER %%04, g"
RECORDS MANAGEMENT OFFICER `b, &�,1 Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER ' �l 4, O*oil
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: December 4, 1998
Transmitted herewith is a copy of application No. 2055 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Marie Aiello and Mary Murphy
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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 -
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
Sig ture
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Date
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OFFICE OF THE TOWN CLERK �' • �Ffr OLK
TOWNOFSOUfHOLD ��� Ce = Application No ;&j )
Fi.i7ABETH A.NEVII.LP,TOWN CLERK
P.O.BOX1179 : Construction
SOUTHOLD,NEW YORK 11971
Alteration
$10.00 -Residential
Telephone �j' 1✓
= �0 �
(516) 765-1801 = �1 �,,►' $25.00 -Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE /11,0 X19 r
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APPLICANT NAME: ,;(-172-kr.
APPLICANT ADDRESS: /-.1 /6 972-
SEPTIC CESSPOOL - 1V-
DESCRIPTION
ESSPOOL - ✓DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
.[✓i�� � �_ , . .�_ I iiia ��A
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: �k<< 0Alliti(lc
OWNER OF PROPERTY: ,///464.4.6 / � f ��� Auivid.1
OWNER MAILING ADDRESS: 74r C
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: f-� 76'5:fe'
TAX MAP NO. : Section I L/3 Block / Lot
CROSS STREET: " '" A-/ ,{
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of App an
RECEIVED
RECEIVED BY L. aT
T wn ClerB'[COffj 998
DATE:
Pecomic
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SEWER& DRAIN SERVICE
P O. BOX 972 BRAY AVENUE MATTITUCK, NEW YORK 11952
(516)298-9658
P)441
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