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HomeMy WebLinkAboutMooney, Maureen StFFO(,� C0 � ELIZABETH A.NEVILLE 6j' Town Hall, 53095 Main Road TOWN CLERK c t ` P.O. Box 1179 ti x i Southold, New York 11971 REGISTRAR OF VITAL STATISTICS .rry7 ` Fax OFFICER O ax (516) 765-1823 RECORDS MANAGEMENT OFFICERti l Telephone (516) 765-1800 FREEDOM OF INFORMATION OFFICER 1? �� li � � ' OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1950 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : MAUREEN M. MOONEY Address 1 : P. O. BOX 702 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 MOONEY, MAUREEN M. Mailing Address 1 P. O. BOX 702 City St Zip MATTITUCK NY 11952 Property Address 1 11520 MAIN ROAD (11520 - 11600 - 11700) City St Zip MATTITUCK NY 11952 Tax Map No. section 122.00 block 3 lot 3.000 Cross Street PACIFIC STREET Building Permit Number Cross Reference: Issue Date: 10/19/98 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) /iii 1%,• /f—r6 - ,. , ,iii akIFF04,.% O ELIZABETH A.NEVILLE is 1= GZ�; Town Hall, 53095 Main Road TOWN CLERK p :4 % P.O. Box 1179 y 2 % Southold, New York 11971 REGISTRAR OF VITAL STATISTICS % v' T t O ' . 0 Fax (516) 765-1823 MARRIAGE OFFICER :` y RECORDS MANAGEMENT OFFICER : 'O! 100 ��� Telephone (516) 765-1800 FREEDOM OF INFORMATION OFFICER ��� �••i/ 0°' OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda Cooper, Southold Town Clerk's Office DATED: October 9, 1998 Transmitted herewith is a copy of application No. 2026 -,b for an ALTERATION PERMIT for a cesspool or septic system submitted by Maureen Mooney • 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. " s"—(A-.......—.4... — Si ature lq/3/1 r Date • OFFICE OF THE TOWN CLERK % ,, &--- TOWNOFSOITfHOLD ;' �CJ�FF� QQ =_ Application No. aoa( ELIZABETH A.NEVILLE,TOWN CLERK P.O.Box 1179 Construction SOUTHOLD,NEW YORK 11971 . Alteration Telephone �O Ay • $10.00 -Residential r/ P � (516) 765-1801 = lilig ,�' $25.00 -Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for ^nT CONSTRUCTION or ALTERATION PERMIT 1998 SEPTIC TANK or CESSPOOL f own Clerk Southold Permit No. Fee $ DATE 10 ( � (q e APPLICANT NAME: /11 /4LE0,) Ale 440e i6 / APPLICANT ADDRESS: Po goy_ 0 ).- /k,I4- 't-`c-(-rcJ C- •A),y . SEPTIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION ( , iit/eA- c -4-CO ✓l5-4Z LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: , f14-✓itEi r/ ,zl Air—WA/X-41 OWNER MAILING ADDRESS: PO / Vi- 1 04._ /Ll IY-21 c e n/y 1(4 r OWNER PROPERTY ADDRESS: /J . . ' - f/ oO —(1'70.2 /2/ 4;ti41 TELEPHONE NUMBER OF COON 12A�CCT PERSON: a q; �-fi 00 C ( AK), TAX MAP NO. : Section Block �.�. Lot 3i 411 S- CROSS STREET: 014 i L BUILDING PERMIT NUMBER CROSS REFERENCE: Signature of Appli ant RECEIVED BY: C GoL Tarn Clerk's Office DATE: t (`j I C( 57 . ca n..wam khh..'/WSMM�7� ....1_— *F5. =I- - �rK ___ .'�' -�- 4=- N idea . .'665 --e.�. rr.Wr...� e1 -- - - - - / .... - •••41 !c I r ` — S 1 TE PLAN ,� r-- ..e6---- , v, P2EPA¢6o F4Q `_. . . /-. t4 b/Ji . !ji t :p • o DAN/EL, C. /►�/0C�/�C )/ t ' i srlld) s '1 `+ • j_ _ - - //644 MAIN 20.40 b4.• %• c MATT:ruc* , A/. Y `e'r'r•//nC i 3 - 26^- Q - - s - '-_L__, = w. •I • J s of y I Scs�c,; ZO'_ I -'� '4 e .l'tdlD`I nes I r [t7: 7 ::: �' �f 1 a (.�1't.S)=S!. TO 06 I. A r �T-._r-._- T.. 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