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ELIZABETH A.NEVILLE 11� _Gy Town Hall, 53095 Main Road
TOWN CLERK p - P.O. Box 1179
ti 2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS �
MARRIAGE OFFICER Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER a��'11� 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. 1932 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 DONALD WISEL
Mailing Address 1 1010 OAK DRIVE
REYDON SHORES
City St Zip SOUTHOLD NY 11971
Property Address 1 1010 OAK DRIVE
REYDON SHORES
City St Zip SOUTHOLD NY 11971
Tax Map No. section 80.00 block 2 lot 7.000
Cross Street NORTH BAYVIEW ROAD
Building Permit Number Cross Reference:
Issue Date: 9/24/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
713
ELIZABETH A.NEVILLE t.~`1`O y� �` Town Hall, 53095 Main Road
TOWN CLERK p - f_ P.O. Box 1179
GO Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS vie O Fax (516) 765-1823
MARRIAGE OFFICER : wt. /
RECORDS MANAGEMENT OFFICER � '01 �/ Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER
.0's
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: September 21, 1998
Transmitted herewith is a copy of application No. 2012 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Donald Wisel
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 wager bodies. EXCAVATION INSPECTION
REQUIRED.
nature
//1-A--/1
Date
FFICE OF THE TOWN CLERK
Town of Southold AVOUrCe_ _ D� i
Q Application No. `2J� 1-
udith T. Terry, Town Clerk � ��
Town Hall, 53095 Main Road Construction i---�
P. O. Box 1179 ; o *+ : Alteration
Southold, New York 11971 s trl W $ - -"-
= Pir+' $10.00 - ResidentialL
------
jTele hone yVe1 � rr+`(516) 765-1801 $25.00 - __
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
F.
for
CONSTRUCTION or ALTERATION PERMIT
,
SEPTIC TANK or CESSPOOL
IF, ,it No.
Fee $
DATE I5hr
, ,APPLICANT NAME : �,
y
• APPLICANT ADDRESS: . 972- ''
`%y- yf
SEPTIC CESSPOOL ''
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERAT ION 1
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_____ aitetee ",-sle ,e2d-'9°,71- e V
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LOCATION MAP: Must be atta&.hed hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR
ALTER
TT�IIQN :
1
OWNER OF PROPERTY : _ 4071.- [--,e%fe . .� el --G !
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS: „...c"...e „r`G/G
__ ____ _ _
TELEPHONE NUMBER OF CONTACT PERSON : oaf1 96Sr
TAX MAP NO. : Section10_ Block— es2-J_- _ Lot 7 —
CROSS STREET :
BUILDING PERMIT NUMBER CROSS REFERENCE:
4 . . .g4ete4/ 1,' .
Signature o Applicant
RECEIVED BY : � _
#�r k'_s_Office -
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DATE:
SEF-2-1, 199a- -- .__---- f.
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Southold Town Clerk r:
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