HomeMy WebLinkAboutKar tr,'� Town Hall, 53095 Main Road
` w P.O. Box 1179
}��s' Southold, New York 11971
sigJUDITH T.TERRY � FAXEPH (516)765-1823765-
TOWN CLERK TELEPHONE(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 488 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 OF CESSPOOL.
APPROVED AS INDICATED ON SUBMITTED DRAWING. NOTE: EXCAVATION
INSPECTION REQUIRED.
Name Of Owner KAR, MATT
Mailing Address 1 P. O. BOX 63
City St Zip LAUREL NY 11948
Property Address 1 PECONIC BAY BOULEVARD
City St Zip LAUREL NY 11948
Tax Map No. section 128.00 block 4 lot 4.000
Cross Street DELMAR DRIVE
Building Permit Number Cross Reference:
Issue Date: 4/21/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
;poets at A...4p C?'W
rrw�, ..y?�q;Y / "
r�. a • $ Town Hall, 53095 Main Roac
•.�Q •►� P.O. Box 1179
•� Southold, New York 11971
JUDITH T. TERRY ii �
� • TELEPHONE
TOWN CLERK
(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
April 18, 1989
To: Victor Lessard, Southold Town Building Department
•
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A499 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Matt Kar
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 - K
DISAPPROVE -
COMMENTS: e...�-e� ' cx _a ov, And.r_CLA.
re ..v '
\C57J-4..
��
Signature
Date
•
OFFICE OF THE TOWN CLERK cjIFUL-
Town of Southold D�.� ; d 9y
Judith T. Terry, Town Clerkr;' j•s` x Application No. n/
Town Hall, 53095 Main Road Construction
P. O. Box 1179
Southold, New York 11971 O42, OH Alteration
Telephone 770 � Residential
(516) 765-1801 '"
Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. •
Fee $ /tai Ot
,4
DATE /67
APPLICANT NAME: ,4 v-L�t!',�L,�
APPLICANT ADDRESS: /-1&• jC56/72-
SEPTIC
jSEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
zilez--x
al= Sys�V L�IP � f z•vi "�
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: /1
OWNER MAILING ADDRESS:,A /5"6
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: decr-'
TAX MAP NO. : Section/-k, k J Block 0 at) Lot ea Sc9�LT
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY:
R ;!I 'tt'f,iwnt/Clerk's Office
DATE:
APR 1SX99
gem otteld
* c,
1/4§4
it
\c,N,
,
fl
1110..Z,,
\./
•
4*='
-"'"\\ r
SURVEYED FOR:- Je:&--/tJiVETi .
LOCATED AT ZAL/eEL , TOWN OF SQL/TA/QL.Z , SUFFOLK COUNTY N.Y.
LOT OESCie/SEDoPEi2Ty .,
MAP OF iLCf/S oWA./tn Sr GE"o'PGE P 81-f5c1( , CO. CLK. NO. y FILED °•'
SCALE 1" = ZQ. ��� �o) ..
1
SUFFOLK CO. TAX MAP DATA:- A
DIST. /2 ,SEC. /26'.co 4///, PQL./ .- ,
BLK. v4•De LOT oc:;4 aD0; J'�� '00:e. �E.sx-E /00 CQ ,
3
OFFSETS FROM STRUCTURES IFilla FM •
TO RELATIVE BOUNDRY LINES, `9t . (
ON SURVEY, ARE FOR A ke Q ''
SPECIFIC USE ONLY, AND ki 1 Uf
SHOULD NOT BE USED FOR 11.1 .4.CONSTRUCTION OF FENCES 12� V
OR OTHER STRUCTURES / \
1. /7 . '
23.0
Y. - 1 451 - 0
Q 0 20Ixji
•
;%
.„r C.,..) 1. iN.
\ i''' • , -,,, "1 - --. K) o\ .. .I ,,, .
i4,11P
.4 I ,v. /‘`4‘'0f3eY.v✓ /00 oQ -
- ,,e/ fir ®rWA >
\` (/ '
' /!QC Ober ,e' fCE SURVEYED �U/C/Ez 1966
BY
) .
` WILLIAM R. SIMMONS JR.
• P/O BOX 377
J
JAMESPORT, L. I., N. Y. 11947'19
/
- FILE NC). ,87? PAGE 2� GRID /�
DRAWN BY /�