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HomeMy WebLinkAboutReynolds • le yDv • JUDITH T.TERRY ` ® Town Hall,53095 Main Road TOWN CLERK c� g P.O.Box 1179 REGISTRAR OF VITAL STATISTICS Southold,New York 11971 MARRIAGE OFFICER %A§ �y Q �� Fax(516)765-1823 � ® 1 RECORDS MANAGEMENT OFFICER ®� 1,„ii� 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. 1311 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : RIVERHEAD CEMENT BLOCK CO. INC Address 1 : P. O. BOX 707 City St Zip RIVERHEAD NY 11901 Descripton of Proposed Construction or Alteration ADDITION OF AN OVERFLOW POOL TO AN EXISTING SYSTEM. APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION REQUIRED. Name Of Owner REYNOLDS, EDWARD AND FAYE Mailing Address 1 P. O. BOX 1074 City St Zip MATTITUCK NY 11952 Property Address 1 855 OLD SALT ROAD City St Zip MATTITUCK NY 11952 Tax Map No. section 144.00 block 5 lot 16.000 Cross Street BAY AVENUE Building Permit Number Cross Reference: Issue Date: 4/07/95 Judith T. Terry Southold Town Clerk (TOWN SEAL) _; cC // ... . ' ` = ® $ *Al JUDITH T. TERRY • ...e. Town Hall, 53095 Main Road TOWN CLERK ® P.O. Box 1179 VS W Southold, New York 11971 REGISTRAR OF VITAL STATISTICS . �® �� Fax (516) 765-1823 MARRIAGE OFFICER ----_s/'/, v�® �.. Telephone (516) 765-1801 RECORDS MANAGEMENT OFFICER _ ®,l ( FREEDOM OF INFORMATION OFFICER „,,1�iiPir1°��1' OFFICE OF THE TOWN CLERK i""� � TOWN OF SOUTHOLD 1gI _'-�— ' TO: Southold Town Building Department 1� ' j, d FROM: Linda Cooper, Southold Town Clerk's Office -� DATED: MARCH 31, 1995 BLDG.DEPT. TOWN OF SOUTHOLD Transmitted herewith is a copy of application No. 1360 for an ALTERATION PERMIT for a cesspool or septic system submitted by RIVERHEAD CEMENT BLOCK CO. INC. FOR FAYE REYNOLDS • 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 - v DISAPPROVE - COMMENTS: Maintain required setbacks from adjacent wells, buildings, property lines and water bodies. EXCAVATION INSPECTION REQUIRED. Signature • OFFICE OF THE TOWN CLERK �,,,'""" Town of Southold �.�'� �FFOLK r'J re Application No/36 Judith T. Terry, Town Clerk �' `�r.: Gy k.; Town Hall, 53095 Main Road Z ,_ . :G ; Constructions P. 0. Box 1179 . = s. ^' Southold, New York 11971 V cvn Alteration.` Telephone ‘10e�O�i� $10.00 - Residential (516) 765-1801 = 1 A �, ' $25.00 - Non-Residential . ,, _ • �,, TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ DATE 3/30/95 APPLICANT NAME: Riverhead Cement Block Co. Inc. APPLICANT ADDRESS:P•0. Box 707 Riverhead, N.Y. 11901 SEPTIC CESSPOOL X DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION Addition of one over flow pool to be piped from existing pool. new pool will be 8 ' in diameter and 6 ' deep. LOCATION MAP: • Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: Edward A. and Fayel L. Reynolds • OWNER MAILING ADDRESS: P.O. Box 1074 Mattituck, NY 11952 OWNER PROPERTY ADDRESS: 855 Old Salt Road Mattituck, NY 11952 TELEPHONE NUMBER OF CONTACT PERSON: 516-298-4090 F-A-yE) TAX MAP NO. : Section 473889 Block 144. 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