HomeMy WebLinkAboutMartinez •
JUDITH T.TERRY
� �d • Town Hall,53095 Main Road
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TOWN CLERK -'j P ,.,C P.O.Box 1179
REGISTRAR OF VITAL STATISTICS , ' Southold,New York 11971
1 Fax(516)765-1823
MARRIAGE OFFICER i 0® 1
RECORDS MANAGEMENT OFFICER ®g `4V„.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. 1426 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
ADDITON OF AN OVERFLOW CESSPOOL 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 MARTINEZ-FONTS, ALFONSO
Mailing Address 1 3436 TWISTED OAKS DR.
City St Zip SAN ANTONIO TX 0000
Property Address 1 115 WEST COVE RD.
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 111 .00 block 3 lot 2.000
Cross Street HAYWATERS ROAD
Building Permit Number Cross Reference:
Issue Date: 12/12/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY �� t‘l Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
r �� Southold,New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER `ti„ �� W"'of Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER 49l �a�•�� Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER ��,,..•'�
OFFICE OF THE TOWN CLERK 1� _, '
it 5
TOWN OF SOUTHOLD 11‘,Nr—r— ; 'I,
TO: Southold Town Building Department
DEC _6 1�9
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: December 6, 1995 - -- —
Transmitted herewith is a copy of application No. Al q82 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Alfonso Martinez-Fonts
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.
- 4. ,,,
Si•nature ,"
Date
OFFICE OF THE TOWN CLERK •,,,•",,,,,
Town of Southold �FF11.x
r9 .� 1)) Application No. /yPoL)
Judith T. Terry, Town Clerk •� �, y
•�0�,.. G� Construction (�
Town Hall, 53095 Main Road Z • K.`
P. 0. Box 1179 v _;' ,*,
Southold, New York 11971 cn �• Alteration
` • $10.00 - Residential
Telephone ,/ ..�0� •
(516) 765-1801 = 01 ' $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 � ' 1 99 •
t „
APPLICANT NAME: 1 ,107
APPLICANT ADDRESS: As
SEPTIC CESSPOOL L
DESCRIPTION OFPROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALT RATION:
OWNER OF PROPERTY: Fazt
/ %e
OWNER MAILING ADDRESS: f �, _. %' � _di •
Ali l�� f �
OWNER PROPERTY ADDRESS: //S- 1.074 ` e4' .e— •��,�
ca&zpitz,e)
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section /4/ Block 3 Lot e
C STREET: 4#(/'17/L; '`'
BUILDING PERMIT NUMBER 61ZROSS REFERENCE:
___,A--4„/ zirt
Signature of Ap , i ant
RECEIVED BY:
alaMerk's Office
DATES DEC 6 1995
ion Clerk Soutttbli
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