HomeMy WebLinkAboutGlytsea, Peter '/,o��FFOI���G
JUDITH T. TERRY Z Town Hall, 53095 Main Road
TOWN CLERK : p r"aci+ P.O. Box 1179
? can � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = VO ��� Fax (516) 765-1823
RECORDS MANAGEMENT OFFICERMARRIAGE OFFICER `= '�1 4 `I� ��� Telephone (516) 765-1801
FREEDOM OF INFORMATION OFFICER � �,i,�'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1138 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 A NEW OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS
BUILDINGS, PROPERTY LINES, WATERS BODIES, AND 2' ABOVE GROUND WATER.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner GLYTSEA, PETER
Mailing Address 1 27 BAYLON ROAD
City St Zip NEW CITY NY 10956
Property Address 1 132 CAPTAIN K I DD DRIVE
City St Zip MATTITUCK NY 11952
Tax Map No. section 106.00 block 2 lot 39.000
Cross Street RHODA ROAD
Building Permit Number Cross Reference:
Issue Date: 5/24/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
7
JUDITH T. TERRY : Town Hall, 53095 Main Road
TOWN CLERK v T P.O. BOX 1 179
REGISTRAR OF VITAL STATISTICS ; Southold, New York 11971
MARRIAGE OFFICER yQ � � Fax (516) 765-1823
1 1D� Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK r
TOWN OF SOUTHOLD
MAY 1994
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office Tra q
SOUTHOLD
DATED: May 17, 1994
Transmitted herewith is a copy of application No. A1177 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Peter Glytsea
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: 4''O�
APPROVE - 7/ ya � ��S
PE
REQU/ Dila ") RE
DISAPPROVE -
COMMENTS: Vio... xfad.. i � Wit;0G -at,reied 1,6
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Signature
3/ /q''
Date
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OFFICE OF THE TOWN CLERK ,,,'",,,""-
Town of Southold c.41 01k /-7
Judith T. Terry, Town Clerk ;' Cil/ Application No. 1 / 7
41
Town Hall, 53095 Main Road ;� Construction
P. O. Box 1179 : c ►►+ ; Alteration
Southold, New York 11971 cn
Telephone O QEi� $10.00 - Residential r(/
(516) 765-1801 ��.� %W O
„�,, ' $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 31/2/0
APPLICANT NAME: C
APPLICANT ADDRESS: 4.,!?
�-X ' ��/ 9 52_,
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRU TION OR A T• R . TION:
OWNER OF PROPERTY: � 41
/
OWNER MAILING ADDRESS: c>7 d7 I
Aar /o 956
OWNER PROPERTY ADDRESS: 3 2-
TELEPHONE
TELEPHONE NUMBER OF CONTACT PERSON: pd fr.- 9 sc'
TAX MAP NO. : Section / Block Lot 29
CROSS STREET: k
BUILDING PERMIT NUMBER CROSS REFERENCE:
Aft
Signature of Appl' t
RECEIVED BY: A°.
Town Clerk's Office
DATE: `
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