HomeMy WebLinkAboutGrippe, Peter r,rFFrrF.
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JUDITH T. TERRY • .0 Town Hall, 53095 Main Road
TOWN CLERK : v ._ : P.O. Box 1179
trs Southold, New York 11971
REGISTRAR OF VITAL STATISTICS �. Fax (516) 765-1823
MARRIAGE OFFICER _ ► «�t Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER A rrr
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. 1248 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
ADDITION 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 GRIPPE, PETER
Mailing Address 1 28100 MAIN ROAD
City St Zip ORIENT NY 11957
Property Address 1 28100 MAIN ROAD
City St Zip ORIENT NY 11957
Tax Map No. section 18.00 block 6 lot 22.001
Cross Street ROBIN LANE
Building Permit Number Cross Reference:
Issue Date: 11/28/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY � _ Town Hall, 53095 Main Road
TOWN CLERK ( o rT+ P.O. Box 1179
tl� • Southold, New York 11971
REGISTRAR OF VITAL STATISTICS '= %04 �. Fax (516) 765-1823
MARRIAGE OFFICER .�` � �' Telephone (516) 765-1801
RECORDS MANAGEMENTOFFICER *�0
_ 1 4
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK _.
TOWN OF SOUTHOLD
TO: ou h l Town
S t o d Building Department
FROM: Linda Cooper, Southold Town Clerk's Office RIt1V 13 oaf
DATED: November 18, 1994
r LO t7EPT
Transmitted herewith is a copy of application No. A1294 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Peter Grippe
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 -
INSPECTION
DISAPPROVE - REWIRED
COMMENTS: Maintain required setbacks from adjacent wells, buildings,
property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
I
s-� - -I-
Signatur=
/�z
Dat:
`OFFICE QF THE TOWN CLERK ""
7 own of Southold ��' ��FFO�xt► -_
Judith T. Terry, Town Clerk ;' Ol/ Application No.�/cy
Town Hall, 53095 Main Road Construction
P. 0. Box 1179 ' _ .2C
Southold, New York 11971 s N Alteration
Telephone ,jjyo � ��' $10.00 - Residential
(516) 765-1801 = 1 �'0 $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 11/7/5)L
APPLICANT NAME: /7"e -
APPLICANT ADDRESS:
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CO RUCTION OR ALTERATION
"2"te-‘.. l�Lrl
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRU TION OR AL ERATION:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS: --►—
TELEPHONE NUMBER OF CONTACT PERSON:� /�i
TAX MAP NO. : Section t e Block Lot 2 Z , /
G4+0366 STREET: 4-4-1'g-g%
BUILDING PERMIT NUMBER CROSS REFERENCE:
Sign.ture of Appli t
_ty
RECEIVED BY: A
Tow Clerk's Office
DATE: 02/8/7
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