HomeMy WebLinkAboutNorkelun, Steven ',,�o� sVf FO("049
ELIZABETH A. NEVILLE �1 y�; Town Hall, 53095 Main Road
TOWN CLERK ` h - P.O. Box 1179
Southold, New York 11971
REGISTRAR,OF VITAL STATISTICSPTV i
MARRIAGE OFFICER
‘‘144,fi �� �, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ; �1Aig *a�/�1,�i Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER - southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2812 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : PECONIC CESSPOOL
Address 1 : PO BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION TO EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner NORKELUN, STEVEN
Mailing Address 1 PO BOX 1592
City St Zip SOUTHOLD NY 11971
Property Address 1 5496 MAIN BAYV I EW ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 78.00 block 4 lot 33.000
Cross Street SMITH DRIVE
Building Permit Number Cross Reference:
Issue Date: 5/17/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
/,O/lOSUFFOL,°c 8/ 2
ELIZABETH A. NEVILLE �sio
h� y Town Hall, 53095 Main Road
TOWN CLERK o P.O. Box 1179
H Z
Southold, New York 11971
REGISTRAR.OF VITAL STATISTICS � � '�
MARRIAGE OFFICER `� ,ji ���� Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER =__7491 .001.0 Telephone (631) 765-1800
FREEDOM OF INFORMATIOIO,OFFICER _ ���� southoldtown.northfork.net
-... • S
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: May 8, 2002
Transmitted herewith is a copy of application No. 2919 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Steven Norkelun by Peconic Cesspool
Please review the application and location map and advise if the project has received Suffolk County
Health Department approval and if this office may issue the permit.
Please complete the form below and return it to me.
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: Maintain required setbacks from adjacent wells,buildings,property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED.
Signature
40402—
Dated
eo a iDated
_ _
•
OFncS OF THE TOWN CLERK AFFBLIT Q
TOWN OF SOUTHOLD 1�.���J QQGy Application No.O� /l
ELIZABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 I -; Construction
SOUTHOID,NEW YORK 11971 t
=v yr+ ; Alteration
S ' ,
Telephone ,‘V �Q�'►' $10.00 - Residential
(631) 765-1800 Ol *woo' $25.00 - Non-Residential
.,.,,,,,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE ,4t4- 0200o1)
APPLICANT NAME: •, (� /,A 4 11.4 .
APPLICANT ADDRESS: ) e) o d�L 77 Z P
•
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
A/Lei) 0-?-e--7-16 ,1
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 7/ y-z,4, & .&-
OWNER MAILING ADDRESS: b„o 6,4,y,
OWNER PROPERTY ADDRESS: 54igo. /yam
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section 7S Block Lot 3 3
QROeSS STREET: S��L
BUILDING PERMIT NUMBER CROSS REFERENCE:
z4ieciL,4" .
Signature of A licant
RECEIVED BY:
Town Cle k s Office
DATE:
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STEVEN NORKELUN
5496 MAIN ROAD
SOUTHOLD