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ELIZABETH A.NEVILLE ���� . Town Hall, 53095 Main Road
TOWN CLERK ; P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS rft
Southold, New York 11971
MARRIAGE OFFICER �� _ ���1, Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER =,_ -.,..'r 'tot. Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ���
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2499 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 OF OVERFLOW TO EXISTING SYSTEM.
APPLICATION APPROVED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner MURPHY, FRANK & ELIZABETH
Mailing Address 1 PO BOX 84
City St Zip MATTITUCK NY 11952
Property Address 1 600 BAYER ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 107.00 block 3 lot 16.001
Cross Street CONKLIN ROAD
Building Permit Number Cross Reference:
Issue Date: 1/22/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
•,
ELIZABETH A.NEVILLE ��' • " •Pri: Town Hall, 53095 Main Road
TOWN CLERK ; CZP.O. Box 1179
REGISTRAR OF VITAL STATISTICS �� Southold, New York 11971
MARRIAGE OFFICER �. • 0 Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER � �®� �y� ��i
so-
OFFICElig ' Telephone (631) 765-1800
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FREEDOM OF INFORMATION OFFICER
OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: January 11, 2001
Transmitted herewith is a copy of application No. 2587 for a Cesspool/Septic Tank Construction-
Permit submitted by:
Peconic Cesspool for Frank& Elizabeth Murphy
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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE ✓
DISAPPROVE
Comments:
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Dated
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OFFICE OF THE TOWN CLERK ,01%14M1(4oj� 4N/V\cation o a'�
TOWN OF SOUTHOLD - ` j.
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ELIZABETH A.NEVILLE,TOWN CLERK 6
P.O.BOX 1179 � � +C •
Construction
SOUTHOLD,NI3W YORK 11971 O
• Alteration
Telephone \ O,y • M./ • -$10.00 - Residential =
(631) 765-1800 = Ol' 46 , $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
RECEIVE
APPLICATION- • •
for JAN 1 1 2061
CONSTRUCTION or ALTERATION PERMIT zoturhimd lawn Cferk
SEPTIC TANK or CESSPOOL
Permit.No.
Fee .$
DATE /0/440I
APPLICANT NAME: ���G;►
APPLICANT ADDRESS: 4:0, Z
%z�lL.litc�r� '
SEPTIC CESSPOOL'
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 64,44 .. £ X 11
OWNER MAILING ADDRESS: fiD
OWNER PROPERTY ADDRESS: • 06 ,l /t
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TELEPHONE NUMBER OF CONTACT PERSON: pt,9,r114-,��'
TAX MAP NO. : Section /D 7 Block 3 Lot ,4, /
CROSS STREET: de#41r4/ /(
- BUILDING PERMIT NUMBER CROSS REFERENCE:
••
Signature of Api cant
RECEIVED BY: ' •
Town Clerk's Office.
DATE:
•
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SEWER&DRAIN SERVICE
P.O. BOX 972 BRAY AVENUE MATTITUCK, NEW YORK 11952
(631) 298-9658
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