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HomeMy WebLinkAboutSharkey OFFOlgt +a®" h. ��®�® c® ELIZABETH A.NEVILLE �� �° Gy ; Town Hall, 53095 Main Road TOWN CLERK ` ® P.O. Box 1179 nay Southold, New York 11971 REGISTRAR OF VITAL STATISTICS 4 �� Fax (631) 765-6145 MARRIAGE OFFICER . �1 RECORDS MANAGEMENT OFFICER =_�®1 jig $b��1i' 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. 2784 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 SHARKEY, WALTER Mailing Address 1 PO BOX 1558 City St Zip MATTITUCK NY 11952 Property Address 1 1930 MARLENE LANE City St Zip MATTITUCK NY 11952 Tax Map No. section 144.00 block 2 lot 3.200 Cross Street MAIN ROAD Building Permit Number Cross Reference: Issue Date: 4/04/02 Elizabeth A. Neville Southold Town clerk (TOWN SEAL) 0004 (9 73- tir ELIZABETH A. NEVILLE �,,��o '` �* ; Town Hall, 53095 Main Road TOWN CLERK % o - P.O. Box 1179 A • Southold, New York 11971 REGISTRAR OF VITAL STATISTICS Fax(631) 765-6145 MARRIAGE OFFICER : #4, i `. �1 RECORDS MANAGEMENT OFFICER =___®1 �a®•1 Fax (631) 765-1800 FREEDOM OF INFORMATION OFFICER ,��� southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD >t i1 2 a 2002 "l is TO: Southold Town Building Department P,-DG DEPT FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: March 20, 2002 Transmitted herewith is a copy of application No. 2885 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Peconic Cesspool for Walter Sharkey 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: 1,711 APPROVE DISAPPROVE Comments: Maintain required setbacks from adjacent wells, buildings, property lines and water Bodies. EXCAVATION INSPECTION REQUIRED. Signature Dated OFFICE OF THE TOWN CLERK ��0Lke TOWN OF SOUTHOLD ��6i n%: Application No. ELIZABETH A.NEVILLE,TOWN CLERK o�T P.o.BOX i179 : Construction SOUTHOLD,NEW YORK 11971 ern I Alteration Telephone �O•P1, $10.00 - Residential (63t) 765-1800 - ®1' �� � �� $25.00 - Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee .$ DATE ._.3/G� Q .2/ APPLICANT NAME: PECONIC CESSPOOL APPLICANT ADDRESS: P. O. BOX 972 MATTITUCK, NEW YORK 11952 SEPTIC CESSPOOL DESCRIPTIONIF PROPOSED CONSTRUCTION OR ALTERATION �._ _ LOCATION MAP: Must be attached hereto before permit may be issued. , LOCATION OF PROPOSED CONSTRUCTION OR ALT RATION: OWNER OF PROPERTY: /4 OWNER MAILING ADDRESS: ep / /5s-es, //F / 5L OWNER PROPERTY ADDRESS: q30 J i ve7je_. Ave_. . �fl✓v�/C 4J // f z_ TELEPHONE NUMBER OF r// V CONTACT PERSON: TAX MAP NO. : Section / 41V Block 2- Lot I, 3 C S'S—STREET: /4Wi(.v ../f eke BUILDING PERMIT NUMBER CROSS REFERENCE: a4 ,41 A ///' • Sire of licant RECEIVED BY k Town Clerk's Office DATE: (-3/267":007. /01-4/1-1/Ck .r • Ng/44W / ftJ"e-- •r-- .1- r SI- 5-S4M . 1 5-/-,, LTi 14-1,-" 1 14-vu.4.....4._ (1; I 931 Or; nfV f _ / O I `./ / Old .1t. 5 C, W r Walter Sharkey 1930 Marlene Lane Mattituck ELIZABETH A. NEVILLE,TOWN CLERK Town of Southold Southold, New York 11971 r s Phone: 631-765-1800 RECEIPT #2885 Peconic, Cesspool P 0 Box 972 Mattituck, NY 11952 Received $ 10.00 1 - Septic Permit - Construct - Resid. on 03/20/2002. Thank you. �eh 0-4 kiel P-P-/ - a- 3