HomeMy WebLinkAboutMehalakes / �®NOSVFF®L4•CO
ELIZABETH A.NEVILLE ; 4# Town Hall,53095 Main Road
TOWN CLERK o - P.O. Box 1179
Pry
Z Southold,New York 11971
REGISTRAR.OF-VITAL STATISTICS
MARRIAGE OFFICER `� gsL ������ Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER � 4'c . iii Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER W ��'� 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. 3086, 8 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 INSPECTINO REQUIRED.
Name of owner MEHALAKES, MARK
Mailing Address 1 1475 PECONIC BAY BLVD
City St Zip LAUREL NY 11948
Property Address 1 1475 PECONIC BAY BLVD
City St Zip LAUREL NY 11948
Tax Map No. section 145.00 block 1 lot 2.000_
Cross Street
Building Permit Number cross Reference:
Issue Date: 9/08/03 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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'MICS OF THE TOWN CLERK " C •
TOWN OF SOUTHOLD
,��.'����►ot'kCOy; Application No. Ef
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ELIZABA.NIIVILL E,TOWN CLERK �* f,
P.O.BOX 1179 ,' Construction
SOUTHOLD,NEW YORK 11971 • rn i
=1 Alteration ✓
Telephone ,� Q��' $IU.UU - Residential v
(631) 765-1800 _ of ,,i � $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 & O �'t97°
APPLICANT NAME: PECONIC CESSPOOL
APPLICANT ADDRESS: P. 0. BOX 972
MATTITUCK, NEW YORK 11952
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
(7
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: A Ai4) ATA
OWNER MAILING ADDRESS: / -
OWNER PROPERTY ADDRESS: �'--
TELEPHONE NUMBER C't: CONTACT PERSON: 0gc5r
TAX MAP NO. : SectioVts, eV Block C9/ Q .0 Lot 0002/ o 00
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
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67 " 4j ,
141
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t/
P
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110
A
MARK MEHALAKES
. 1475 PECONIC BAY BOULEVARD
LAUREL
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