HomeMy WebLinkAboutZito , # 11 OFFOLer
ELIZABETH A.NEVILLE
seOP Town Hall, 53095 Main Road
,
TOWN CLERK % wh. P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER
Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ®d - �01 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ,i" southoldtown.northfork.net
OFFICETTOF TTFHEppTOTTWgNLDDCLERK
SOUTHOLD WAGS WATERUDISOFOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2860 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 ZITO, RONNIE
Mailing Address 1 568 MCCULLOCK PLACE
City St Zip HAWORTH NJ 7641
Property Address 1 1185 BUNGALOW LANE
City St Zip MATTITUCK NY 11952
Tax Map No. section 123.00 block 3 lot 16.000
Cross Street CENTER STREET
Building Permit Number Cross Reference:
Issue Date: 8/22/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE
toe,,# s /� \ 'UN ; ,t� 2002 '
`)own Hall, 53095 Main Road
1.
TOWN CLERK ® - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS , $BLDGDEPT. Southold, New York 11971
MARRIAGE OFFICER ® l%"N OF SOUTHOLDF
Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER `� ®� .. ��®''��� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ r��� southoldtown.northfork.net
.....iii
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 5, 2002
Transmitted herewith is a copy of application No. 2934 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Peconic Cesspool for Ronnie Zito
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: Maintain required setbacks from adjacent wells,buildings,property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED.
Signature
o -7///9
Dated
-
OFFICE OF THE TOWN CLERK C5. �LKc
TOWN OF SOUTHOLD • ®l/ Application No. c9.23 3
ELIZABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 � Construction \/,
SOUTHOLD,NEW YORK 11971o •
• 9"1-1ill1 Alteration
Telephone
‘.0A � �•• $10.00 - Residential L.
(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 7* 3D/0 Z�
APPLICANT NAME: PECONIC CESSPOOL
APPLICANT ADDRESS: P. 0. BOX 972
MATTITUCK, NEW YORK 11952'
SEPTIC CESSPOOL ✓
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
• OWNER OF PROPERTY:
OWNER MAILING ADDRESS: S63
v.7&cL/
OWNER PROPERTY ADDRESS: //'s-- /j Gcl ,
;74, '.� / i%; 11957—
TELEPHONE NUMBER OF CONTACT PERSON: r ,g`
TAX MAP NO. : Section /7-3 Block 3 Lot /‘,
.GRass STREET: d:-. 1.. S7- -
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Appli f.a:nt
RECEIVED BY:
wn Clerk's Office
DATE: 6/r/O - _
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Ron Zito
1185 Bungalow Lane
Mattituck
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