HomeMy WebLinkAboutBrabazon ,
ff®50
11FF0`4 =
, O
ELIZABETH A.NEVILLE e A, '�� Town Hall, 53095 Main Road
TOWN CLERK % o - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �� ',i Southold, New York 11971
MARRIAGE OFFICER `, Fax (631) 765-6145
VI*
RECORDS MANAGEMENT OFFICER ®l ,0„®0 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ���� southoldtown.northfork.net
OFFICEOF THE
ppTOWN
LDDCLERK
SOUTHOLD WAS aATERUDISI�OSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2882 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 BRABAZON, WANDA
Mailing Address 1 195 FIDDLER LANE
City St Zip GREENPORT NY 11944
Property Address 1 195 FIDDLER LANE
City St Zip GREENPORT NY 11944
Tax Map No. section 36.00 block 2 lot 6.001
Cross Street
Building Permit Number Cross Reference:
Issue Date: 9/24/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
2/
•
s ��„i oFF04 S's5' ?
-
ELIZABETH A.NEVILLE if Gy ‘` Town Hall, 53095 Main Road
J---,�— TOWN CLERK % y ? ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS +,i Southold, New York 11971
MARRIAGE OFFICER :` 1i O �� Fax(631) 765-6145
=_
RECORDS MANAGEMENT OFFICER \-7°1 lig �a '�0' Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER ---'---...,..0°
southoldtown.northfork.net
'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD 1 C! LT n
TO: Southold Town Building Department I I' AUGill
s 26 2002
FROM: Linda J. Cooper, Southold Town Clerk's OfficeL -77:7157'----'
DATED: August 26, 2002
Transmitted herewith is a copy of application No. 2997 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Peconic Cesspool for Wanda Brabazon
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. .
r
e...2„,...,„,2,g,
Signature
P .9/)—C/2—
Dated
'000,
OmCEOFTHE TOWN CLERK ". `` ULk C��
TOWN OF SOUTHOLD ��� �" cI = Application No.
ELIZABETH A.NBVILLE,TOWN CLERK ,�
� �Z` +L
P.O.BOX 1179
Construction
SOUTHOLD.NSWYORK 11971 v rn Alteration
��®�o'1� $10.00 Residential
Telephone " 0
(631) 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 $ 115107,
APPLICANT NAME: PECONIC CESSPOOL
APPLICANT 'ADDRESS: P. 0 . BOX 972
MATTITUCK, NEW YORK 11952 ' '
SEPTIC . CESSPOOL .v
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: . /4-7 `
OWNER OF PROPERTY: 1 ,44 /h /Z J d i' (, ; N
OWNER MAILING ADDRESS: /95— /, /.- /4. o
G Ai pe
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: I
TAX MAP NO. : Section36 Blocko2. 1 Lot , I
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
•
Signature, of Applic na t
•
j �o
RECEIVED 13Y: o�
Town's Office
DATE: p
s _ ; f7 / ,qD4-2 A
GA)6-Lc-Ari4A---7
v
\ 1
-„, r____;_____,_... ..,.
, ,5re,„„,,
k‘ 4! ,
0,6. \ Ilk\ Ici 5- ,
.,\ l , ‘,0
..-----7-'
yrs-7
._,
:-,„
, „,.
-- ,
_, , rM ' W f \3 I
- --- __. V, -=(:45.467° 0 ()') ,
Pap L S
J/15
rrra-itLf