HomeMy WebLinkAboutGarobrant I,,�o�"StFFO(,�cOG
ELIZABETH A. NEVILLE i�_O * ; Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS i Southold, New York 11971
MARRIAGE OFFICER Fax e��, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER = jig
$ '�i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ,fis � southoldtown.northfork.net
OFFICETTOF TTFHEEQpTOTgWNLDCLERK
SOUTHOLD WAOSWATERU DISOPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2915 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 GAROBRANT, PATRICIA
Mailing Address 1 9625 MAIN ROAD
City St Zip EAST MARION NY 11939
Property Address 1 9625 MAIN ROAD
City St Zip EAST MARION NY 11939
Tax Map No. section 31 .00 block 21 lot 3.000
Cross Street
Building Permit Number Cross Reference:
Issue Date: 10/30/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE 01°S 4 ; Town Hall, 53095 Main Road
TOWN CLERK % o - % P.O. Box 1179
tiZ $
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER : 416 l��1�, Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER =__�Ql 4. ia',0 Telephone (631) 765-1800
FREEDOM OF INFORMA.TIOI OFFICER ���,,," southoldtown.northfork.net
''- ` _ 11, ' OFFICE OF THE TOWN CLERK
�1! \.t ou m9 2002 �', TOWN OF SOUTHOLD
T( by O w?°-'" i
Olt own Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: October 9, 2002
Transmitted herewith is a copy of application No. 3033 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Peconic Cesspool for Patricia Garabrant
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 ii -
DISAPPROVE
Comments: Maintain required setbacks from adjacent wells,buildings,property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED. .
2/zt„....e.. ."4_
Signature
/V2../0 r/—
Dated
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OFFICE OF THE TOWN CLERK 11 sCAO�k,','
TOWN OF60VR10LD Application No. —
ELIZABETH A.NBVW.H,TOWN CLERK
P.O.BOX 1179 ,
Cons ructw
SOUTHOLD,NEW YORK 11971 �rn
teration
Telephone oy�' Are- .$10.00 = Residential -lo'
(631) 765-1800 • . ". �,� $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION _
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE //2/1/A2—
APPLICANT
D v ZAPPLICANT NAME: PECONIC CESSPOOL
APPLICANT ADDRESS: P. 0. BOX 972
MATTITUCK, NEW YORK 11952 '
SEPTIC CESSPOOL •
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
er1
LOCATION MAP: Must be attached hereto before permit may be issued:
LOCATION OF PROPOSED. CONSTRU TION- OR ALTS TION: -
• _ OWNER OF PROPERTY:
CLI/L�
OWNER MAILING ADDRESS: .
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 691,----945r
TAX MAP NO. : Section 3/ Block 2-4 Lot' 3
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
•
•
Signature of A. ' ica t
RECEIVED BY:
Town Clerk's Office
DATE: '
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Patricia Garabrant
' 9625 Main Road
East Marion