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Home My WebLink AboutDeMott, Richard H t ®g%iFFO[,�c ELIZABETH A.NEVILLE,MMC �.Z®\` ®may Town Hall,53095 Main Road TOWN CLERKC* � P.O.Box 1179 v� Southold,New York 11971 REGISTRAR OF VITAL STATISTICS ® Fax(631)765-6145 MARRIAGE OFFICER Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER ®� jg '� www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK D TOWN OF SOUTHOLD SEP 2 7 2016 TO: Southold Town Building Department BUILDING DEPT' TOWN OF SOUTHOLD FROM: Sabrina Born, Southold Town Clerk's Office DATED: September 27, 2016 i RE: Cesspool Construction/Alteration Application Transmitted herewith is a copy of application No. 4428 for a Cesspool/Septic Tank Construction Permit submitted by: Peconic Cesspool for Richard De Mott Please review the application and location map and advise if this office may issue the permit. Please complete the form below and return it to me. Thank you. I have reviewed the application and location map of-the project cited above and make the following recommendations: APPROVE DISAPPROVE i d 1 Comments: RECEIVED Signature SEP 2 8 2016 Dated Southold To C erk SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 4428 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : PECONIC CESSPOOL Address 1: P.O. BOX 487 City St zip LAUREL NY 11948 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. Name Of Owner RICHARD DEMOTT ------------------------------ Mailing Address 1 5275 SKUNK LANE ------------------------------ ------------------------------ City St zip CUTCHOGUE NY 11935 -------------------- -- ---------- Property Address 1 5415 SKUNK LANE ------------------------------ ------------------------------ City St zip CUTCHOGUE NY 11935 -------------------- -- ---------- Tax Map No. section 138.00 block 2 lot 7.000 ------ --- ------ Cross Street STERLING ROAD ------------------------------ Building Permit Number Cross Reference: a na ---------- Issue Date: 9/28/16 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) f FlItIr ELIZABETH A. NEVILLE,MMC Town Hall,53095 Main Road TOWN CLERK m P.O. Box 1179 ca Southold,New York 11971 REGISTRAR OF VITAL STATISTICS 15 Fax(631)765-6145 MARRIAGE OFFICER Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER www.soutlioldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Sabrina Born, Southold Town Clerk's Office DATED: September 27, 2016 RE: Cesspool Construction/Alteration Application Transmitted herewith is a copy of application No. 4428 for a Cesspool/Septic Tank Construction Permit submitted by: Peconic Cesspool for Richard De Mott Please review the application and location map and advise if this office may issue the permit. Please complete the form below and return it to me. Thank you. I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE, DISAPPROVE Comments: Signature Dated ELVA29M A..NEVULZ 2 Soa&,boId,New York 1197 1-1 FaGoTBaa 4F' AL QC ` 765-6145 MASSIAGE OPMER T e{631.3165-i8M RECE?3�S fln�aart �ar �s TOWN-OF SOUTHOLD gy IC MON CONM. ,�Ays.as d ON,,� TION PES 3 :* TANM /or Noll esk, $� �on () e8i P' - ApplzN ss - P.®. o. 487 Applicml A . _ S �T X31 of �Sn,or `� $ 6f r moo` of Propelty-=, owner MmTmg A Owl=Prope L �. Nane d phe n= .of Tax MV No: crow stvet O . NEW NOTE: LOCATION AAF MM— BE Date Recive&by, w v l!` I I 's i i E * * * RECEIPT * * * Date: 09/27/16 Receipt#: 213524 Quantity Transactions Reference Subtotal 1 Septic Permit-Construct- Resid. 4428 $10.00 Total Paid: $10.00 Notes: Payment Type Amount Paid By CASH $10.00 Peconic, Cesspool Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Peconic, Cesspool P O Box 487 Laurel, NY 11948 Clerk ID: BONNIED Internal ID:4428