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Home My WebLink AboutSawicki ELIZABETH A. NEVILLE, MMC p Town Hall,53095 Main Road TOWN CLERK P.O.Box 1179 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS �ra �� w �u� Fax(631)765-6145 MARRIAGE OFFICER ��"� � SII Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER �M, : °� OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Sabrina Born, Southold Town Clerk's Office DATED: March 19, 2018 RE: Cesspool Construction/Alteration Application Transmitted herewith is a copy of application No. 4606 for a Cesspool/Septic Tank Construction Permit submitted by: Peconic Cesspool-Sawicki 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 Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 05/02/18 Receipt#: 238696 Quantity Transactions Reference Subtotal 1 Septic .n Ic Permit- Construct- Resld, 4606 10.00mm 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:4606 ELIZABETH A.NEVILLE �� Town Hall, 53095 Main Road TOWN CLERK . P.O. Box 1179 REGISTRAR,OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER " Fax (631) 765-6145 RECORDS MANAGEMENT OFFICERs Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER �* southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTU OLID WASTEWATER DISTRICT APPLICATION CONSTRIJC ION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @ $10 �, or Non-Residential @ $25 Application No. Permit No. Applicant Name PECONiC CESSPOOL Applicant Mailing Address _ P .. _._._. Septic Tank or Cesspool" Brief Description of Pro os _,onstrL1Cti011 or Alterati 2, Location of Proposed Constnictionv"Alterati1 �. Owner of Property: Owner Mailing Address: Owner Property Address: � ? Y � � , 91_�' .mm Name and phone number of c°orita.ct person Tax Map No: ..�mm. �Secton � .� Block, Lot Cross Street NOTE: LOCATION MAP 4UST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH IIIA., - 1 EPART'"WN-A, PROV,AL Signature of p alicaht Date Received by: _ITw � h h ELIZABETH A. NEVILLE MMC ��°o �� ,�� „ ,� �u Town Hall,53095 Main Road TOWN CLERK P.O.Box 1179 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS w Fax(631)765-6145 MARRIAGE OFFICER ° oP �i j` Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER � p � www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER " *� w � OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Sabrina Born, Southold Town Clerk's Office DATED: March 19, 2018 RE: Cesspool Construction/Alteration Application Transmitted herewith is a copy of application No. 4604 for a Cesspool/Septic Tank Construction Permit submitted by: Peconic Cess ool-D'Angelo 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 Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 05/02/18 Receipt#: 238694 Quantity Transactions Reference Subtotal 1 Septic Permit- Construct- Resid, 4604 $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:4604 ELIZABETH A.NEVELLE Town Hall, 53095 Main Road P.O. Box 1179 TOWN CLERK REGISTRAR,OF VITAL STATISTICS Southold,New York 11971 MARRIAGE OFFICER Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER �� southoldtown.northfork.net i OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTH0LD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @ $10__� or Non--1 esidential @ $-25 Application No. Permit No. Applicant Name PECONIC CESSPOOL Applicant Mailing Address PO BOX 487 L REL NY-1 8 Septic Tank or "esspool _.. l�sepro'eio eAltertoBnef DesCrdpt.r ,,of Pr 07� 1r�...�.. - '. 0 Location of Proposed �'olislracll r1 Allera�rr µ Owner of Property: Owner Mailing Address Owner Property Address: _.,4911, __ ficwl' � NX Name and phone number of contact person E �- p Lot Tax Ma No: Sectio�a Block Cross Street i BE SUBMITTED WITH .__•..._ NOTE: LOCATION MAP [ APPLICATION. NEW 1 CONSTRUCTION REQUIRES SURVEY WITH HEALTI- . O AR"I M NT APPI O A . Signattire, f Ap i Date Received by: ........ .•. °. � •...._ I I .�'""� ,.°^" �� „..�,�,^' �i r ��. Ali d � �,�. ,� �' ��"" � �� . �.,,. � ,^ LLL------ �, V'1 �� ""-,., I .�� `.�"m I� 1 ELIZABETH A. NEVILLE,MMC �� Town Hall,53095 Main Road TOWN CLERK � P.O.Box 1179 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS � w Fax(631)765-6145 MARRIAGE OFFICER �i Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER if www.southoldtownny.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: March 19, 2018 RE: Cesspool Construction/Alteration Application Transmitted herewith is a copy of application No. 4605 for a Cesspool/Septic Tank Construction Permit submitted by: Peconic Cesspool-Bowe 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 Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 05/02/18 Receipt#: 238695 Quantity Transactions Reference Subtotal 1 Septic Permit- Construct- Resid. 4605 $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:4605 r ,"w*4 F /( ELI7.ABETH A.NEVII.LE ,�* *`•; Town Hall,53095 Main Road TOWN CLERK P.O. Box 1179 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS N ARRrAGE OFFICER "�" Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER �" southoldtown.northfork.net Off'"F C: OF THE TOW-N CLERK TOWN OF SOUTHOLD .i SOUTDOLD WASTEWATER DISTRICT APPLICATION CONSTRI C"TION or ALTERATION PERAUT C t SSPOOL or SEPTIC TANK Residential @$10 V or Non, esidential @$25 Application No. Permit No. Applicant Name PECONIC CESSPOOL Applicant Mailing Address PO BOX 487 LAUREL NY 119 8 Septic Tank_V or Cesspool � AlteraliBrief Descriptio o of 4--otictio� �' zo r7 Location of Proposed Con tuci ° .titer tion. 1 Owner of Property:. - � Owner Mailing Address Owner Property Address: c Name and phone number of cot,act person . � Tax Map No: �ectD. Block_° ..__ Lot c)- Cross Street ` z JY NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURNrEY WITH 11 r-1EP TMENT APPROVAL Sign ata e-of. lel carat Date Received by � .... __....._ . l E' `fin z 1IIIm N IF