HomeMy WebLinkAboutMaggio ELIZABETH A. NEVILLE MMC " "
�A���,'� t ���� �� Town Hall,53095 Main Road
TOWN CLERK r P.O.Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS Fax(631)765-6145
MARRIAGE OFFICER0 , Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER U1°'" � � 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: June 8, 2018
Transmitted herewith is a copy of application No. 4614 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Peconic Cesspool for Steven Maggio
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. Thank you
* * * * * * * * * * * *
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
Dated
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 OFFICER Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOU`:1"1 OLID WASTEWATER DISTRICT
APPLICATION
CON'STRtCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential@ $10 or Non-Residential @ $25 Appcation No. 'y
Permit No..
Applicant Name ... .. ..... __ PECONiC CESSPOOL
Applicant Mailing AddressP, LA U YBOX 487'
..
11948
_ .... _
Septic Tank or Cesspool
P p
Brief Description oor Alteration
Location of Proposed Constnjctioi�llteration.
Owner of Property
Owner Mailing Address
�" dw
Owner Property Address-, 1 Z, L�
Name and phone number of co tact person .m.^ ...f
r
Tax Map No: ecti.o.11 d Block_.._. / Lot ,
.�m...... .
Cross Street �" pd" ' t '�� b,
�.
NOTE: LOCATION MAP ' USTBE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SUIT VEET WITH I-IE A 11 HIMP T-IJE'N�1 A PR,firu......... ._.....a ( ^°, �
a'
Si,g L .A "l) . '11 Date
Received by.
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Town of Southold
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Date: 06/08/18 Receipt#: 241984
Quantity Transactions Reference Subtotal
1 Septic Permit-Construct- Resid, 4614 $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: SABRINA Internal ID:4614