HomeMy WebLinkAboutCampbell, John ' •
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Ifs �' Town Hall, 53095 Main Road
0�- � P.O. Box 1179
jit'r��l � 109 Southold, New York 11971
JUDITH T.TERRY FAX(516)765-1823
TOWN CLERK TELEPHONE(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 604 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PECONIC CESSPOOL
Address 1 : P. O. BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION OF NEW OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. HOLD TO 12'0" BETWEEN POOLS. EXCAVATION
INSPECTION REQUIRED. CALL 765-1802 FOR AN APPOINTMENT.
Name Of Owner CAMPBELL, JOHN
Mailing Address 1 330 JERICHO TURNPIKE
City St Zip FLORAL PARK NY 11001
Property Address 1 1185 FLEETWOOD ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 137.00 block 14 lot 27.000
Cross Street BETTS STREET
Building Permit Number Cross Reference:
Issue Date: 5/04/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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APR 2 41990 . �
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=-�x 4 •,� Town Hall, 53095 Main Road' .�,0 ���'�• P.O. Box 1179
1 .0�� Southold, New York 11971
JUDITH T. TERRY �1.�."0, " TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
April 24, 1990
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To: Southold Town Code Enforcement Officer
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A619 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for John Campbell
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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 this office.
Thank you.
Linda J. Cooper
* * * * * * * * * * * * * -
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - X
DISAPPROVE - / n
COMMENTS: 14424 .142.A.. I A.—v U 4. 'u�Qy,s„ �cr�Q..
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OFFICE OF THE TOWN CLERK Cj�FFOCI�'`+"
Town of Southold j Application No.
Judith T. Terry, Town Clerk j
Town Hall, 53095 Main Road ' g Construction
P. O. Box 1179
Southold, New York 11971 y�o •`, Alteration
Telephone 1 t �O " Residential
(516) 765-1801
Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ />
DATE 9"
APPLICANT NAME: -� C ea--1'
APPLICANT ADDRESS: 6? !% ?72--
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SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: C-40
OWNER MAILING ADDRESS: tS.3S
OWNER PROPERTY ADDRESS: //cP5 / a Z 1v-�-aa� �� .
TELEPHONE NUMBER OF CONTACT PERSON: F(
TAX MAP NO. : Section /33 7 Block 7 Lot z 7
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
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Signature of Appli nt
RECEIVED B
APR 2 DM Clerk's Office
DATE:
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