HomeMy WebLinkAboutCelic, Deborah •
Town Hall, 53095 Main Road
��`�, P.O. Box 1179
' 1 ��•�'�` Southold, New York 11971
JUDITH T.TERRY %..,i.��4'�I FAX 765-1823
TELEPHONE(516)765-1801
TOWN CLERK
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. 498 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 19520
Descripton of Proposed Construction or Alteration
REPLACE EXISTING CESSPOOL WITH NEW TYPE PRECAST.
APPROVED AS SUBMITTED. BASE TO BE AT LEAST 2'0" ABOVE AVERAGE HIGH
WATER MARK. EXCAVATION INSPECTION REQUIRED.
Name Of Owner CELIC, DEBORAH
Mailing Address 1 P. O. BOX 786
City St Zip MATTITUCK NY 11952
Property Address 1 MARRATOOKA POINT
City St Zip MATTITUCK NY 11952
Tax Map No. section 123.00 block 8 lot 29.000
Cross Street PARK AVENUE
Building Permit Number Cross Reference:
Issue Date: 6/06/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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0.„ it Town Hall, 53095 Main Roac
:� " • P.O. Box 1179
'c'�.� *� 0 Southold, New York 11971
JUDITH T. TERRY "„ "I' TELEPHONE
TOWN CLERK (516)76$-181
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
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To: Victor Lessard, Southold Town Building Department . LY 2 3 � 1
From: Linda J. Cooper, Southold Town Clerk's Office BLDG DEPT
TOWN OF SOUTHOLD
Transmitted herewith is a copy of application No. A510 or an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Deborah Celic
Please review the application and location map and advise if this office may
issue the permit.
Please complete the form below and return it to this office.
Thank you.
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - Ix
DISAPPROVE - t
•
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Signature
,-#00 6141 ?
Date
OFFICE OF THE TOWN CLERK c$FUL4 D
Town of Southold -•
Judith T. Terry, Town Clerk Application N6! U
��. Cl/
Town Hall, 53095 Main Road Construction
P. O. Box 1179
Southold, New York 11971 Alteration
*Q(Telephone
��� Residential V
(516) 765-1801
Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE A4-/ 7-34-?
APPLICANT NAME: ,_,Ce,9 ,L
APPLICANT ADDRESS: /`:D. }s- 972,E
SEPTIC CESSPOOL
DESCRIPTI N OF PROPOSED CONSTRUCTION OR ALTERATION �A
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 6.—eget
OWNER MAILING ADDRESS: . / L'( 7J
OWNER PROPERTY ADDRESS: • "9,47-,C42-7';-?X-#1/-
/174-7,777
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TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section /X3 Block Fs.- Lot 27
CROSS STREET: Ani,- 9 ' /
BUILDING PERMIT NUMBER CROSS REFERENCE:
/1/1.-7
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nt
Signature of A lii
RECEIVED BY: RECEIVED
MAY gwi8�Ierk's Office
DATE: f
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