HomeMy WebLinkAboutChristensen, Robert o��FFoLk�Do
JUDITH T. TERRY ;, yL : Town Hall, 53095 Main Road
TOWN CLERK 0 T ; P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS il'2 •• Southold, New York 11971
MARRIAGE OFFICER
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.4 768 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 ONE OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. EXCAVTION INSPECTION REQUIRED.
Name Of Owner CHRISTENSEN, ROBERT
Mailing Address 1 100 DEVOE ROAD
City St Zip CHAPPAQUA NY 10514
Property Address 1 MIDWOOD ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 110.00 block 2 lot 7.000
Cross Street WEST CREEK
Building Permit Number Cross Reference:
Issue Date: 10/18/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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Town Hall, 53095 Main Road
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P.O.P.O. Box 1179
ttL Southold, New York 11971
JUDITH T. TERRY rj '? 1 TELEPHONE
TOWN CLERK ($16)76$-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF,THE TOWN CLERK
TOWN OF SOUTHOLD 4 r
September 30, 1991
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To: Southold Town Code Enforcement Officer at '
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A784 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Robert Christensen
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 -
DISAPPROVE -
COMMENTS: o x..,.11, ettA tTn cat ' j & .
AA,L., 4F Signature
CA I\ \
Date
OFFICE' OF THE TOWN CLERK ,,,'",,"'"'--
Town of Southold 1" COUI.k`i, _
Judith T. Terry, Town Clerk ,%'O. c• Application No. 7 17
Town Hall, 53095 Main Road ; Z .G; Construction �--
P. 0. Box 1179 , = - 'c :
Southold, New York 11971 :
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