HomeMy WebLinkAboutCucuru, Pat f,,inn•..
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JUDITH T. TERRY y‘ Town Hall, 53095 Main Road
TOWN CLERK Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS T Southold, New York 11971
Fax (516) 765-1823
MARRIAGE OFFICER 0, Telephone (516) 765-1801
I 44 PTO.
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 678 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 POOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. CALL FOR PROPER EXCAVATION INSPECTION BEFORE
BACKFILLING.
Name Of Owner CUCURA
Mailing Address 1 BOX 771
City St Zip SOUTHOLD NY 11971
Property Address 1 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 66.00 block 2 lot 1 .000
Cross Street TOWN HARBOR ROAD
Building Permit Number Cross Reference:
Issue Date: 1/14/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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TOWN OF SOUTHOLD •Llb : Town Hall, 53095 Main Road
��../ P.O. Box 1179
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i ,> t ilk 0 Southold, New York 11971
JUDITH T. TERRY ' ,,," 4/ TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
January 10, 1991
To: Southold Town Code Enforcement Officer
- From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A696 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Pat Cucura •
Please review the application and location map and advise if this office may
issue the permit.
Please complete the formbelow and return it to this office.
Thank you. \�`_
_`Ct
_`\`_`<Q Linda J. Cooper
* * �4�0 (Zr * * * * * * * * *
I hav ke'vie ed the application and location map of the project listed
abovend make the following recommendation:
APPROVE - x
DISAPPROVE -
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Signature
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Date
OFFICE OF THE TOWN CLERK ,,,'",,,,,
Town of Southold o'"c5lFULK cep
Application No.
Judith Ta `
Hall,Terry, Town Clerk ,�' � G2
Town H , 53095 Main Road Z Construction
P. O. Box 1179 o ,.=r,
Southold, New York 11971 t ,;in WAlteration
Telephone ‘-%%9 �Q�i $10.00 - Residential Com'
(516) 765-1801 1jit
,,,, $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE ///o P
APPLICANT NAME: -�7
APPLICANT ADDRESS: _ '7i-
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION, OR ALTERATION
i %
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION
OWNER OF PROPERTY: /G..0
OWNER MAILING ADDRESS: /! 77/
OWNER PROPERTY ADDRESS: -- S-•y�
TELEPHONE NUMBER OF CONTACT PERSON:L f- 5-
TAX MAP NO. : Section jp Block ' Lot /
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
ie4711f
Signa re of Applicant
RECEIVED BY:
ToClerk's Office
DATE: )d//7
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