HomeMy WebLinkAboutBarra, Edith ,', "I,,.,,
JUDITH T. TERRY ;S �C : Town Hall, 53095 Main Road
TOWN CLERK =v T t P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS : Southold, New York 11971
Fax (53
MARRIAGE OFFICER = O � � �,` Tel ph nel(516)765-1
57651801
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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. 780 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PECON I C CESSPOLL
Address 1 : P. O. BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION OF AN OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. HOLD 10'0" SEPARATION. CALL FOR REQUIRED
EXCAVATION INSPECTION.
Name Of Owner BARRA, EDITH
Mailing Address 1 475 ORCHARD STREET
City St Zip ORIENT NY 11957
Property Address 1 475 ORCHARD STREET
City St Zip ORIENT NY 11957
Tax Map No. section 25.00 block 2 lot 20.013
Cross Street VILLAGE LANE
Building Permit Number Cross Reference:
Issue Date: 12/05/91 Judith T. Terry
Southold Town Clerk
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JUDITH T. TERRY Z L Town Hall, 53095 Main Road
TOWN CLERK = Z • P.O. Box 1179
REGISTRAR OF VITAL STATISTICS T � Southold, New York 11971
MARRIAGE OFFICER y �� Fax ne (5 6) 1823
����1 Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
November 25, 1991
To: Southold Town Code Enforcement Officer
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. 802 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Edith Barra
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: �►+�a J O - o
RECEIVEDeu%.. "J.
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ktAit"
Signature
town Clerk S' `' 44W U, .i.\o►1
� Date
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OFFICE OF THE TOWN CLERK , """"'
Town of Southold +so' c�FFOLI'/;. ^2
Judith T. Terry, Town Clerk ,+' � 4Ol/ Application No.
Town Hall, 53095 Main Road Z Construction
P. O. Box 1179
Southold, New York 11971 tt) ; Alteration
Telephone
$10.00 - Residential c/
= .j' �'
(516) 765-1801 .14 %K��i,, $25.00 -Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE f/L4/9/
APPLICANT NAME: ia�2'?'YLets `
APPLICANT ADDRESS: 4/J A-7- / 922_
SEPTIC CESSPOOL
DESCRIPTION OF. PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ZeeZtX
OWNER MAILING ADDRESS: -447r—
OWNER
'7s OWNER PROPERTY ADDRESS: .--
TELEPHONE NUMBER OF CONTACT PERSON: 8—y�Sve
TAX MAP NO. : Section 0-5 Block 2- -- Lot 201 t?
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:,
i‘erk-4-4(41
Signature of A licant
RECEWEO BY:
Town Clerk's Office
DATE: •
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