HomeMy WebLinkAboutBerkmier, Jack „ ,
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JUDITH T. TERRY � < : Town Hall, 53095 Main Road
TOWN CLERK p T P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS tri
�� Southold, New York 11971
MARRIAGE OFFICER �O` O ��,�” Fax (516) 765-1823
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(516) 765-1801
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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. 932 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PECON I C CESSPOOL
Address 1 : P. O. BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
REPLACE OLD CESSPOOL WITH NEW TYPE.
APPROVED WITH CHANGES (SEE ATTACHED). REMOVE OLD POOL TO LANDFILL.
EXCAVATION INSPECTION REQUIRED, CALL FOR AN APPOINTMENT.
Name Of Owner BERKMIER, JACK
Mailing Address 1 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 70.00 block 7 lot 10.000
Cross Street ORWIN LANE
Building Permit Number Cross Reference:
Issue Date: 11/27/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY ` ; Town Ha11, 53095 Main Road
TOWN CLERK p rZf 1 P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �` Southold, New York 11971
Fax 3
MARRIAGE OFFICER Gfr ��0�,'•�� Telephone (5 6) 765-18016)
••OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
November 9, 1992
Nijv 9
To: Southold Town Code Enforcement Officer
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A957 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Jack Berkmier
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: ( ,� 444-111-c, 4r d . Colo 3.44..
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Date
OFFICE OF THE TOWN CLERK ,,,,""
Town of Southold •,�',, �FF���C-': q
Judith T. Terry, Town Clerk ,�' &� Ol/y.. Application No.
Town Hall, 53095 Main Road Z <; Construction
P. O. Box 1179 � � z : -
1,1
Southold, New York 11971 • 1,1c:3 Alteration
Telephone Q�.••• $10.00 - Residential 1/
p(516) 765-1801 ' * � �'� $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
APPLICANT NAME: ,
APPLICANT ADDRESS: ,ted y,, Q71--
SEPTIC
7Z..SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
°
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATIQN:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS: /14,4G3.J
.. �1 /177/
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: h � '
TAX MAP NO. : Section id- Block `? . Lot / a
CROSS STREET: e5/G w,
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of A licant
.REC€ VEO 43Y: .
o n Clerk's Office
DATE: /1 ( f' f� •
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