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Home My WebLink AboutBoursiquot, Ange - .2G i4 rit Town Hall, 53095 Main Road P.O. Box 1179 `0 ��•� Southold, New York 11971 JUDITH T.TERRY - 1 ��,,, '� CLERK FAX(516)765-1823 TELEPHONE(516) 765-1801 TOWN 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. 580 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 NEW OVERFLOW CESSPOOL TO EXISTING SYSTEM. APPROVED AS SUBMITTED. NOTE: HOLD TO 12'0" BETWEEN POOLS. EXCAVATION INSPECTION REQUIRED. CALL 765-1802 FOR AN APPOINTMENT AT LEAST 24 HOURS IN ADVANCE. Name Of Owner BOURSIQUOT, ANGE AND BARBARA Mailing Address 1 100 BEEKMAN STREET, APT. 12L City St Zip NEW YORK NY 10038 Property Address 1 MAIN ROAD City St Zip MATTITUCK NY 11952 Tax Map No. section 122.00 block 6 lot 15.000 Cross Street FACTORY AVENUE Building Permit Number Cross Reference: sue Date: 2/01/90 Judith T. Terry Southold Town Clerk (TOWN SEAL) A ffff FEB .. ;� .' �,•� Town Hall, 53095 Main Road -x,„ R...` %�-.,, P.O. Box 1179 „� .. t or Southold, New York 11971 JUDITH T. TER BLDG.DEFT. -...001 "A"Pr TOWN CLERK TOWN OF SOUTHOLD TELEPHONE REGISTRAR OF VITAL STATISTICS (516)765-1801 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD January 31, 1990 To: Victor Lessard, Southold Town Building Department From: Linda J. Cooper, Southold Town Clerk's Office Transmitted herewith is a copy of application No. A594 for an ALTERATION PERMIT for a cesspool or septic system submitted by Peconic Cesspool for Anqe & Barbara Boursiquot . 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. . 4 . GvXraLu JE :Or Linda J. Cooper - ,-Tyl, * * * * * * * * * * * * * I have reviewed the application and location map of the project listed above and make the following recommendation: APPROVE - ,( DISAPPROVE - COMMENTS: - 1'• , .;c �p - ` l j V Ac l —7 \ Av (24-,....4 '\(( )) --r.,4 FA �� Signature S' -Vi /70 Date 1. ) . ¢. • OFFICE OF THE TOWN CLERK �c��FFU(K`,� Town of Southold �� y0 �t Application No./f) .-5-7L/ Judith T. Terry, Town Clerk Town Hall, 53095 Main Road g Construction P. O. Box 1179 Southold, New York 11971 Alteration Telephone #44( J�t ' " Residential (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 ,l/-givA APPLICANT NAME: re"r-'79/1-"6- APPLICANT ADDRESS: ,se© A SEPTIC CESSPOOL DESCRIPTIO 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: 4. Dc-/±d,' Gvl OWNER MAILING ADDRESS: /01) /3 � c5'7— t, /2 L 4, yuz-�C. zoo 3,F' OWNER PROPERTY ADDRESS: TELEPHONE NUMBER OF CONTACT PERSON: ft 5-k TAX MAP NO. : Section /7„.2. Block li Lot /5 CROSS STREET: BUILDING PERMIT NUMBER CROSS REFERENCE: Signature of Ap icant RECEIVED BY: Town Clerk's Office DATE: I.=. '" . •-,,,,,'ilie,14,i:',.',.t.'.' .7-',"'.4:-...tr" -,, ... . .. '1 A • • -""*.1) . N... _._ ., •.- . 4/ , 1 ,.._ . . „. , , • _ ....., .._ ,., 1:t1j, ....., , t , . , - . I.-, eit-‘x- cf,%. - .-, --,--- --.-- -------, ----'--1.!.---‘-- . ._ ,. • . . . . . :.„.,„ • ” ,....... .. .. „ ..... _ , .a. ... .,_ ) . ,., ' . : --........, _ ‘r _ 014P.#17,-C -L."7.9 a,•*A.o .''' - '''' S'f' .,..: __._____...—....o. , . . i I . i . . _,_- ---1 .. ,.... ,. , I A . , . . . .., , .. . ..... -.. - .-- .. ..1 , ,,,,,:40•-" ..,.V. ' :.7.,..I. . . I , - ... _ -.. .. 1 -",-.- .--'