HomeMy WebLinkAboutBradley, Margaret ,,oc��FFOLkc�y
JUDITH T. TERRY
Town Hall, 53095 Main Road
TOWN CLERK : v T P.O. Box 1179
U' �� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = VO �� Fax (516) 765-1823
MARRIAGE OFFICER 4�//�� �) I*' Fax
(516) 765-1801
RECORDS MANAGEMENT OFFICER -."/1 + `1 P.°
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1189 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 AN OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS
BUILDINGS, PROPERTY LINES, AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner BRADLEY, MARGARET
Mailing Address 1 1015 FACTORY AVENUE
City St Zip MATTITUCK NY 11952
Property Address 1 1015 FACTORY AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 122.00 block 2 lot 2.001
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 8/29/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY ; Town Hall, 53095 Main Road
TOWN CLERK : a T P.O. Box 1179
VS Southold, New York 11971
REGISTRAR OF VITAL STATISTICS %=20,04,b. '. ,” Fax (516) 765-1823
MARRIAGE OFFICER _ -,�//�/ .� �.' Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER -�"KJ,I + ri
FREEDOM OF INFORMATION OFFICER "...,,,,,,,i041
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD F "
18 1994 lH
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
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lOWN IdA
DATED: August 17, 1994
Transmitted herewith is a copy of application No. A1235 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Margaret Bradley •
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 - v
ON INSMON
DISAPPROVE - EX""
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Signature 9'
AUG 2 6 1994
Town Clerk Southold Date
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OFF.GE O THE TOWN CLERK ,,,'",,,""''--
Town of Southold �.'' ,c3011L'�`'I =
Application No4/ o S
Judith T. Terry, Town Clerk ,` Gy
Town Hall, 53095 Main Road Construction
P. O. Box 1179 , = ,=r
Southold, New York 11971 . t1� Alteration
Telephone ` O �`Cr�' $10.00 - Residential
(516) 65-1801 762 ��'�
- , �,,
,, ' $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 ,10/fr
APPLICANT NAME: / _ _
APPLICANT ADDRESS: 004:
SEPTIC CESSPOOL 1/
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: --r....42..-Z -,o.„
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section /2-7- Block Z_ Lot v1 , /
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applica
RECEIVED BY:
fo - •jerk's Office
DATE: S-/71r
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