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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK T P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER yQ it Fax (516) 765-1823
10, t� Telephone (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. 945 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : P. M. DEVELOPEMENT OF NEW YORK
Address 1 : P. O. BOX 300
City St Zip MASTIC BEACH NY 11951
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES.
Name Of Owner BYRNES, PATRICIA ANN
Mailing Address 1 C/O KOEHLER
HORTON LANE
City St Zip SOUTHOLD NY 11971
Property Address 1 HORSESHOE DRIVE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 95.00 block 4 lot 18.027
Cross Street ROUTE 48
Building Permit Number Cross Reference:
Issue Date: 12/22/92 Judith T. Terry
Southold Town Clerk
I TOWN SEAL)
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JUDITH T. TERRY ;
Town Hall, 53095 Main Road
: p rZ P.O. Box 1179
TOWN CLERK
REGISTRAR OF VITAL STATISTICS .VI *" Southold, New York 11971
MARRIAGE OFFICER 1.Os Ar �4 Fax (516) 765-1823
,yo ��� Fax
(516) 765-1801
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OFFICE OF THE TOWN CLERK
y r
TOWN OF SOUTHOLD '`
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office `.
OLD
DATED: December 7, 1992
Transmitted herewith is a copy of application No. 972 for a Cesspool/
Septic Tank Construction Permit submitted by:
P.M. Development of New York, Inc.
Please review the application and location map and advise if the project
has received Suffolk County Health Department approval and if this office
may issue the permit.
Please complete the form below and return it to me.
Thank you.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE X
DISAPPROVE nn
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Signature DEC 1 � ��
1 1— It, Z' Tr�wn Clefsmoke
Dated
OFFICE OF THE TOWN CLERK F�(,�
Town of Southold �� taz
Judith T. Terry, Town Clerk ��t 6. Application No. / /c
Town Hall, 53095 Main Road o1.�,
P. O. Box 1179 u" �' Construction L�
Southold, New York 11971 0 • � Alteration
Telephone •�1 xc ly��% 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 Zl 7/97-/
APPLICANT NAME: pm, pt.-I/Li-pp,6,7-- 4,c- ,14fPV # ,k yewk
APPLICANT ADDRESS: / e 11 ,,, , "4/�
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: P197.kl_i/9 J9-//Ay' j,3'V fc',vZ$
OWNER MAILING A DRESS:e`�/ y , •
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OWNER PROPERTY ADDRESS* •
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section 9,S Block 4 Lot
27
CROSS STREET: ,,
BUILDING PERMIT NUMBER CROSS REFERENCE:..
Signature of Applicant,
RECEIVED BY: /0/; 'G G"L-�/n�/�j Ii�G ,e '�S
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DATE: / •
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