HomeMy WebLinkAboutLa Gazelle Restaurant (2) 1
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\ JUL I .1988 •o� ., fis - .�
BLDG. DE 1T. : ct1 Town Hall, 53095 Main Road
TOWN OF SOUTHOLD �
P.O. Box 1179
�1 14 j ,. Southold, New York 11971
JUDITH T.TERRY `•f ��
TOWN CLERK �, TELEPHONE
REGISTRAR OF VITAL STATISTICS (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Victor Lessard, Southold Town Building Department
From: Linda Cooper, Southold Town Clerk's Office
Dated: July 19, 1988
Transmitted herewith is a copy of application No. 380 N for a Cesspool/
Septic Tank Construction Permit submitted by:
Peconic Cesspool for La Gazelle
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
Comments: Q,o �.�.i.� R� tr. ,i� LLui a 4 CALA-
Signature
Dated
4LA'-
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Ce
Town Hall, 53095 Main Road
P.O. Box 1179
_*6 1*),• Southold,New York 11971
JUDITH T.TERRY TELEPHONE
TOWN CLERK (516)765-1801
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. 11 N Residential Non-Residential X
Fee $ 25.00 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 TO EXISTING SYSTEM.
APPROVED AS SUBMITTED.
Name Of Owner LA GAZELLE RESTAURANT
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 63. 00 block 3 lot 21. 005
Cross Street TOWN HARBOR ROAD
Building Permit Number Cross Reference:
____Aelke,XeCIT:
Issue Date: 7/20/88 Judith T. Te y
Southold Town Clerk
(TOWN SEAL)
a 'S
OFFICE OF THE TOWN CLERK O�j FULt`+O
Judith T. Terry, Town Clerk Town of Southold
�� L ; )
y Application N
. Q?0
Town Hall, 53095 Main Road Construction '`
P. O. Box 1179 �t 'W$ Alteration
Southold, New York 11971 '�l
Telephone Ol ‘N• �9 Residential
p
(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 SLC `c'e
DATE a, /at
APPLICANT NAME: /1-<---er-32(....f._
APPLICANT ADDRESS: /31,-L 972i-
Ai/7---74/1/7"7/6-/t"
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTE,RATIONzsid;' ec w L
C L' /�.V Z ) 7E, e iTee J' f/6✓' ' �f/�"✓Q?,��
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CON TRUCTION OR ALTERATION:
OWNER OF PROPERTY: #//9 , /f�� E�' �res'5744"/t 44, r
OWNER MAILING ADDRESS: e/%f}//(/' /Z q/ 744"~
9ov/4o/gt/1/. F //977
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 24F---26fY
TAX MAP NO. : Section 3� Block .3 Lot 2-_ 7, S
CROSS STREET: 7 ij i..�y, /1 , .
BUILDING PERMIT NUMBER CROSS REFERENCE:
•
Signature of Applica
RECEIVED BY:(4i2.. --)cc C.,
n Cler s Office /
DATE:
JUL 181988
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