HomeMy WebLinkAboutGatz, Marilyn JUDITH T. TERRY L Town Hall, 53095 Main Road
TOWN CLERK Z P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS MI i Southold, New York 11971
MARRIAGE OFFICER y4� '�, Fax (516) 765-1823
� 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. 27 N Residential Non-Residential X
Fee $ 25.00 Septic X Cesspool
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 CESSPOOL TO EXISTING SYSTEM
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 5/2/91 .
Name Of Owner MARILYN GATZ
Mailing Address 1 SOUND AVENUE
City St Zip MATTITUCK NY 11952
Property Address 1 LOVE LANE
(VILLAGE MARKET)
City St Zip MATTITUCK NY 11952
Tax Map No. section 140.00 block 3 lot 42.004
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 5/02/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
JUDITH T. TERRY / • L Town Hall, 53095 Main Road
TOWN CLERK = i P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS C=ir71i Southold, New York 11971
MARRIAGE OFFICER 1Yp� TelephonFax e(516)57651801
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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. 27 N Residential Non-Residential X
Fee $ 25.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MARILYN GATZ
Address 1 : SOUND AVENUE
City St Zip MATTITUCK, NY 11952
Descripton of Proposed Construction or Alteration
ADDITION OF CESSPOOL TO EXISTING SYSTEM
Name Of Owner MARILYN GATZ
Mailing Address 1 SOUND AVENUE
City St Zip MATTITUCK NY 11952
Property Address 1 LOVE LANE, VILLAGE MARKET
City St Zip MATTITUCK NY 11952
Tax Map No. section 62 block 3 lot 7
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 5/02/91 Judith T. Terry 4.
Southold Town Clerk
(TOWN SEAL)
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• oma o� _ \ NIR 2 61991
MAR 2 21991 Y - ,
1 %.o,, ft • Town Hall, 53095 Main Road
1 -r,iv, _ P.O. Box 1179
�' - _0.( NP Os 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
March 22, 1991
To: Southold Town Code Enforcement Officer
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No.A 714 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Marilyn Gatz .
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
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I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - K
DISAPPROVE -
COMMENTS: ova 1 t„XtaQ p,.1 C1-v._S2—
'erAh'uutcH,,,,, 1 „ i ..t. 14 $ CO- gDaiX
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Signature
Date •.. I '
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OFFICE OF. THE TOWN CLERK ,.��"""
Town of Southold .,''�c�ttMK",
Judith T. Terry, Town Clerk Application No.T7/
Town Hall, 53095 Main Road Z .G: Construction L�
P. O. Box 1179
Southold, New York 11971 Alteration
Telephone ;�O �Q�' $10.00 - Residential
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(516) 765-1801 _ �.�
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,, �� $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 3/Z 2/9 f
APPLICANT NAME: toe‘-‘422%,
APPLICANT ADDRESS: AO 972—
/217Z-j-7
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SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: /n#4,/p•y
OWNER MAILING ADDRESS: ,).
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
qlo--cIC
TAX MAP NO. : Section
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CROSS STREET: tia
BUILDING PERMIT NUMBER CROSS REFERENCE:
Anat pp c t
RECEIVED BY: irl CE
Town Cl rIr r Office
DATE:
1NAR22- 1997
south Town Clerk
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