HomeMy WebLinkAboutDeLuca, William C i
Town Hall, 53095 Main Road
�O 0� P.O. Box 1179
Southold, New York 11971
JUDITH T.TERRY FAX(516)765-1823
TOWN CLERK TELEPHONE(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. 547 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. NOTE: EXCAVATION INSPECTION REQUIRED.
Name Of Owner DELUCA, WILLIAM
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Mailing Address 1 53 GREEN AVENUE
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City St Zip MADISON NJ 7940
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Property Address 1 BREAKWATER ROAD
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City St Zip MATTITUCK NY 11952
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Tax Map No. section 99.00 block 2 lot 18.000
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Cross Street NAUGLES ROAD
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Building Permit Number Cross Reference:
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Issue Date: 9/14/89 Judith T. Terry
-------- Southold Town Clerk
(TOWN SEAL)
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® Town Hall, 53095 Main Road
P.O. Box 1179
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
September 11, 1989
1989
To: Victor Lessard, Southold Town Building Department
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A561 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for William Deluca
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.
v u C,
Linda J. Cooper
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - �—
DISAPPROVE -
COMMENTS: a
td
Signature
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Date
OFFICE OF, THE TOWN CLERKTown of Southold O�jV �CI�`►O
Judith T. Terry, Town Clerk Application No. �
Town Hall, 53095 Main Road L Construction
P. 0. Box 1179 ,
Alteration
Southold, New York 11971
Telephone alt � 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 `C✓��< ��� _
APPLICANT NAME:
APPLICANT ADDRESS:
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:��� �
OWNER MAILING ADDRESS:
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OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: !��Cc
TAX MAP NO. : Section 79 Block Z Lot /Y
CROSS STREET : A 46 �^
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applieffril
RECEIVED BY:
Town Clerk's Office
DATE:
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