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HomeMy WebLinkAboutDickerson, Chester Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 JUDITH T.TERRY TELEPHONE. ToWN CLI RK (516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD December 4, 1986 Chester and Parker Dickerson 14100 Bayview Road Southold, New York 11971 Re: Main Bayview Road Southold, New York Enclosed herewith is the Construction, Alteration or Modification Permit for a Septic Tank or Cesspool System for which you applied. Please be advised that each owner of real property operating an on-site sewage disposal system, such as a septic tank or cesspool must, prior to such operation, possess in the name of the owner an Operation Permit for the system. The Operation Permit is issued by the Town Clerk's Office. The fee for an Operation Permit is ten dollars ($10. 00) for residential use and twenty-five dollars ($25-00) for non-residential. Please have the owner complete the enclosed Application for an Operation Permit and return it to this office along with the proper fee. For your general information I have enclosed an Informational Bulletin regarding the Scavenger Waste Laws adopted by the Southold Town Board. Should you have any questions pertaining to either permits or the Scavenger Waste Laws, please do .not hesitate to contact this office. We will be glad to assist you in any way possible. Very truly hours, 049�� Judith T. Terry Southold Town Clerk Enclosures (3) JTT /Ijc OFFICE OF THE TOWN CLERK Town of Southold Judith T. Terry, Town Clerk Town Hall, 53095 Main Road 'mac P. 0. Box 1179 Southold, New York 11971 O Telephone! [ (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 79 Residential X Fee $ 10.00 Non-Residential . Septic Cesspool X PERMIT ISSUED TO: NAME: Chester and Parker Dickerson ADDRESS: 14100 Bayview Road Southold- New York 11971 DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION New house LOCATION 'OF PROPOSED CONSTRUCTION or ALTERATION: OWNER OF PROPERTY: Chester and Parker Dickerson OWNER MAILING ADDRESS: 14100 Bayview Road Southold, New York 11971 OWNER PROPERTY ADDRESS: Main Bayview Road Southold, New York TAX MAP NO. : Section 88 Block 6 Lot 4.1 CROSS STREET: Jacobs Lane BUILDING PERMIT NUMBER CROSS REFERENCE: Pending • Judith T. Terry Southold Town Clerk DATE : December 3. 1986 (TOWN SEAL) OFFICE OF THE TOA CLERK Town 'of Southold Application No. -.F--> Judith T. Terry, Town Clerk PP Town Hall, 53095 Main Road Construction__ P. 0. Box 1179 Alteration Southold, New York 11971 Telephone Residential_w__ (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 $ /-0, 00 DATE` / __-- APPLICANT NAME: e.t�ic � 1�i¢�sC'�C `� lc. SO •J APPLICANT ADDRESS: / V/&-o SEPTIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION _ u LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: C.?Q �a' � OWNER MAILING ADDRESS: gu,q q7.1 OWNER PROPERTY ADDRESS: TELEPHONE NUMBER OF CONTACT PERSON: TAX MAP NO. : Section p -8'1 Block © —Lot_ 4. 1 CROSS STREET: J A� o ►S. �-,L1 BUILDING PERMIT NUMBER CROSS REFERENCE: j �l icgnature of Applicant RECEIVED BY: Town Jerk Office DATE: h a • �- sss � j wr- AL WFFOLV COUNTY UEl°AF,l a"E'y FOR APPROw. or zr; <� Single Fws,i'y DATEN&JAJM APPROVED EXPIRES TWO YEARS FROV �zZ'W. q ^r If � ! w �e f f yt y ' 46 S � OFNF COCK V /u °' Lr/'i i 13 NOV te P 19 �36e1 cr � �;p e 8, 44NO g� 3 S C DEPT. OF ; � HEALTH SERVICES