HomeMy WebLinkAboutDickson, Marjorie ftf
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Town Town Hall, 53095 Main Road
A, to,
r� P.O. Box 1179
Southold, New York 11971
JUDITH T.TERRY FAX(516)765-1823
TOWN CLERK TELEPHONE(516)7654801
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. 619 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
ADDITON OF NEW OVERFLOW POOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. HOLD 12'0" INDICATED ON SUBMITTED SKETCH.
EXCAVATION INSPECTION REQUIRED. CALL THE SOUTHOLD TOWN BUILDING DEPT.
AT 765-1802 FOR AN INSPECTION BEFORE BURYING.
Name Of Owner DICKSON, MARJORIE
Mailing Address 1 WEST CREEK ROAD
City St Zip CUTCHOGUE NY 11935
Property Address 1 WEST CREEK ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 110.00 block 5 lot 10.000
Cross Street DUCK POINT ROAD
Building Permit Number Cross Reference:
Issue Date: 6/26/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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,Y . - Town Hall, 53095 Main Road
--+�Lo.�E3ir� #- '�/fu ®�t� P.O. Box 1179
D� C� NT. r I A "N°. Southold, New York 11971
JUDITH ---CR1NN OF SOUTf1O ��.,y,..0'
TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
June 5, 1990
To: Southold Town Code Enforcement Officer
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A 634 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Marjorie Dickson
•
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
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - >c
DISAPPROVE -
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RECEIVED Signature
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Date
Town Clerk South*
OFFICE THE TOWN CLERK c\C.IlffOL4 O
Town of Southoldwn Clerk ,�
Judith T. Terry, oCI r �\► C J' Application No. �1
Town Hall, 53095 Main Road
Construction
P. 0. Box 1179
Southold, New York 11971 ,4 O�,`J Alteration
Telephone �1 t y►� 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
APPLICANT NAME: lri"?
APPLICANT ADDRESS: ,,e2 /3"--y
SEPTIC CESSPOOL
DESCRIPTIONWROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION;
OWNER OF PROPERTY: .'7 °
OWNER MAILING ADDRESS: /�r�ar-& c .ie•I'
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: Gr
TAX MAP NO. : Section lI v Block .5-• Lot / 0
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
-10/4/.4,
Signature of Applicant,
RECEIVED BY:
Town Clerk's Office
DATE:
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