HomeMy WebLinkAboutKinnen, David 1=1l� �� Town Hall, 53095 Main Road
.� P.O. Box 1179
=�'yQl 7►,•,• Southold, New York 11971
JUDITH T.TERRY .,,�.i�''� FAX(516)765-1823
TELEPHONE(516)765-1801
TOWN CLERK
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. 653 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 OVERFLOW TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. EXCAVATION INSPECTION REQUIRED.
Name Of Owner KINNEN, DAVID
Mailing Address 1 4135 SOUTH FIRESIDE DRIVE
City St Zip WILLIAMSVILLE NY 14221
Property Address 1 THIRD STREET
City St Zip NEW SUFFOLK NY 11956
Tax Map No. section 117.00 block 7 lot 12.000
Cross Street ORCHARD STREET
•
Building Permit Number Cross Reference:
Issue Date: 10/15/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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��•% Town Hall, 53095 Main Road
� .•• P.O. Box 1179
01 ��•�� Southold, New York 11971
JUDITH T. TERRY " woo 10 TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK11
(`,� QNI\ _`''TOWN OF SOUTHOLD L5 -r : ;"
October 12, 1990 co ' 21990 , �I
To: Southold Town Code Enforcement "Officer BLDG. DEPT.QLD
TOWN OFSO H .
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A668 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for David Kinnen •
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 -
DISAPPROVE -
COMMENTS: a. L,,,_,` LA , D. g kttS),
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Date
OFFICE OF THE TOWN CLERK """"',,""''--
Town of Southold
S CO �to
Judith T. Terry, Town Clerk ���
'sApplication No.
� Gy'�
Town Hall, 53095 Main Road z . Construction e
P. O. Box 1179 •
Southold, New York 11971 c=3t� Alteration
Telephone ,j" �Q�/ $10.00 - Residential
(516) 765-1801 '11 4'�, �' $25.00 -Non-Residential
•TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE /P/ 1Z- i1S
APPLICANT NAME:
APPLICANT ADDRESS: A D L 97
Ma_
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: �3fi' i Tf ,/ fiJAJFft/
OWNER MAILING ADDRESS: 6/3j ,S0-
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OWNER PROPERTY ADDRESS: .c'•t .YJ . /94/6-11-4. ---15e
TELEPHONE
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section /77 Block Lot / Z.--
CROSS STREET: (} (--ki
BUILDING PERMIT NUMBER CROSS REFERENCE:-
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Signatu of Applicant
AZ-CEP/ED araingtei,
Town lerk's Office
DATE: •
OCT1a 1990
Town Clerk MO
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