HomeMy WebLinkAboutKoster, Edward .
JUDITH T. TERRY !� • Town Hall, 53095 Main Road
TOWN CLERK v aM ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Cli •• Southold, New York 11971
MARRIAGE OFFICER ya �. Fax (516) 765-1823
I�� Fax
(516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 690 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PECON I C CESSPOOL
Address 1 : P. O. BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED. HOLD 10' SEPARATION. EXCAVATION INSPECTION
REQUIRED.
Name Of Owner KOSTER, EDWARD
Mailing Address 1 3685 PINE NECK ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 3685 PINE NECK ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 70.00 block 6 lot 23.000
Cross Street OAKLAWN AVENUE
Building Permit Number Cross Reference:
Issue Date: 3/20/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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• �FFO ”-A, RECEIVED
wRia �99� ,,p ; MAR191c _r) D
TO'' ° ' w `0 .�. ,$Tom Clerk SOUthOh 'own Hall, 53095 Main Road
N.-4 ,` iv P.O. Box 1179
0#9 Southold, New York 11971
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JUDITH T. TERRY "0� TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
March 14, 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 710 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Edward Koster .
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 - K
DISAPPROVE - ALL n
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Signature
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Date
OFFICE OF THE TOWN CLERK ,.,'""""'--
',Town of Southold ,0"4 0 IfCe
Judith T. Terry, Town Clerk ,0'QG Application No. '27 c
Town Hall, 53095 Main Road Z G Construction _
P. O. Box 1179 ; =v m
Alteration
Southold, New York 11971 ul
Telephone �Q �� $10.00 - Residential s/
(516) 765-1801 !_ �l
'� $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/ 21W
APPLICANT NAME: C
APPLICANT ADDRESS: /?, / 972—
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: J 5 Afg—CX
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: (99,---9Se
TAX MAP NO. : Section 7 Block 6. Lot 2-3
CROSS STREET: 41'--
BUILDING PERMIT NUMBER CROSS REFERENCE:
etZ11(141
Signature of App cant
RECE4 VEO B Y: _
Town Clerk's Office
3/7-2_,
DATE: �y ,
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