HomeMy WebLinkAboutLamerise, John JUDITH T. TERRY ►► Town Hall, 53095 Main Road
TOWN CLERK p r7%
` P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER yQ O�' *4 Fax (516) 765-1823
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1049 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. MAINTAIN REQUIRED DISTANCES FROM ADJACENT
WELLS, BUILDINGS AND PROPERTY LINES. EXCAVATION INSPECTION REQUIRED.
Name Of Owner LEMERISE, JOSEPH
Mailing Address 1 108 RIDGE CRESCENT
City St Zip MANHASSET NY 11030
Property Address 1 1475 SIGSBEE ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 144.00 block 2 lot 9.000
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 10/27/93 Judith T. Terry
Southold Town Clerk
(TO1NN SEAL)
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JUDITH T. TERRY % Z Town Hall, 53095 MainRoad
TOWN CLERK ,I. v T
;in P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS `� Southold, New York 11971
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MARRIAGE OFFICER =yO�'�0 ��0�,'C�� TelephonFax e (516) 765-18016)
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OFFICE OF THE TOWN CLERK ( (; [0 riv '
TOWN OF SOUTHOLD • f ,_�__ .
993
TO: Southold Town Building Department
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FROM: Linda Cooper, Southold Town Clerk's Office
DATED: October 4, 1993 z-"'
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Transmitted herewith is a copy of application No. A1080 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Joseph Lemerise
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.
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Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE -
EXCAVATION INSPECTION
DISAPPROVE - REQUIRED
COMMENTS: *Y�a4!e / �rte,e.-`
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Signat e
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OF THE TOWN CLERK ",,,,,
1-- of Southold r-
Judith T. Terry, Town Clerk ;' � Application No./0 �Cl
Town Hall, 53095 Main Road Construction
P. 0. Box 1179 ; c
Southold,
New York 11971 • trl Alteration
Telephone "y0,� *%b ��'� $10.00 - Residential
(516) 765-1801 _ 1 '�
� $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE /6/4/9
APPLICANT NAME:
APPLICANT ADDRESS:/64-1 / 7 2
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUC ION OR ALTERATION:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS: /el
/laid
OWNER PROPERTY ADDRESS: /e-i7
TELEPHONE NUMBER OF CONTACT PERSON: g- f65
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TAX MAP NO. : Section A(C Yr Block 2- r Lot 9
CROSS STREET: // '.c•�-- '��'
BUILDING PERMIT NUMBER CROSS REFERENCE:
Sig ' :ture of Applicant
RECEIVED BY: •
Town C erk's Office
DATE: /O -
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