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Town Hall, 53095 Main Road
Off- P.O. Box 1179
'_oOl 41 ����i� Southold, New York 11971
JUDITH T.TERRY =�,�,,,,i����� FAX(516)765-1823
TOWN CLERK TELEPHONE(516) 765-1801
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. 621 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : HERBERT LINDTVEIT
Address 1 : WINDY POINT LANE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITION OF A NEW OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. EXCAVATION INSPECTION REQUIRED. CALL THE
BUILDING DEPARTMENT (765-1802) FOR AN APPOINTMENT AT LEAST 24 HOURS IN
ADVANCE. INSPECTION REQUIRED PRIOR TO BURYING POOL.
Name Of Owner LINDTVEIT, HERBERT
Mailing Address 1 634 ADAMS JPLACE
City St Zip WEST HEMPSTEAD NY 11552
Property Address 1 WINDY POINT LANE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 87.00 block 4 lot 7.000
Cross Street BAYV I EW ROAD
Building Permit Number Cross Reference:
Issue Date: 7/02/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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BLDG. DEPT..TOWN OF SOUTHOLD ' 4' ' „,` �N
•t �� Town Hall, 53095 Main Road
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P.O. Box 1179
...fit i+ ,r Southold, New York 11971
JUDITH T. TERRY '-�..mw Si
TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
June 25, 1990
To: Southold Town Code Enforcement Officer
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A636 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Herbert Lindtveit .
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 - X
DISAPPROVE - AA
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Signature
Coi-Z 7 / 9ô
Date
OFFICE OF THE TOWN CLERK „ ,,,,,,,,,,,,,,,,
Town of Southold "
0 = Application No. (g 3C”.
Town Clerk
Judith T. Terry, ,--� ;`
Town Hall, 53095 Main Road ; E•.. .G - Construction
P. O. Box 1179 •xn ` Alteration JC
Southold, New York 11971 t
Telephone ,y �Q�,/ $10.00 - Residential
(516) 765-1801 �.14', $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ l0 ,1-5D
DATE (Q - - (MO
APPLICANT NAME: !°� eX��y-�- L\ ,c4A-J Q j
APPLICANT ADDRESS: j �1" . G Yl ( P`('‘ UG )
5.0-4-41\ )
SEPTIC CESSPOOL 54--
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
\41-ACI 0Qe4 lo-u3 C es5\eoc)1 e x\ \-iszt essv I
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Pe-kr -QA }-
OWNER MAILING ADDRESS: ,
\oe s- 4v,,\ -e o o \ al. I .�
OWNER PROPERTY ADDRESS: \ �, \ne
„NAki, t,uA
TELEPHONE NUMBER OF CONTACT PERSON: ---� - sou 4
TAX MAP NO. : Section g1- Block (4 Lot
CROSS STREET: 9.- .A.)--)\ \'e3 e1•k
BUILDING PERMIT NUMBER CROSS REFERENCE:
Si•nature of Applicant
RECEIVED BY:
Rlerk's Office
DATE: JUN 2 6 19tu
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