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HomeMy WebLinkAboutLowery, Gloria '/I � o�^O, Town Hall, 53095 Main Road crs ya ��� P.O. Box 1179 .`a" Southold, New York 11971 JUDITH T.TERRY '�� ,,,, ' 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. 508 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 REPLACE EXISTING POOL WITH NEW TYPE PRECAST. APPROVED AS INDICATED ON SUBMITTED SKETCH. *** NOTE: EXCAVATION INSPECTION REQUIRED. CONTACT THE SOUTHOLD BUILDING DEPARTMENT (765-1802) TO ARRANGE INSPECTION. Name Of Owner LOWERY, GLORIA Mailing Address 1 234 GIANT AVENUE City St Zip ISLIP NY 11751 Property Address 1 650 OAK AVENUE City St Zip SOUTHOLD NY 11971 Tax Map No. section 77.00 block 1 lot 2.000 Cross Street CEDAR AVENUE Building Permit Number Cross Reference: Issue Date: 6/27/89 Judith T. Terry Southold Town Clerk (TOWN SEAL) , , I j g n e .N.,, ; *-.. f-Nr.T(9....g .8--,-----1 1, :, • o • ) ) 1989 O� �,�� q To 1Y a ,53095 Maio Road _ ( l s z#� > , Medi►.York 11971 ���..�� ���l so JUDITH T. TERRY -,-,..., TELEPHONE TOWN CLERK (516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD June 20, 1989 To: Victor Lessard, Southold Town Building Department From: Linda J. Cooper, Southold Town Clerk's Office Transmitted herewith is a copy of application No. A 521 for an ALTERATION PERMIT for a cesspool or septic system submitted by Peconic Cesspool for Gloria Lowery • 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 - tie DISAPPROVE - COMMENTS: 0,0 .10v..CQZ Ca4L , cltn Ott a.9, Iutc_z AO \( D2 - :),.3r., ......i._ OCC°1 Signature C 0\`0 Date tees . OFFICE OF THE TOWN CLERK Oc0FQ Town of Southold 0\. Judith T. Terry, Town Clerk ' Application No. .5-02-I Town Hall, 53095 Main Road ` a Construction P. O. Box 1179 Southold, New York 11971 Alteration Telephone el t *6 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 (6/Jmoo APPLICANT NAME -e-er7j APPLICANT ADDRESS: A0 , / y 97 -.- SEPTIC CESSPOOL ,r---- DESCRIP ION OF PROPOSED CONSTRUCTION OR ALTERATION A..,/"} "......T57-7----Ae- a, e LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: C 6—a/C/'4 IL U 1-r/GT-X,f,. OWNER MAILING ADDRESS: 4/ 6/r7 v7 `y C/ - A/. ) //2 S/ OWNER PROPERTY ADDRESS: 6, 5>j 0s1-* zJ&- " . i7'ho/d 765-- 7-6Sy TELEPHONE NUMBER OF CONTACT PERSON: -25f; Yap 5r' TAX MAP NO. : Section 77 Block / Lot 2 CROSS STREET: BUILDING PERMIT NUMBER CROSS REFERENCE: Signature of Ap?icant RECEIVED BY: RectivED �jwn Clerk's Office DATE: Air • fit- • 01 C . obi peg), ?0,1 w s �-- N Oote/4/ 77 - 1 -- Z