HomeMy WebLinkAboutLucka, Fred �oc�FFOIK��Gy
JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK : p P.O.P.O. Box 1 179
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REGISTRAR OF VITAL STATISTICS Southold, New York 11971
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MARRIAGE OFFICER ----Ale' 1 . 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. 927 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
ADDITION OF AN OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. EXCAVATION INSPECTION REQUIRED.
Name Of Owner LUCKA, FRED
Mailing Address 1 BREAKWATER ROAD
City St Zip MATTITUCK NY 11952
Property Address 1 BREAKWATER ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 99.00 block 2 lot 17.000
Cross Street NAUGLES, DRIVE
Building Permit Number Cross Reference:
Issue Date: 11/09/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY Z -m ; Town Hall, 53095 Main Road
TOWN CLERK .. v T P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS trl W $ Southold, New York 11971
V� Fax Fax (516) 765-1823
MARRIAGE OFFICER =0i�o ���,��
QTelephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
3 0 °992 TOWN OF SOUTHOLD
October 30, 1992
To: Southold Town Code Enforcement Officer
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A954 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Fred Lucka .
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 - pc
DISAPPROVE -
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Date
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OFFICE OF THE TOWN CLERK � ,,,,'"',"""'- yS
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Town of Southold �.� �FFak le- 1-7
C� Application
Judith T. Terry, Town Clerk .%' O G ';
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Town Hall, 53095 Main Road ;a° = Construction
P. 0. Box 1179 o ,�,
Alteration
Southold, New York 11971 trs
Telephone =A, Q�i� $10.00 - Residential
(516) 765-1801 ---..V462 0�'
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$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 70/1/17./
APPLICANT NAME: /�
APPLICANT ADDRESS: /- Q 7 7?i
SEPTIC CESSPOOL
DESCRIPTION F PROPOSED CONSTRUCTION OR ALTERATION
(-
LOCATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR LLTERRAATION:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: ,.9y-., Fess'
TAX MAP NO. : Section 79 t Block 2- Lot / 7
CROSS STREET: A-
BUILDING PERMIT NUMBER CROSS REFERENCE:
i.e.c/tic
Signature of Ap cant
RECEIVED BY:
Town erk's Office
DATE: c? l
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