HomeMy WebLinkAboutMcGuire, Margaret OFFICE OF THE TOWN CLERK c°Fair/,�G
Town of Southold
Judith T. Terry, Town Clerk ` y
Town Hall, 53095 Main Road
P. O. Box 117900
Southold, New York 11971 O �0 •'`,
Telephone l *
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(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 9 Residential X
Fee $ 10. 00 Non-Residential
Septic Cesspool X
PERMIT ISSUED TO:
NAME: P . E. Dieffenbach
ADDRESS: P . O. Box 412
Cutchogue, NY 11935
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New system for new house being constructed
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Margaret McGuire
OWNER MAILING ADDRESS: Weatherbee Court
Pelham Manor, NY
OWNER PROPERTY ADDRESS : 365 Campfire Lane
Peconic, NY
TAX MAP NO. : Section 098 Block Q3 Lot 17
CROSS STREET: Arrowhead Lane
BUILDING PERMIT NUMBER CROSS REFERENCE: 14850Z
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Judith.T. err
Southold Town C rk
DATE : August 1 , 1986
(TOWN SEAL)
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,,• Southold, New York 1 1971
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JUDITH T.TERRY TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
August 1 , 1986
P . E. Dieffenbach
P .O. Box 412
Cutchogue, NY 11935
Enclosed herewith is the Construction, Alteration or Modification
Permit for a Septic Tank or Cesspool System for which you applied.
Please be advised that each owner of real property operating an
on-site sewage disposal system, such as a septic tank or cesspool must,
prior to such operation, possess in the name of the owner an Operation
Permit for the system. The Operation Permit is issued by the Town
Clerk's Office.
The fee for an Operation Permit is ten dollars ($10.00) for
residential use and twenty-five dollars ($25.00) for non-residential.
Please have the owner complete the enclosed Application for an Operation
Permit and return it to this office along with the proper fee.
For your general information I have enclosed an Informational
Bulletin regarding the Scavenger Waste Laws adopted by the Southold
Town Board. Should you have any questions pertaining to either permits
or the Scavenger Waste Laws, please do not hesitate to contact this
office. We will be glad to assist you in any way possible.
Very truly yours,
tOrf<41144Vir.di
Judith T. Terry
Southold Town Clerk
Enclosures (3)
JTT/Ijc
OFFICE OF THE TOWN CLERK
Town of Southold Application No. A
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road Construction
P. 0. Box 1179 Alteration
Southold, New York 11971
Telephone Residential ✓ _
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ /6 "`
DATE
APPLICANT NAME: 7)ia7)7.-4.1 v ' L IC
�x S�IZ
APPLICANT ADDRESS: Com.
SEPTICXESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
1 /)
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 7Y C' )11 e
OWNER MAILING ADDRESS: D =Jv
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 73 - 6 sir-2_,
TAX MAP NO. : Section Dye Block 03 Lot /7
CROSS STREET:
-K-Q-
BUILDING PERMIT NUMBER CROSS REFERENCE: /LX( Z
i
Signature •f'Applicant
RECEIVED BY: G d&
Town Jerk's ffice '(tv ,�\%
DATE: Sli /ift,
1 SUF FOLK LO. HEALTH DEPT. APPROV,
H. S. NO.
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EXPIRES TWO Y "1S I=its �; 5J ►f_
�- STATEMENT OF INTENT
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THE WATER SUPPLY AND SEWAGE DISPC
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N. 8 S"36'40—E. to CONFORM TO THE STANDARDS OF
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MAP 0 F PAZ OPE,QT Y
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SERVICES - FOR APPROVAL
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