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JUDITH T. TERRY
,' ® Town Hall, 53095 Main Road
TOWN CLERKP.O. Box 1179
REGISTRAR OF VITAL STATISTICS .�` Southold, New York 11971
MARRIAGE OFFICER ® O r,sib' Fax (516) 765-1823
e4f ��®;I! Tel (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. 855 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 TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. HOLD 10'0" FROM EXISTING POOLS. EXCAVATION
INSPECTION REQUIRED. CALL 765-1802 FOR AN APPOINTMENT.
Name Of Owner HAMILTON, WILLIAM
Mailing Address 1 PEQUASH AVENUE
City St Zip CUTCHOGUE NY 11935
Property Address 1 PEQUASH AVENUE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 103.00 block 11 lot 2.000
Cross Street FIRST STREET
Building Permit Number Cross Reference:
Issue Date: 6/25/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY ' Town Hall, 53095 Main Road
TOWN CLERK � p P.O.4 Box 1179
REGISTRAR OF VITAL STATISTICS (P �,0 Southold, New York 11971
MARRIAGE OFFICER �® O r ���' • Fax (516) 765-1823
„.. ��® �! Telephone (516) 765-1801
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' OFFICE OF THE TOWN CLERK
lkjid JUN Q 1992 ' I l TOWN OF SOUTHOLD
_______Ik , i June 15, 1992
To: Southold Town Code Enforcement 'Officer
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A879 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for William Hamilton .
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 - ›(
DISAPPROVE -
COMMENTS: Q„ 44,1.o ,�• � n �
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��� Signature
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Date
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JUDITH T. TERRYTown Hall, 53095 Main Road
TOWN CLERK ' i P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS • %{,, f Southold, New York 11971
` 'r • •
Fax (516) 765-1823
MARRIAGE OFFICER
t
j}•y Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
June 15, 1992
To: Southold Town Code Enforcement 'Officer
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A879 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for William Hamilton
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 -
DISAPPROVE -
COMMENTS:
Signature
-Date
OFFICE OF THE TOWN CLERK ��'"����" A ' C _
�I FF0� y
Town of Southold - - O. � k "
_z, �� Application No.
Judith T. Terry, Town Clerk ��� Gy ��
Town Hall, 53095 Main Road % ,r.' 4•; Construction
P. O. Box 1179 ; v r .
Southold, New York 11971 1•`
Alteration t/
Telephone ��O.f,�0 _ $°;01
&1-�' $10.00 - Residential G�
• (516) 765-1801 ----_40/
44 0 $25.00 Non Residential
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TOWN OF SOUTHOLD
•
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. .
Fee $ +
DATE //,'.0Z.-/',
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APPLICANT NAME: a261/2� /� r-
APPLICANT- ADDRESS: ,t, j��194 6% 7'
elit.- -4,---ie.c...-e
SEPTIC CESSPOOL
DESCRIPTION • F PROPOSED CONSTRUr ION OR ALTERATION
,
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION.,.9,,R ALTERATION:
OWNER OF PROPERTY: 4M . i
OWNER MAILING ADDRESS: f ,I...--2,44/..., ,0j
"...ez
6(4 #(. /4-71 ,
OWNER PROPERTY ADDRESS: _ ...�--
TELEPHONE NUMBER OF CONTACT PERSON: ®`9-4, 5'
TAX MAP NO. : Section /03 Block 1/ Lot
CROSS STREET: / 1
BUILDING PERMIT NUMBER CROSS REFERENCE:
e -.4''' --'1--‘04; , /?_/"...-- ,
Signature of A.,?' cant
RECEIVED BY: c) ° e,(0--& ,
MASI Clerk's Office .
DATE: --
JUN 11Qq,
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Town Clerk Wfio'fd -
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