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c� ,� Town Hall, 53095 Main Road
�® o .,' P.O. Box 1179
••�� Southold, New York 11971
JUDITH T.TERRY "1"�-A.zivb„ 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. 536 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 ONE NEW OVERFLOW POOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. NOTE: EXCAVATION INSPECTION REQUIRED.
Name Of Owner HAMMA, ELIZABETH
Mailing Address 1 P. O. 1008
City St Zip MATTITUCK NY 11952
Property Address 1 CEDAR DRIVE
City St Zip MATTITUCK NY 11952
Tax Map No. section 106.00 block 11 lot 8.000
Cross Street BAYVIEW ROAD
Building Permit Number Cross Reference:
Issue Date: 8/24/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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s i :rccx i 1 Town Hall, 53095 Main Road
BLDG DEPT O.
M TOWN OF SOUTHOLD �•� '` ;,-"�,•.,y�e P.O. Box 1179
:4 1 '•,l Southold, New York 11971
JUDITH T. TERRY "ill ill° TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
August 22, 1989
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Avpi To: Victor Lessard, Southold Town Building Department
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A551 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Elizabeth Hamma •
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
* * * * * * * * * 4 * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - DC
DISAPPROVE -
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OFFICE-OF THE TOWN CLERK c0FOUr��"
Town of Southold � CD
Judith T. Terry, Town Clerk ,;_ Application No.��s
Town Hall, 53095 Main Road ` „ '�' Construction
P. O. Box 1179 u-�
Southold, New York 11971 0 Alteration
Telephone of �� Residential L�
(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 2 2/d
APPLICANT NAME: ,i1); 17 - `lam
APPLICANT ADDRESS: /4,2•& : iX d 7L
SEPTIC + CESSPOOL
DESCRIPTIO 0.. PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS: 'j /06,?' --re&- ]
OWNER PROPERTY ADDRESS: r
TELEPHONE NUMBER OF CONTACT PERSON: --D--,c"-^ 77 (rte J
TAX MAP NO. : Section /0 (,0 Block // Lot
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applic
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RECEIVED BY: --11// C• / / •
own Clerk's Offici
DATE: A ,a. A
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