HomeMy WebLinkAboutHooper JUDITH T. TERRY
Town Hall, 53095 Main Road
TOWN CLERK r a P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER �� ' Fax (516) 765-1823
e° " Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1025 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
ADDITION OF AN OVERFLOW CESSPOOL TO AN EXISITNG SYSTEM.
APPROVED. MAINTAIN REQUIRED SET BACK FROM WELLS AND PROPERTY LINES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner HOOPER, SUZANNE
Mailing Address 1 SKUNK LANE
City St Zip CUTCHOGUE NY 11935
Property Address 1 SKUNK LANE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 97.00 block 3 lot 14.000
Cross Street EUGENE ROAD
Building Permit Number Cross Reference:
Issue Date: 7/16/93 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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$® 1 Town Hall, 53095 Main Road
JUDITH T. TERRY y C`;
TOWN CLERK C3 e P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER `�® .�>� Fax (516) 765 1823
N- Ill
��®Itr Telephone (516) 765 1801
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OFFICE OF THE TOWN CLERK /'117-'7'-'.7
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TOWN OF SOUTHOLDu r-
UUL 1131993
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office 9Llr=r a� �.-'.
DATED: July 13, 1993
• Transmitted herewith is a copy of application No. A1054 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Suzanne Hooper
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: • L! . ,,_ . w�
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ivn.t ,
REWIRE'
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Signatur• r/ RECOVID
Date JUL 15
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OFFICE OF THE TOWN CLERK ,,'",,,,,
Town of Southold .0"C51fUli(e'0Application No./0
Judith T. Terry, Town Clerk ��' �, • Alt
Town
Town Hall, 53095 Main Road ;�� _ Construction %
P. O. Box 1179 v m
Southold, New York 11971 tt� • Alteration f
Telephone �yO,f' �� �•�, $10.00 - Residential
(516) 765-1801 -'x'01 '.,
� $25.00 - Non-Residential
IIS
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 1/13/f,
APPLICANT NAME:•
APPLICANT ADDRESS: d e
mss ;- //��
SEPTIC CESSPOOL
DESCRIPTION OF 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: i
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 01-7,-a
TAX MAP NO. : Section '77 Block Lot /44
CROSS STREET: ,
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Apple.nt
RECEIVED BY: R,
Town Cl rk's Office
DATE: 2 -
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