HomeMy WebLinkAboutIrwin JUDITH T. TERRY : Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS t Southold, New York 11971
��� Fax (516) 765-1823
MARRIAGE OFFICER ere,. Ar 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. 1127 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
REPLACE OLD CESSPOOL IN EXISTING SYSTEM WITH NEW TYPE.
APPROVED AS SUBMITTED. REPLACEMENT POOL SHOULD NOT BE CLOSER THAN
EXISTING POOL TO ADJACENT WELLS, BUILDING AND PROPERTY LINES.
EXCAVATION INPECTION REQUIRED.
Name Of Owner IRWIN, TED AND DON
Mailing Address 1 2771 WALLACE AVENUE
City St Zip NORTH BELLMORE NY 11710
Property Address 1 4570 STILLWATER AVENUE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 137.00 block 2 lot 10.000
Cross Street PEQUASH AVENUE
Building Permit Number Cross Reference:
Issue Date: 5111194 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY P® Town Hall, 53095 Main Road
TOWN CLERK ® T .• P.O. Box 1179
REGISTRAR OF VITAL STATISTICS tr% �` Southold, New York 11971
ute 4% Fax (516) 765-1823
MARRIAGE OFFICER r
i.. ��` Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD 0 N l�fnl R O R _-
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TO: Southold Town Building Department ! MAY 2 q
ll'
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: May 2, 1994 BLDG DEPT
_ TOWN OF SOUTHOLD
Transmitted herewith is a copy of application No. A1166 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Ted and Don Irwin '
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 - z...„,./
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DISAPPROVE - II MUMS)
COMMENTS: Vii.. / " ® - , _, /2,7
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MAY
1 1 1994 Signature
Torn Clea Southokf 7 /5
Date
OFFICE OF THE TOWN CLERK ,,,,,,,,,,,,
Town of Southold �FFDlK / '4
%.0 BOG= Application No./
Judith T. Terry, Town Clerk 4� �,j _ y
Town Hall, 53095 Main Road ;��: Construction
P. O. Box 1179 z �
c=37. ^' ; Alteration
Southold, New York 11971 to �
Telephone /�' �Q���' $10.00 - Residential
(516) 765-1801 _ Ol 4 1, of $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
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APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 5://17/.,12
APPLICANT NAME: / 00, r-
-
APPLICANT ADDRESS: j-'- //V 97Z-
SEPTIC
7ZSEPTIC 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: / �jffl _7-4/1///i/
' OWNER MAILING ADDRESS:277/ /2/A_.../.1-4.-.,
OWNER' PROPERTY ADDRESS:____#&Sy_e 572�i.,� _, Qit�c�c
TELEPHONE NUMBER OF CONTACT PERSON: 9-5'F--
TAX MAP NO. : Section /37 Block Lot to
CROSS STREET:
BUILDING PERMIT NUMBER CASS REFERENCE:
/7 .f.‘e,
Signature of App 1.nt
RECFIVED BY: Q.
Town Clak's Offic
DATE: r12, /-9
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