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Town Hall, 53095 Main Road
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' ���` P.O. Box 1179
�� Southold, New York 11971
JUDITH T.TERRY � .0`1!-11/1'T. 0. 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. 457 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : JAMES, THEODORE, JR.
Address 1 : RR 3, 1415 INDIAN NECK LANE
City St Zip PECONIC NY 11958
Descripton of Proposed Construction or Alteration
ADDITION OF POOL (8' DEEP, 4° ACROSS WITH DOME).
APPROVED AS Y ?, SUBJECT TO THE PLACEMENT OF A NEW WELL POINT
50'0" OR MORE FROM THE NEW POOL.
Name Of Owner R'e-LAS''841 JAMES, THEODORE JR.
Mailing Address 1 RR 3, 1415 INDIAN NECK LANE
City St Zip PECONIC NY 11958
Property Address 1 1415 INDIAN NECK LANE
City St Zip PECONIC NY 11958
Tax Map No. section 86.00 block 5 lot 2.000
Cross Street SPRING LANE
Building Permit Number Cross Reference: 017498
Issue Date: 1/25/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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' " ' " w ' I Town Hall, 53095 Main Road
®�; '_,'.''NN-'�0 P.O. Box 1179
.:Cfla e %,,i�� Southold, New York 11971
JUDITH T.TERRY ..„,„ooi TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Victor Lessard, Southold Town Building Department
From: Linda Cooper, Southold Town Clerk's Office
Dated: JANUARY 24, 1988
Transmitted herewith is a copy of application Nog 468 for a Cesspool/
Septic Tank Construction Permit submitted by:
Thdore James Jr.
Please review the application and location map and advise if the project
has received Suffolk County Health Department approval and if this office
may issue the permit.
Please complete the form below and return it to me.
Thank you.
vi ,
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE x
DISAPPROVE
Comments: �} - ►J� (,c) Fes;„�- S o if...4)-2.-3.-1
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• Signature
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Dated
OFFICE OF THE TOWN CLERK ` �OC,31FOI/('`+D
Town of Southold �O J. Application No. /716' r
Judith T. Terry, Town Clerk �G
Town Hall, 53095 Main Roadcrz ''' :