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JUDITH T. TERRY Town Hall, 53095 Main Road
P.O Box 1179
TOWN CLERK t v
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER ® ;1� Fax (516) 765-1823
1! Telephone (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. 857 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
REPLACE EXISTING CESSPOOL WITH NEW TYPE.
APPROVED WITH STIPULATIONS. REMOVE EXISTING CESSPOOL. EXCAVATE 5'0"
ALL AROUND NEW POOL, FILL WITH SAND. EXCAVATION INSPECTION REQUIRED.
CALL FOR AN APPOINTMENT.
Name Of Owner JESTER, CLARENCE
Mailing Address 1 3875 OAKLAWN AVENUE EXT.
City St Zip SOUTHOLD NY 11971
Property Address 1 ROUTE 25
City St Zip GREENPORT NY 11944
Tax Map No. section 45.00 block 4 lot 2.000
Cross Street SILVERMERE ROAD
Building Permit Number Cross Reference:
Issue Date: 6/25/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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s JUDITH T. TERRY . Town Hall, 53095 Main Road
TOWN CLERK ® t� P.O. Box 1179
REGISTRAR OF VITAL STATISTICS 0 Southold, New York 11971
MARRIAGE OFFICER �® O .�' Fax (516) 765-1823
r j�® ®I�t� Fax
(516) 765-1801
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OFFICE OF THE TOWN CLERK _
yI TOWN OF SOUTHOLD
--%T _int_'b, ____ 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. 4 878 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Clarence Jester .
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 - Pc
DISAPPROVE -
COMMENTS: e�,e�pdh.Q . - tC�, .c , ,t-e,
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,;,,-, , ,,,,, :„ Signature
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Date
JUDITH T. TERRY
'E., v , 4; Town Hall, 53095 Main Road
TOWN CLERK ` c e r`•; P.O. BOX 1 179
'
'' Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ;',4, r Fax (516)
3
MARRIAGE OFFICER Telephone (5 1 66 7651 801
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. 4 878 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Clarence Jester
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 �,,,'",,," /�
Town of Southold �••'O�j�FFO�K`'OG Application No. (g7Judith T. Terry, Town Clerk ��
Town Hall, 53095 Main Road Z • .41 Construction
P. O. Box 1119 ; =v ; Alteration rs
Southold, New York 11971 to = ; ��`
Telephone - DQ .i• $10.00 - Residential
(516) 765-1801 =W01
$25.00 - Non-Residential
•
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
•
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE , /5/1,--
APPLICANT
5 b—APPLICANT NAME: i,
APPLICANT ADDRESS: ,/ 9-` 2,--
SEPTIC
sSEPTIC 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: /iV ,g _
OWNER MAILING ADDRESS: �3'75- 0.44`;f h eilAi /9-690- e- T
.S atheij,, /197/
OWNER PROPERTY ADDRESS: -res T
TELEPHONE NUMBER OF CONTACT PERSON: sa �
TAX MAP NO. : Section cig" Block 6( Lot o`2�
CROSS STREET: S '%' h./ x-r 4--aa
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Ap J' cant
RECEIVED BY:
Jerk's Off"ce. •
DATE: - JUS . F 190
•
• Town Clerk Southold
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