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OFFICE OF THE TOWN CLERK c3IFU(/Q,
Town of Southold
Judith T. Terry, Town Clerk - `� x .:
Town Hall, 53095 Main Road
P. O. Box 1179 •.trl , ,
41
Southold, New York 11971 O � '�g!�,
Telephone !
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit-No. 246 Residential • X
- Non-Residential
Fee $ 10.00
Septic Cesspool X
PERMIT ISSUED TO:
NAME: Laurence Reeve
ADDRESS: 1475 Suffolk Avenue, P.O. Box 1157
- = Mattituck, New York 11952
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling with Cesspool System
APPROVED-as per Suffolk County Health Department approval.
•
- LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Alicia Reeve
OWNER MAILING ADDRESS: P.O. Box 1157 -
Mattituck, New York 11952
OWNER PROPERTY ADDRESS : 1235 Suffolk Avenue -
Mattituck, New York
TAX MAP NO. : Section 114 Block 11 Lot 25
CROSS STREET: Reeve Avenue -
BUILDING PERMIT NUMBER CROSS REFERENCE:
Judith T. T rry
Southold Town Clerk
DATE : November 2, 1987 11 1
:.(TOWN SEAL).
iti $'- -
` GI' Town Hall, 53095 Main Road
b rAe ,t• P.O. Box 1179
` ( 'no Southold, New York 11971
JUDITH T. TERRY ' '"
" ...0��� TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
November 2, 1987
Laurence Reeve -
P:D'. Box 1157 •
Mattituck, New York 11952
Re: Alicia Reeve •
1235 Suffolk Avenue - - -- -
Mattituck, New York
Enclosed herewith is the Construction, Alteration or Modification
Permit for-a- Septic Tank or Cesspool System for which you applied.
Please be advised that each owner of real property operating an
on-site sewage disposal system, such as a septic tank or cesspool must,
prior to such operation, possess in the name of the owner an Operation
Permit for the system. The Operation Permit is issued by the Town
Clerk's Office. - -
R The fee for an Operation Permit is ten dollars ($10. 00) for •
residential use and twenty-five dollars ($25.00) for non-residential.
Please have the owner complete the enclosed Application for an Operation
Permit and' return it to this office along with the proper fee. .-
For your general information I have enclosed ' an Informational
Bulletin regarding the Scavenger Waste Laws adopted by the Southold
Town Board. Should you have any questions pertaining to either permits
or the Scavenger Waste Laws, please do not hesitate to contact this
office. We will be glad to assist you in any way possible.
Very truly,iyours, •
• Judith T. Terry -
Southold Town Clerk -
Enclosures (3) -
JTT/Ijc
,,I
OFFICE OF THE TOWN CLERK ,cj�FFOC/(I�"
Town of Southold '7.00� Application No. <163
Judith T. Terry, Town Clerk � � `f• �, � �
Town Hall, 53095 Main Road ` yan ` Construction
P. O. Box 1179 ' ® ,t4; Alteration
Southold, New York 11971
Telephone $01 41 ��O e, Residential
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. c
Fee $
DATE
APPLICANT NAME: r- P VKg N - F F V
APPLICANT ADDRESS: / 175 , UF-%"U 12Yril 'ric t�
SEPTIC CESSPOOL �C
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
AfQAr
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: J , A s' Afc �`-
OWNER MAILING ADDRE --' Gr 4' t3 �� �L K1/r•
A.2,y
OWNER PROPERTY ADDRESS: - � V %� (� t/
ivy 7777-0
r�7-0
TELEPHONE NUMBER OF CONTACT PERSON: "..51p - Z crg>tr /3'7f
TAX MAP NO. : Section \ \i^` Block \ \ Lot "15
CROSS STREET: 'Wee / e
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY: � �-
B -� /
CEIVELI"own erk' Office
DATE: Nov 02 1987
. Town Clerk Southold
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