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' Town Hall, 53095 Main Road
>y v� %' P.O. Box 1179
`� ��� �'1��t Southold, New York 11971
JUDITH T.TERRY =_ / �0 TELEPHONE
� „ii/ti'°' (516) 765-1801
TOWN CLERK
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. 425 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
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 SEPTIC TANK WITH NEW TYPE.
APPROVED AS SUBMITTED.
Name Of Owner REILLY, JEAN
Mailing Address 1 P. O. BOX 2
City St Zip SOUTHOLD NY 11971
Property Address 1 OAKLAWN AVENUE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 70.00 block 3 lot 3.000
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 11/17/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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BLDG. DEPT. ":.?-t :. Town Hall, 53095 Main Road
i_ TOWN OF SOUTHOLD `�®$ ' ®�'0��� P.O. Box 1179
.---- ®1 .1%,•,..°� • Southold, New York 11971
JUDITH T.TERRY '—���iid,,1TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
November 16, 1988
To: Victor Lessard, Southold Town Building Department
From: Linda Cooper, Southold Town Clerk's Office
Dated:
Transmitted herewith is a copy of application No. 432 for a Cesspool/
Septic Tank Construction Permit submitted by: •
Peconic Cesspool for Jean Reilly .
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.
Linda J. Cooper
•* * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE )C
DISAPPROVE
Comments: Gte4 .Ll',C CM2{Q, 0—e► *C--U e`3-1 t�
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Dated
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OFFICE OF THE TOWN CLERK c�vFFOLj
Town of Southold C� ////
Application No; 4 J
02
Judith T. Terry, Town Clerk G
Town Hall, 53095 Main Roadc Construction
P. O. Box 1179
Q ��� AlterationL/
Southold, New York 11971 - \- ;
/ Residential
Telephone *I `tt ��%
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ /b `+
DATE, / OV
APPLICANT NAME: „e2... .0-7-7„,e...;
APPLICANT ADDRESS: 'le ,/
774'iL2tt&CA 21'
SEPTIC6,-,'CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: T ,,i 4 -i.
OWNER MAILING ADDRESS: 'lei, / 2 ®:9X* & 4'ry
'3 o7X.o /V° k // 9 7/
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section Block Lot 3
CROSS STREET:
•
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applica4
RECO TE B
Town C/rk's O ice
DATENOV 16 1988
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