HomeMy WebLinkAboutRogers (2) 1 cr' � Town Hall, 53095 Main Road
�,y� �O�►,, P.O. Box 1179
__ Q( 4 � 0► Southold, New York 11971
JUDITH T. TERRY ''� "f- //0- ► TELEPHONE
TOWN CLERK (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. 493 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
ADDITION OF ANOTHER OVERFLOW POOL TO EXISTING SYSTEM.
APPROVED AS SHOWN ON SUBMITTED SKETCH AND NOT TO EXCEED 12'0" FROM
EXISTING POOL.
Name Of Owner ROGERS, ED
Mailing Address 1 825 SALT LAKE ROAD
City St Zip MATTITUCK NY 11952
Property Address 1 825'SALT LAKE ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 144.00 block 5 lot 21 .000
Cross Street BAY AVENUE
Building Permit Number Cross Reference:
Issue Date: 5/03/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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, A1' ° " '� •' Town Hall, 53095 Main
. .,,: • Road
,1�c. �• ;i_ t �. e� t �%- P.O. Box 1179
`_�' �, i Southold, New York 11971
JUDITH T.TERRY �� 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: May 1, 1989
Transmitted herewith is_ a copy of application No.' 504 for a Cesspool/
Septic Tank Construction Permit submitted by:
Peconic Cesspool for Ed Rogers
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.
'vY`a{A_)
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments: Oi,o r r c_4116 A, cry, fic..Q 04-+ + car �v C-121-CQ
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Signature
Dated
257 9
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OFFICE OF THE TOWN CLERK OrjVF5/(0.1
JudithTT. Terry,own of Southold Town Clerk ','" ' �` "< ' Application No. 0
Town Hall, `
53095 Main Road _"" Construction
P. O. Box 1179
Southold, New York 11971 -` Alteration
Tele hone .01 �� Residential ti
p
(516) 765-1801
Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
• for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 9
Fee $
DATE I �II J
APPLICANT NAME: /1„..iti:1-C-4-724.--e:
APPLICANT ADDRESS: /1) , 9 7 2
SEPTIC CESSPOOL
DESCRPN OF�PROPOSED CONSTRUCTION OR ALTERATION ie
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Are AIe ,
OWNER MAILING ADDRESS: s 7.1„,e0
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: may- 7e S 2
TAX MAP NO. : Section "kV Block ,� Lot 2/
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE: ----
pp
Si nature of Appli nt
9
RECEIVED BY:
Lu
jown Clerk's Office
WAY 011989
Town Clerk Southold
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