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OFFICE OF THE TOWN CLERK %IFDCA' ,
Town of Southold � .-- T ��
Judith T. Terry, Town Clerk , Z ( c 11-
Town
1Town Hall, 53095 Main Road
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P. 0. Box 1179 •u7 , f.r
Southold, New York 11971 02, t� AO�'•�
Telephone - l t ;
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. A310 Residential X
Fee $ 10.00 Non-Residential
Septic Cesspool X
PERMIT ISSUED TO:
NAME: Peconic Cesspool
ADDRESS: P.O. Box 972
Mattituck, New York 11952
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
Addition of new overflow cesspool to existing system.
APPROVED with the condition that new pool to be maximum of 15' from
existing pools.
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Raymond MacLean
OWNER MAILING ADDRESS: 230 Old Shipyard Lane
Southold, New York 11971
OWNER PROPERTY ADDRESS :230 Old Shipyard Lane
Southold, New York 11971
TAX MAP NO. : Section 64 Block 2 Lot 50
CROSS STREET: L'Hommedieu Lane
BUILDING PERMIT NUMBER CROSS REFERENCE: ,
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Tu• th T. Ter, e7.
Southold Town Clerk
DATE: March 17, 1988 - -
(TOWN SEAL)
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11 ie 1988
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TOWN OF
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JUDITH T. TERRY ��"������ _ TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
March 15, 1988
To: - Victor Lessard, Southold Town Building Department
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A314 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Raymond MacLean
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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 - II
COMMENTS: A)94.4 "� U. Adi 44,14 ...,E y,, (� l /a )-1,x).1,..,
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Signature
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Date
OFFICE OF THE TOWN CLERK C$FUU(
Town of Southold 0� 1 C3
Judith T. Terry, Town Clerk :; Application No.' 3&.
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Town Hall, 53095 Main Road ` s� }, Construction
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P. O. Box 1179 v ' Alteration
Southold, New York11971
Telephone of151 )et. Residential f
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE / 'f
APPLICANT NAME: Zige----r7L'-
APPLICANT ADDRESS: /�d� 972_ -�
SEPTIC CESSPOOL'��
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
iy $7// 7
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:� /
OWNER OF PROPERTY: ,47 '/M ' O"/4( h
OWNER MAILING ADDRESS: 2 c2 (. 9/0/a.71,,-~
es/`P' // 7)
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: .2, b ---,‘nO
TAX MAP NO. : Section 6:-X Block Lot
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CROSS STREET: I L A w
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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