HomeMy WebLinkAboutMain (2) IF
Town Hall, 53095 Main Road
V'
c
$ P.O. Box 1179
' 42......:,,c- ����' Southold, New York 11971
JUDITH T.TERRY `' ��� TELEPHONE
TOWN CLERK II" (516) 7654801
REGISTRAR OE VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 433 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 AN OVERFLOW POOL TO EXISTING SYSTEM.
APPROVED AS SHOWN ON SUBMITTED SKETCH. NOT TO EXCEED 12'0' BETWEEN
POOLS.
Name Of Owner MAIN, SAM AND EVA
Mailing Address 1 BOX 106
City St Zip MATTITUCK NY 11952
Property Address 1 ROW OFF PECONIC BAY BLVD
City St Zip MATTITUCK NY 11952
Tax Map No. section 126.00 block 6 lot 11 .000
Cross Street MARLENE LANE
Building Permit Number Cross Reference:
Issue Date: 12/05/88 Judith T. Terry
Southold Town Clerk
(TOWN SFAI 1
'I • WOO'�•�i I
BOG =
C0 Fair
.� O
$ Town Hall, 53095 Main Road
P.O. Box 1179
/C17,i Southold New York 11971
JUDITH T. TERRY ������si111'� TELEPHONE
TOWN CLERK
(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD r't � � -� s r � •
December 1, 1988 q ;
To: Victor Lessard, Southold Town Building Department B-�G. ®-
EPY
TOWNp!SOUTHOLD
From: Linda J. Cooper, Southold Town Clerk's Office
' Transmitted herewith is a copy of application No. 440 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Sam and Eva Main
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: cam, ,I ���a �c9. eY-v) 'c► C.JiseQ.. S
c.CgIND
Signature
DEC 0 5 1 .?i I z'
Date
To. i Met So. .®8�1
OFFICE OF THE TOWN CLERK cjV�FU(/�',O
Town of Southold Application No.4`7'C/
Judith T. Terry, Town Clerk �%
Town Hall, 53095 Main Road Construction •
P. O. Box 1179
Southold, New York 11971 �•!, Alteration
o� . ;t/
Telephone �� �� Residential
p I
(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 /rf
APPLICANT NAME: /9.-C,0")7. (
APPLICANT ADDRESS: /61, 40/ '72—
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION -
r
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: ,�
OWNER OF PROPERTY: �C.�,� �S�/iA /7,64 �G1/
OWNER MAILING ADDRESS: /07r/ .
9/47
OWNER PROPERTY ADDRESS: / / � 07
TELEPHONE NUMBER OF CONTACT PERSON: � � 9,gY
TAX MAP NO. : Section /ZC Block Lot /7
CROSS STREET: /l ���
BUILDING PERMIT NUMBER CROSS REFERENCE:
y‘,0
‘.2%),
Signature of App cant
RECEIVED BY:
REce s.)i. Clerk's Office
DATE:
DEC 01 ie
Otte Southold
d /rte t l
s