HomeMy WebLinkAboutNoble (2) JUDITH T. TERRY .4. Town Hall, 53095 Main Road
TOWN CLERK ®ers T P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �`' Southold, New York 11971
� Fax (516) 765-1823
MARRIAGE OFFICER _ Nr. v
��®1 �1�®;•' Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 944 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
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
ADDITON OF AN OVERFLOW TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. EXCAVATION INSPECTION REQUIRED.
Name Of Owner NOBLE, DOUGLAS
Mailing Address 1 35 MADISON STREET
City St Zip GREENPORT NY 11944
Property Address 1 35 MADISON STREET
City St Zip GREENPORT NY 11944
Tax Map No. section 40.00 block 5 lot 23.000
Cross Street WILMARTH ROAD
Building Permit Number Cross Reference:
Issue Date: 12/22/92 Judith T. Terry
Southold Town Clerk
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JUDITH T. TERRY . , Town Hall, 53095 Main Road
TOWN CLERK gl �� P O. Box 1179
REGISTRAR OF VITAL STATISTICS r �,� Southold, New York 11971
• MARRIAGE OFFICER -$1-_,;711,20
, 40 Fax (516) 765-1823
=_ �®:�! Fax
(516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD W + t
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TO: Southold Town Building Department , q
FROM: Linda Cooper, Southold Town Clerk's Office' ,, DEC 1992
DATED: NOVEMBER 30, 1992 - -_=
Transmitted herewith is a copy of application No. A971 for an •
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Douglas Noble .
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.
(4-1.---7-•-cZ ce__
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - X.
DISAPPROVE -
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Signature DEC 16 1992
Datei.1 ,\Q\�` T M! Clete D SLID
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OFFICE OF THE TOWN CLERK ,,,'"',,""'
Town of Southold .1',, �FfU[K0 (‘.1
c'J Q ' Application No.
Judith T. Terry, Town Clerk '�� G
Town Hall, 53095 Main Road Z _ yL Construction
P. O. Box 1179
Southold, New York 11971 : tt� Alteration
Telephoneue
,� $10.00 - Residential -1/
(516) 765-1801 Ol l' , �' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$ -
DATE
APPLICANT NAME:
APPLICANT ADDRESS: A p i y 97L.
-241-44,4
SEPTIC CESSPOOL V
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: /,L
OWNER MAILING ADDRESS: �j 5 St' ,fig
6,-/..,e-Lii-a4rtir _77 //1//ct
OWNER PROPERTY ADDRESS: -
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section Block 5" Lot 01-3
CROSS STREET: ®✓
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Ap 'licant
RECEIVED BY:
o/wn Clerk's Office
DATE: /`73d/�j' ---
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