HomeMy WebLinkAboutNorkelun (2) ,
JUDITH T. TERRY ��_ 53095 Main Road
��` � Town Hall,
TOWN CLERK � 2 P.O Box 1179
REGISTRAR OF VITAL STATISTICS t® ! Southold, New York 11971
MARRIAGE OFFICER '��-'',�. Fax (516) 765-1823
� Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 676 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
ADDITION OF ONE OVERFLOW POOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. HOLD TO 12'0" SEPARATION AND CALL FOR AN EXCA-
VATION INSPECTION FOR PROPER HOOK-UP.
Name Of Owner NORKELUN, MICHAEL
Mailing Address 1 P. O. BOX 592
City St Zip SOUTHOLD NY 11971
Property Address 1 MAIN BAYVIEW ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 78.00 block 4 lot 37.000
Cross Street SMITH ROAD
Building Permit Number Cross Reference:
Issue Date: 1/14/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JAN 1 01991 a, `= ,
t.r✓` , � ,wt_ ; �? Town Hall, 53095 Main Road
�n ` ii /� \- '� P.O. Box 1 179
BLDG. DEPT.
TOWN OF SOUTHOLD -z U "� l�
_ ,( <_�3 r� Southold, New York 11971
JUDITH T. TERRY ��'"�!"44, TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
January 10, 1991
To: Southold Town Code Enforcement 'Officer
- From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A694 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Michael Norkelun
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 - pr
DISAPPROVE - n ��� � R �
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��Q��V Signature
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Date
OFFICE OF THE TOWN CLERK ,.,,""""'
Town of Southold �.''��C001./(0' _ 69
Town Clerk �' Vl/ Application No.
Judith T. Terry, • " y' -
Town Hall, 53095 Main Road � ` :G Construction
P. O. Box 1179 ; c •y ,z
Alteration
Southold, New York 11971 `cn •;. �•
Telephone �yDi� ���•• $10.00 -Residential v
(516) 765-1801 = OlPI It.
$25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$ /
DATE / / /i /9/
APPLICANT NAME:
APPLICANT ADDRESS: / 2 97?�
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
IG.
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATI N:
OWNER OF PROPERTY: d
OWNER MAILING ADDRESS: Ne, /six-
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OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: c91®7O
TAX MAP NO. : Section � Block Lot 37
CROSS STREET: j�i22i[
BUILDING PERMIT NUMBER CROSS REFERENCE:,
Signature of Applicant
R CEW€O BY:
own Clerk's Office
DATE: 6 /�� ;
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