HomeMy WebLinkAboutPaterson Alfglir
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twzTown Hall, 53095 Main Road
P.O. Box 1179
.0 .EL �j� Southold, New York 11971
JUDITH T.TERRY FAX(516)765-1823
TOWN CLERK TELEPHONE(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. 537 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PATERSON, VIRGINIA FASZCZEWSKI
Address 1 : BOX 378
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
NEW CESSPOOL TO EXISTING SYSTEM.
APPROVED AS SUBMITTED. NOTE: EXCAVATION INSPECTION REQUIRED.
Name Of Owner PATERSON, VIRGINIA FASZCZEWSKI
Mailing Address 1 BOX 378
City St Zip SOUTHOLD NY 11971
Property Address 1 50025 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 70.00 block 5 lot 1 .000
Cross Street AKERLY POND LANE
Building Permit Number Cross Reference:
Issue Date: 8/25/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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",..p.' ue' �\ Town Hall, 53095 Main Road
". .`y°f,';'� t. :�:-'-� .0��I P.O. Box 1179
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�_.( � � �i - Southold, New York 11971
JUDITH T. TERRY �'�����Si" TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
August 25, 1989 -
To: Victor Lessard, Southold Town Building Department
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A556 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Virginia Faszczewski Paterson .
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:
' Signature
Date
o9 •.���
OFFICE OF THE TOWN CLERK �jVFFpC/�'
Town of Southold %& .. Application No. S/
Judith T. Terry, Town Clerk y Y2
Town Hall, 53095 Main Road ` cal OA Construction
P. O. Box 1179 �. . ,-,
Southold, New York 11971 "* � Alteration
Residential
Telephone
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(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit N4737
Fee $ b
DATE
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APPLICANT NAME: k Pft
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APPLICANT ADDRESS: (Y1pi'w (?aril
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SEPTIC CESSPOO
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: - SM./4E--
OWNER MAILING ADDRESS: 69; ' /r),")./ /�ry,�� ��ooJf
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OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: '766-- 860s--
TAX
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TAX MAP NO. : Section `745- Block L Lot
CROSS STREET: Aft...44x, p��,
BUILDING PERMIT NUMBER CROSS REFERENCE:
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C Signatu- of�c Applicant
RECEIVED BY: **-21 , '21,
Town Clerk's Office
DATE:' t 57
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