HomeMy WebLinkAboutPope OFFICE OF THE TOWN CLERK cOFOLA- ,
Town of SoutholdtA
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road • k`
P. 0. Box 1179 sti
Southold, New York 11971
Telephone alt'* ,ri,•
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 159 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool x
PERMIT ISSUED TO:
NAME: Henry P. Pope
ADDRESS: 10 Country Club Drive
Huntington, New York 11743
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling with Sanitary 'System
.LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Henry P. Pope (Contract Vendee)
OWNER MAILING ADDRESS: 10 Country Club Drive
Huntington, New York 11743
OWNER PROPERTY ADDRESS : Fairway Drive
Cutchoque, New York
TAX MAP NO. : Section 109 Block 5 ' Lot 14.10
CROSS STREET: , Wood Way
BUILDING PERMIT NUMBER CROSS REFERENCE:
iOre.446441°'.
Judith T. Terry
Southold Town Clerk
i
DATE: April 30, 1987•
(TOWN' SEAL)
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OFFICE OF THE TOWN CLERK
Town of Southold /�
Judith T. Terry, Town Clerk
Application.-No.
Town Hail, 53095 Main Road Construction
P. 0. Box 1179
Southold, New York 11971 Alteration
Telephone Residential
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK. or CESSPOOL
51
Permit No.
Fee •$ /O
DATE I leo.1E+7
APPLICANT NAME: 1\El41
2-11. F. 1C7 Q�
APPLICANT ADDRESS: 1 0 Co U WWI C L U [3 Dr2—
u >t I�ems. o J�`1 Iii 3
SEPTIC ' CESSPOOLK
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
t4Cw S e q: '( —. P
LOCATION MAP-: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: •Po PE Lc c 14-10.449 Lf -jJ'Da—E
OWNER MAILING ADDRESS: , o Cod' Art cLL_ Q!'1,_,
OWNER PROPERTY ADDRESS: _ieLvtuar
TELEPHONE NUMBER OF CONTACT PERSON: C4) ted.--1
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TAX MAP NO. : Section (D 1 Block_ Lot (e.4,4 ( 0
CROSS STREET: Woo b
BUILDING PERMIT NUMBER CROSS REFERENCE:
....110VeZ/Z
Signature of A ,4licant
RECEIVED BY: Grt. ILLT�-_
Town Cerk's fice
DATE: 0 Al. � 9 �l�
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