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® ray Town Hall, 53095 Main Road
t '&0 P.O. Box 1179
Southold, New York 11971
JUDITH T.TERRY =_ FAX(516)765-1823
TOWN CLERK ��zi 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. 584 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 NEW OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. EXCAVATION INSPECTION REQUIRED. PLEASE CALL
THE SOUTHOLD TOWN BUILDING DEPARTMENT (765-1802) FOR AN APPOINTMENT AT
LEAST 24 HOURS IN ADVANCE.
Name Of Owner SNIDER, GEORGE
Mailing Address 1 1330 BAY AVENUE
City St Zip MATTITUCK NY 11952
Property Address 1 1330 BAY AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 143.00 block 3 lot 21 .000
Cross Street RILEY AVENUE
Building Permit Number Cross Reference:
Issue Date: 2/26/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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1 �i�� Southold, New York 11971
JUDITH T. TERRY -.'-""i
TOWN CLERK ,_ _ TELEPHONE
16 7.5-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK ; E 0 W r
TOWN OF SOUTHOLD I
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February 15, 1990 I "y 1 5 '''i`
To: Southold Town Code Enforcement "Officer
- TOWN F SOUTHOLD '
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. MOO for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for George Snider
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. `
• 4i. i_aw
Linda J. Cooper
* * * * * •* * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE X
DISAPPROVE -
COMMENTS: •
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OFFICE OF THE TOWN CLERK Oc§WFVUrD
Town of Southold om. L'1+ Application No. (0O
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Roadcr) .K Construction
P. 0. Box 1179
Southold, New York 11971 �4 #.0' Alteration
Telephone � [ I „ .�� Residential 0—
(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 $ /p
DATE c>1. it T�
9
APPLICANT NAME:
APPLICANT ADDRESS: A ', 'gyp-?e,
SEPTIC CESSPOOLL—
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRU ON ORA TERATION:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS: /33 /7 .
0199
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 2// 7i w
TAX MAP NO. : Section / •-_,3 Block 3 Lot 2/
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
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Signature of Ap. ant
RECEIVED BY:
Town Clerk's Office
DATE:
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