HomeMy WebLinkAboutThibaut (2) -4701%
c� �v Town Hall, 53095 Main Road
�``�l�i` P.O. Box 1179
r� 1�!'!! Southold, New York 11971
JUDITH T.TERRY , ` FAX(516)765-1823
TELEPHONE(516)765-1801
TOWN CLERK
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. 570 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 NEW OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. NOTE: HOLD TO A MAXIMUN OF 10'0" BETWEEN
POOLS. EXCAVATION INSPECTION REQUIRED.
Name Of Owner THIBAUT, ELIZABETH
Mailing Address 1 RUCH LANE
City St Zip SOUTHOLD NY 11971
Property Address 1 RUCH LANE
City St Zip SOUTHOLD NY 11971
Tax Map No. section '52.00 block 2 lot 23.000
Cross Street NORTH ROAD
Building Permit Number Cross Reference:
Issue Date: 12/06/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
0.001 OF,,,,,,, 4 /0
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cr3 � � Town Hall, 53095 Main Road
/ P.O. Box 1179
`10/ O 'P s. Southold, New York 11971
JUDITH T. TERRY ����'`
TELEPHONE
TOWN CLERK
(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
®r_-��
TOWN OF SOUTHOLD
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December 5, 1989
_ � v
/a• ¢
To: Victor Lessard, Southold Town BuildingN De artmen ,0 eCO
From: Linda J. Cooper, Southold Town Clerk's Officee0
Transmitted herewith is a copy of application No. A584 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Elizabeth Thibout
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 - ,C
DISAPPROVE -
COMMENTS: 04 t .x,..a otter ZPAL tc.k*Ot.Z) -
dl%%0‘4,00134!%' /
Signature
Date
i
0111101 ,
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IliwC . Y �t Town Hall, 53095 Main Road
ff "`,`,Ox P�' P.O. Box 1179
"1/4-.-4.4'..w.,",
OI �:•0► Southold, New York 11971
.JUDITH T. TERRY ' .i i"�'-
TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
December 5, 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. A584 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Elizabeth Thibout . •
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
OFFICE OF THE TOWN CLERK COFOU(
Town of Southold Q�� F ; ".A. 4 : Application No. 3 ��
Judith T. Terry, Town Clerk �'" " _y
Town Hall, 53095 Main Road ` _ ' • Construction
P. O. Box 1179
En ,,77.-_,
Southold, New York 11971 �,y, O�•yJ Alteration
Telephone 1l t NN '• Residential
(516) 765-1801 0 /
Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ 10J O-a
DATE I j Z7 A/ 7
APPLICANT NAME: J f/, ,
APPLICANT ADDRESS: i',) . /` 7'. •
7/44Z- atir---A
SEPTIC CESSPOOL
DESCRIPTISN 0 PROPOSED CONSTRUCTION OR ALTERATION
69-,_,--, 4#07 /
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTE' ION:
OWNER OF PROPERTY: /471
OWNER MAILING ADDRESS: 4.1 ��,a,.?„.../ .1 -
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: "Fr�.2 --ry
TAX MAP NO. : Section 52. Block 2 Lot 2 5
CROSS STREET: 7/-01 (-741-4--
BUILDING PERMIT NUMBER CROSS REFERENCE:
_......e.2),
Signature of Appl cant
RECEIVED BY :
Town Clerk's Office
DATE:
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