HomeMy WebLinkAboutWilkinson (3) JUDITH T.TERRY �� ' Z "4. ��
` Town Hall,53095 Main Road
TOWN CLERK ""'
P.O.Box 1179
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REGISTRAR OF VITAL STATISTICS k 1� Southold,New York 11971
MARRIAGE OFFICER �6y�J 5S4- ��� Fax(516)765-1823
RECORDS MANAGEMENT OFFICER ,� `o° Fax
(516)765-1800
FREEDOM OF INFORMATION OFFICER , • ��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1331 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : ROBERT AND JEAN WILKINSON
Address 1 : 3930 OAKLAWN AVENUE EXT.
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITION OF AN OVERFLOW TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION
INSPECTION REQUIRED.
Name Of Owner WILKINSON, ROBERT AND JEAN
Mailing Address 1 3930 OAKLAWN AVENUE EXT.
City St Zip SOUTHOLD NY 11971
Property Address 1 3930 OAKLAWN AVENUE EXT.
City St Zip SOUTHOLD NY 11971
Tax Map No. section 70.00 block 9 lot 10.000
Cross Street PINE NECK
Building Permit Number Cross Reference:
Issue Date: 5/12/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY : Town Hall, 53095 Main Road
TOWN CLERK a P.O. Box 1179
it Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ‘ 4, 0 - Fax (516) 765-1823
MARRIAGE OFFICER �_✓®'' 0 §,��t Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER = O,l
FREEDOM OF INFORMATION OFFICER .~0//°°.0
OFFICE OF THE TOWN CLERK � -° -7-------___TOWN OF SOUTHOLD I f Ir. / n (-- `
TO: Southold Town Building Department I/ 11 _ 1ti
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FROM: Linda Cooper, Southold Town Clerk's Office l
DATED: May 8, 1995 I iptP;�L"-'-'�,,I �-
Transmitted herewith is a copy of application No. A1380 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
- Robert and Jean Wilkinson (Work to be done by Arte Foster) .
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.
Oi3c2``
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE -
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
4''.2--- i `-4
Signature
Date
OFFICE OF THE TOWN CLERK ,,,,"""'''%
Town of Southold 0." �Ff[11.�
Town Clerk �� -�,
Application No. /
Judith T. Terry,
Town Hall, 53095 Main Road ; '„ Construction
•
P. Cl. Box 1179 • � A-
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Southold, New York 11971 • ct� et
Alteration
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Telephone _ 4n. *�ro• $10.00 - Residential
(516) 765-1801 = 1 � ' $25.00 - Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERAT ION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE
APPLICANT NAME: �e}) L.)) . 1k//)Sd
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APPLICANT ADDRESS: J 93o (1-Ii\-) ezcd.), /
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SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTI�O
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-AOR ALTER TION
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LOCATION MAP: . Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: /424 6.9/7T— V --reeL4 j --Z"ax-)
OWNER MAILING ADDRESS: 5 0 £9 / A -Les1L) /X/
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: -765:—
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TAX MAP NO. : Section 7 O Block Lot /a
CROSS STREET: /f e
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY: 4/.//Town Clerk's • ice
DATE:
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