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HomeMy WebLinkAboutWilkinson (4) 1-4 air JUDITH T. TERRY AT Town Hall, 53095 Main Road TOWN CLERK ° G+ P.O. Box 1179 REGISTRAR OF VITAL STATISTICS .�� Southold, New York 11971 MARRIAGE OFFICER �® �� Fax (516) 765-1823 � ,,ssemZ,, Telephone (516) 765-1801 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1022 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : SAMUEL WILKINSON Address 1: 1150 WATERVIEW DRIVE City St Zip SOUTHOLD NY 11971 Descripton of Proposed Construction or Alteration INSTALLATION OF AN ADDITIONAL CESSPOOL RING TO AN EXISTING SYSTEM. APPROVED AS SUBMITTED. KEEP 10' APART. EXCAVATION INSPECTION REQUIRED. Name Of Owner WILKINSON, SAMUEL Mailing Address 1 1150 WATERVIEW DRIVE City St Zip SOUTHOLD NY 11971 Property Address 1 1150 WATERVIEW DRIVE City St Zip SOUTHOLD NY 11971 Tax Map No. section 78.00 block 7 lot 26.000 Cross Street MAIN BAYV I EW ROAD Building Permit Number Cross Reference: Issue Date: 7/08/93 Judith T. Terry Southold Town Clerk (TOWN SEAL) /0 _ ,;,,, 4f our At JUDITH T. TERRY4. Town Hall, 53095 Main Road TOWN CLERK ® t,, P.O. Box 1179 REGISTRAR OF VITAL STATISTICS r:gl $ Southold, New York 11971 MARRIAGE OFFICER ties® O v 0 Fax (516) 765-1823 ��® ��®,�!' Telephone (516) 765-1801 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD bil.t ----ici.fir--7,77,1, TO: Southold Town Building Department ,' ie ,°' FROM: Linda Cooper, Southold Town Clerk's Office I Jt1L - 11 1993 p;,'; DATED: June 30, 1993 =--°___ ,- • Transmitted herewith is a copy of application No. A1051 for an ALTERATION PERMIT for a cesspool or septic system submitted by ' Samuel Wilkinson . 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. oP Linda J. Cooper * * * * * * * * * * * * * I have reviewed the application and location map of the project listed above and make the following recommendation: APPROVE - DISAPPROVE - / COMMENTS: _'1( /, /L_X' �. / JUL 8 ,. .s, ::,,,.,..11.. f . , 4 .4..74 7--"-------4,1 ,76:e....2.r.‘2,..1,..-.____ a`'EQUOIED Signature Dea01-1 -_,,,1 9 3 OFFICE OF THE TOWN CLERK ,,,'"" Town of Southold ,s" 001.1re� /05-/ Town Clerk �' ®� ®� Application No. Judith T. Terry, �, �' Town Hall, 53095 Main Road ; , ', s,. Construction P. 0. Box 1179 Southold, New York 11971 Fr' r",: Alteration Telephone =�o,�; Qi1 $10.00 - Residential (516) 765-1801 Ql � '0� $25.00 -Non-Residential • ,110 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICAT ION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ DATE -' - 7�� APPLICANT NAME: 6 1"7/ /i,/, 50"( APPLICANT ADDRESS: //j-O 7-Eo vt ;L-eii Q, , SOUTI-10Lb /SCt // -7 ( SEPTIC CESSPOOL ,X DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION ztisi•�ii �dd, Toj. / C spoof e:As LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: i g _ L bit OWNER MAILING ADDRESS: //6-0 k/,q.72E-iev r- (/Z . OWNER PROPERTY ADDRESS: SA- ,E' TELEPHONE NUMBER OF CONTACT PERSON: 7 „23 cE R kcalk TAX MAP NO. : Section 7 Bl,ock Lot c=.7 ,, CROSS STREET: BUILDING PERMIT NUMBER CROSS REFERENCE: SignatureApplicant RECEIVED 0(F'3 BY: TowRe Office DATE: JUN 3 f4..�