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JUDITH T. TERRY .014. Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS id') �� Southold, New York 11971
�✓ �� Fax (516) 765-1823
MARRIAGE OFFICER � ® ®�' •
''yo! �� �� Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1034 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 AN OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED - MAINTAIN SCHD SETBACKS FROM BODIES OF WATER
AND ADJACENT WELLS.
Name Of Owner WILLIAM, WHENTLEY B.
Mailing Address 1 NEW SUFFOLK AVENUE
City St Zip CUTCHOGUE NY 11935
Property Address 1 NEW SUFFOLK AVENUE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 116.00 block 1 lot 5.000
Cross Street MOORES LANE
Building Permit Number Cross Reference:
Issue Date: 8/04/93 Judith T. Terry
Southold Town Clerk
(TOWN SEAL
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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK i P.O. BOX 1179
REGISTRAR OF VITAL STATISTICS .�` Southold, New York 11971
MARRIAGE OFFICER %C® C C,,'^40. Fax (516) 765-1823
�� 0 Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK -w' 'ry ` `�''
TOWN OF SOUTHOLD U '-`�- - tii i l li
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TO: Southold Town Building Department AUG ® 2 9993 4
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FROM: Linda Cooper, Southold Town Clerk's Office BLDG.DEPT.
DATED: August 2, 1993 �OW. ,..� ®
Transmitted herewith is a copy of application No. A 1064 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for B. Whentley William .
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. �o
�y..."°`EC`.--
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - EXCAVATION
DISAPPROVE - REQUIED
COMMENTS: w. ` 9 i , se ID /_4_,. -
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OFFICE OF'THE TOWN CLERK �,,,'",,,•
,Town of Southold " Wire
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Judith T. Terry, Town Clerk ��' � Gy' Application No /0;
Town Hall, 53095 Main Road � Construction
P. O. Box 1179
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Southold, New York 11971 u1 irr ,,' Alteration i/
Telephone O
�T• $10.00 - Residential
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(516) 765-1801 = 01 41 $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRIFE C E l V E
APPLICATION
AUG 02 1993
for Southold Towne Clerk
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
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DATE LeoL'y2-- /?9
APPLICANT NAME: � - -
APPLICANT ADDRESS: Ae-e? v ,97z-
SEPTIC CESSPOOL
DESCRIPTION� � OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: /fir
OWNER MAILING ADDRESS:
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OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 9f®9
TAX MAP NO. : Section /./w Block / Lot
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE: , •
Signature of,404 plicot -.
RECEIVED BY: - ��11&,.• S ,
T:wn Cle k's Office
DATE: ' �, -
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