HomeMy WebLinkAboutGoldsmith, Russ a-
Town Hall, 53095 Main Road
�� P.O. Box 1179
••• Southold, New York 11971
JUDITH T.TERRYO.. TELEPHONE
TOWN CLERK (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. 373 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 OVERFLOW POOL TO EXISTING SYSTEM.
APPROVED AS SUBMITTED. NEW POOL NOT TO EXCEED 15 ' 0" FROM OLD POOL.
Name Of Owner GOLDSMITH, RUSS
Mailing Address 1 P. O. BOX 251
City St Zip ORIENT NY 11957
Property Address 1 BAY AVENUE
City St Zip EAST MARION NY 11939
Tax Map No. section 31. 00 block 8 lot 5. 000
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 7/14/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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�' ' `t' i" \ Town Hall, 53095 Main Roar
BLDG. DEPT. �.ke �- ' P.O. Box 1179 •
TOWN OF SOUTHOLD ,I y.; �\), ••$ Southold,
_ • Southold, New York 11971
.JUDITH T. TERRY �d."..roos 0.0#‘1 TELEPHONE
TOWN CLERK - (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
July 11, 1988
To: Victor Lessard, Southold Town Building Department
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. 375 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Russ Goldsmith .
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 - X
DISAPPROVE - r
COMMENTS: cc a„ti1-�-c c , a-, alto. L S I kD . ---Nf. C.;a„,,e,L. .
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Signature
Date
•"
OFFICE OF THE TOWN CLERKS1FRI( '
Town of Southold % 4'y� Application No.?-7;-
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road ` tr2 Construction
P. O. Box 1179 v.
Alteration
Southold, New York 11971 �`J
Telephone Ol t ' ' Residential
(516) 765-1801
Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE e74 Pir
APPLICANT NAME: 46294-e--z,„
APPLICANT ADDRESS: ,d,d. 27 Z._.
SEPTIC CESSPOOL
DESCRIP ION OF RROPOSED CONSTRUCTION OR ALTERATION
i
•LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION ORA TERATION:
OWNER OF PROPERTY: 43r 25'
OWNER MAILING ADDRESS: 4441 4-4
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:c ', 941
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TAX MAP NO. : Section . / f‘ Block Lot 5 •
CROSS STREET: (✓„
BUILDING PERMIT NUMBER CROSS REFERENCE:..
Signature of Applica
RECEIVED BY: ;--)cC,
Town C rk's Offi e
DATE: 7 �>' 6PC-
NOP
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