HomeMy WebLinkAboutGoldwasser, Elizabeth OFFICE OF THE TOWN CLERKS�FFO(K
Town of Southold f') C�lj
Judith T. Terry, Town Clerk �'.
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971 O 0`.. .;
401 ��
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Telephone ,,;
(516) 765-1801 '
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 007 Residential X
Fee $ 10 . 00 Non-Residential
Septic Cesspool X
PERMIT ISSUED TO:
NAME: Richard Magill d/b/a Peconic Cesspool
ADDRESS: P . O. Box 972
Mattituck, NY 11952
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
Add to existing system, another cesspool
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Elizabeth Goldwasser (Formerly Teton)
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS: 490 Peconic Bay Blvd.
Laurel, NY 11948
TAX MAP NO. : Section 145 Block 2 Lot 5
CROSS STREET: Laurel Lane
BUILDING PERMIT NUMBER CROSS REFERENCE:
epolrIgIe4;e:Vr7:17
Judith T. Terry
Southold Town Clerk
DATE : July 25, 1986
(TOWN SEAL)
0° 1Facir;
4 �'\: Town Hall, 53095 Main Road
=_ 41 �� e P.O. Box 728
=___(// y -Nvp ,•� Southold, New York 11971
JUDITH T.TERRY -"',, 101"s TELEPHONE
Tow^ CLERI:
(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
July 25 , 1986
To: Victor Lessard, Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 007 for a
CONSTRUCTION Permit for a cesspool or septic system submitted
by Richard Magill for Elizabeth Teter Goldwasser
Please advise if we may issue the permit.
0001:04WPar"""%"—'"*.
Judith T . Terry
Southold Town Clerk
Attachments
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„JO FOUre,.1k\
CONSTRUCTION
ALTERATION $;
RESIDENTIAL
NON-RESIDENTIAL
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ /O i
DATE 7AVV‘
APPLICANT NAME:_____ C C
APPLICANT ADDRESS: / 2, / 972- //3L
CD e„
ea-a-7,-)7,-/
SEPT IC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION:
/4-074/ 723 74;./fr-ff fyr/2.37--A., /#%V't Wair7-6
ee-S5/50-1'
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
Pre`fj
OWNER NAME: 22/ 2.4fg% &O//%/ girmt /7 7
OWNER ADDRESS: �� /6 73 2; Z4 ',r lri /71.1".”
TAX MAP NO. : Section /4$-- Block 2 Lot X
CROSS STREET: .cif/
BUILDING PERMIT NO. CROSS REFERENCE:
ee
Si nature of A Ii t
J Pp
RECEIVED BY: u �
Town Clec's Off e
DATE: ( S /9
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