HomeMy WebLinkAboutGoodwin, Raymond Z
JUDITH T. TERRY z1'= yZ
Town Hall, 53095 Main Road
TOWN CLERK . v �, P.O. Box 1179
cls � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ‘‘VA,
BYO�� �. Fax (516) 765-1823
MARRIAGE OFFICER .O ,•' Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER -. W4/ * n
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. 1139 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
REPLACE OLD CESSPOOL IN AN EXISTING WITH A NEW TYPE OF POOL.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS
BUILDINGS, PROPERTY LINES, AND WATERS BODIES
EXCAVATION INSPECTION REQUIRED.
Name Of Owner GOODWIN, RAYMOND
Mailing Address 1 163 WEYFORD TERRACE
City St Zip GARDEN CITY NY 11530
Property Address 1 2445 PINE TREE ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 104.00 block 3 lot 3.000
Cross Street BETTERSWEET LANE
Building Permit Number Cross Reference:
Issue Date: 5/26/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY :, L Town Hall, 53095 Main Road
TOWN CLERK : p r= : P.O. Box 1179
cls *• $ Southold, New York 11971
REGISTRAR OF VITAL STATISTICS "-V:021,. �. �% Fax (516) 765-1823
MARRIAGE OFFICER '_'`^ ��O ��� Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER 1 4 i�
FREEDOM OF INFORMATION OFFICER = ,,,�wif......�r
OFFICE OF THE TOWN CLERK =_.SZ f
TOWN OF SOUTHOLD
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TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office TOyVMnF-DEPT.
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DATED: May 20, 1994
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Transmitted herewith is a copy of application No. A1180 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
. Peconic Cesspool for Ray Goodwin .
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.
ertAs....a.t...,....,
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - t .
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DISAPPROVE - .4 I: , Z1
COMMENTS: -/-92,;(,),e.,..., f -244-77-)
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Date
OFFICE OF THE TOWN CLERK ,,,,�fol
Town of Southold • ' c,j� �
'� Application No.//��
Judith T. Terry, Town Clerk ,'' Gy�;
Town Hall, 53095 Main Road $ 1 1 .<1
Construction L_
P. O. Box 1179
aAlteration
Southold, New York 11971 s clk
Telephone - �O �Q �� $10.00 - Residential
(516) 65-1801 . ', 1 , �' $25.00 -Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE
APPLICANT NAME: // � �`� .� ,` ``/
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APPLICANT ADDRESS: / 77 Z_
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SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONST' UCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: Ay /
OWNER OF PROPERTY:
OWNER MAILING ADDRESS: /� AA' A ,'
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OWNER PROPERTY ADDRESS: , ;� ` A-ef7
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TELEPHONE NUMBER OF CONTACT PERSON: 9$ !G Sj
TAX MAP NO. : Section /0 Z Block 3 Lot 3
CRSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
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Signature of Applicaniti
RECEIVED BY:
Town Clerk's Office
DATE:
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