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Guild, Jay
''�,,FF01k""- .s 0' c c `' o I� Town Hall, 53095 Main Road 1.V.4,,_ �. �J P.O. Box 1179 _' 1 4. ���.�� Southold, New York 11971 JUDITH T.TERRY ---',.....,01,0-' FAX(516)765-1823 TOWN CLERK TELEPHONE(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. 497 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 ONE NEW OVERFLOW CESSPOOL TO EXISTING SYSTEM. APPROVED AS SUBMITTED. Name Of Owner GUILD, JAY AND JEAN Mailing Address 1 RR 3, 36400 NORTH ROAD City St Zip PECONIC NY 11958 Property Address 1 36400 NORTH ROAD City St Zip PECONIC NY 11958 Tax Map No. section 69.00 block 4 lot 7.000 Cross Street PECONIC LANE Building Permit Number Cross Reference: ___.godroftedineA''_ 6 _ _czia0.40''''apipteen._zz Issue Date: 5/30/89 Judith T. Terry.. errry d Southold Town Clerk (TOWN SEAL) ,•'CNo. � 7_ o - . ��. � 0• 1 11 $1:64 CI TOWN UF`SCitJDS309 t Main Roac 179 "-'''4/1 yII$•• isox __.t! ! Southold, New York 11971 JUDITH T. TERRY ����omr TELEPHONE TOWN CLERK (516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD May 22, 1989 To: Victor Lessard, Southold Town Building Department From: Linda J. Cooper, Southold Town Clerk's Office Transmitted herewith is a copy of application No. A509 for an ALTERATION PERMIT for a cesspool or septic system submitted by Peconic Cesspool for Jay Guild • 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 - DISAPPROVE - COMMENTS: cy n21: vita. o,l arca CPU,oQ fc_ Signature Date • OFFICE OF THE TOWN CLERK �S��FUL4 Judith T. Terry Town Clerk n of Scuthold �� Cy . Application No.AST Terry, y Town Hall, 53095 Main Road ; g Construction cn P. 0. Box 1179 Southold, New York 11971 O Alteration � �� ' Residential 4— Telephone - 1 i (516) 765-1801 Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ /a, OLD DATE ©5f/V4/ APPLICANT NAME: ,..efii.i, 6.-#---Py,07/ APPLICANT ADDRESS: Xie - /43-A/_ 972------ SEPTIC CESSPOOL 4.--- DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION / f / LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATIO , OWNER OF PROPERTY: \Yr/7 LQ-o-or.— OWNER MAILING ADDRESS: iote_,Ori) c Gc[e,-y ';; ,e-ice ' OWNER PROPERTY ADDRES: - --,.,_ 4--. TELEPHONE NUMBER OF CONTACT PERSON: TAX MAP NO. : Section Block / Lot 7 CROSS STREET: 146-'6 BUILDING PERMIT NUMBER CROSS REFERENCE: Signature of Ap cant L ^ RECEIVED BY: ��,tkaP ,�'; .2 // -own Ie 's Office DATE: L_/67 - f • - - s vu0--,z 00,0 p cp6Dis Gltc'C���'� � �