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JUDITH T. TERRY :, iG : Town Hall, 53095 Main Road
TOWN CLERK
p rZ P.O. Box 1179
th Southold, New York 11971
REGISTRAR OF VITAL STATISTICS : y 1MARRIAGE OFFICER O/� a� � Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER .t' �� Telephone (516) 765-1801
FREEDOM OF INFORMATION OFFICER =� �i'��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 51 N Residential Non-Residential X
Fee $ 25.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : JOSEPH AND ANNE NOLAN
Address 1 : 685 ORCHARD STREET
City St Zip NEW SUFFOLK NY 11956
Descripton of Proposed Construction or Alteration
ADDITION OF CESSPOOL TO AN EXISTING SYSTEM. APPROVED AS SUBMITTED.
EXCAVATION INSPECTION REQUIRED. MAINTAIN REQUIRED SETBACKS FROM ADJA-
CENT WELLS, BUILDINGS, AND PROPERTY LINES. PROVIDE MANHOLES AS REQUIRE
BY SANITARY CODE. PROVIDE PROTECTION AT EXCAVATION FOR CARS/PEDESTRIAN
Name Of Owner NOLAN, JOSEPH AND ANNE
Mailing Address 1 685 ORCHARD STREET
City St Zip NEW SUFFOLK NY 11956
Property Address 1 21800 MAIN ROAD
(CUTCHOGUE VILLAGE MARKET)
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 102.00 block 6 lot 8.000
Cross Street NEW SUFFOLK LANE
Building Permit Number Cross Reference:
Issue Date: 8/01/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE ,TOWN CLERK „ ,'” "'-
Town of Southold �'' C�F�D�x`►. Application No. 0202
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road Construction
P. O. Box 1179 .41
179 •
Southold, New York 11971 'P Alteration ✓�
Telephone ,y�'0 (Zr , $10.00 - Residential
(516) 765-1801 = 1 ,, '' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
ct
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE
(.c 1 o ic<< (37'
APPLICANT NAME: ./cgepff k-. 4 &111 .- l • 0 Li/v
APPLICANT ADDRESS: 6�'.S' e 641ei Sr! i4Je- ✓
SEPTIC CESSPOOL ✓
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: . Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 'j,,� .-e
OWNER MAILING ADDRESS: Aff,4,C
•
OWNER PROPERTY ADDRESS: n/ 'Oo M4 n/ iQ
4-e 944 e_
TELEPHONE NUMBER OF CONTACT PERSON: 3(•f• 54C?
TAX MAP NO. : Section /Oa Block G Lot ,
CROSS STREET: f(,J S'
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
•
RECEIVED BY:
Town Cie/ries-Office
DATE: 6//5S7 •
Al ac- R ?v R . ` ,,'A ! . . ' ► ;
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'6ECTION 7209 OF THE NEW YORK ST/ER� •
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LENDING INtTENTION LISTED II-REON•
RO THE ASSIGNEES OF LIE LENOIEI - .
TUTION.GUARANTEES ATE NGT TRANSFERyLE I
TO ADDIIION41 It'II ` �'� '`'
'.O 4L Town Hall, 53095 Main Road
JUDITH T. TERRY
TOWN CLERK ` v T P.O. Box 1179
IP W Southold, New York 11971
REGISTRAR OF VITAL STATISTICS BYO �. 4* Fax Fax (516) 765-1823
MARRIAGE OFFICER ,,��jj�� �� ,�' Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER —f"K/j e.
FREEDOM OF INFORMATION OFFICER
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OFFICE
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OFFICE OF THE TOWN CLERK j 411111-am
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Offic
,,...:T.tV - 1,
DATED: August 1 , 1994
Transmitted herewith is a copy of application No. A1222 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Joseph and Anne Nolan (Cutchogue Village Mkt) work by Artie Foster .
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 - (� EXCAVATION INSPECTION
DISAPPROVE - REQUIRED
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