HomeMy WebLinkAboutBaker, Paul r 000 at,
OFFOUr
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JUDITH T.TERRY � _ 'y ��
� Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. Box 1179
t Southold,New York 11971
REGISTRAR OF VITAL STATISTICS
Fax(516) 765-1823
MARRIAGE OFFICER �y �
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RECORDS MANAGEMENT OFFICER = 49 *a01�� Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER , ,is"
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION. PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1631 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL
Address 1 : 2760 YENNECOTT
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITION OF CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS
BUILDINGS, PROPERTY LINES, AND WATER BODIES. EXCAVATION INSPECTION
REQUIRED.
Name Of Owner BAKER, PAUL
Mailing Address 1 1385 OLD SHIPYARD LANE
City St Zip SOUTHOLD NY 11971
Property Address 1 1385 OLD SHIPYARD LANE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 64.00 block 5 lot 27.000
Cross Street FOUNDERS PATH
Building Permit Number Cross Reference:
Issue Date: 4/17/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
4 _ I
7
4 1997 ;:-c��FFOUI�e�ti,4 i 431)
Town Hall, 53095 Main Road
0j v0 �. i P.O. Box 1179
11'1%' �� : Southold, New York 11971
JUDITH T.TERRY �`,1. TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: April 4, 1997
Transmitted herewith is a copy of application No. A1709 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool Service for Paul Baker •
Please review the application and location map and advise if this office may
issue the permit. /V
Please complete the form below and return it to this office. � / Q
/ /
Thank you.
•.d/ ''-
Linda J. Cooper
s/
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following rec ndation:
APPROVE -
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
RECEIVED
3:3atofu f
APR 1 6 1997 Si•na 'ure
/
—nolo!Town Clerk Date
OFFICE OF THE TOWN CLERK
Town of Southold glir
Judith T. Terry, Town Clerk � , : Application o. C 14,
Town Hall, 53095 Main Road ( Construction
P. O. Box 1179Alteration
Southold, New York 11971 : �;
Telephone ���e' $10.00 -Residential
(516) 765-1801 "1 $25.00 -Non-Residential
•
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE /Of 7 /777
7
APPLICANT NAME: 79A4tee5
APPLICANT ADDRESS: ,'77o 1Li d
CSS ft 17
SEPTIC CESSPOOL\/
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTIO ZeLTERAT IN:
OWNER OF PROPERTY: dg.09,
4/6
OWNER MAILING ADDRESS: F ���Z�''L /fir cf0- /0,(49LA
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section Y Block S Lot C
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
.lam /fr/
ignature of Applicant
RECEIVED BY: / '►
•
own C erk's Office
DATE: 7•/7/T9,7
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