HomeMy WebLinkAboutCannon, Lisa JUDITH T.TERRY �� = yj Town Hall, 53095 Main Road
TOWN CLERK ; y i P.O. Box 1179
�t Southold, New York 11971
REGISTRAR OF VITAL STATISTICS O 1
MARRIAGE OFFICER . -*# W.
Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER .1 '► .0 Telephone(516) 765-1800
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. 1468 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL SERVICE
Address 1 : 2760 YENNECOTT DRIVE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITION OF AN OVERFLOW POOL 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 CANNON, LISA
Mailing Address 1 1050 ARSHAMOMAQUE AVENUE
City St Zip SOUTHOLD NY 11971
Property Address 1 1050 ARSHAMOMAQUE AVNEUE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 66.00 block 2 lot 27.000
Cross Street ROGER ROAD
Building Permit Number Cross Reference:
Issue Date: 4/30/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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(y#1iOSUFFU(�`; ,
JUDITH T.TERRY 4• Town Hall, 53095 Main Road
TOWN CLERK y i P.O. Box 1179
W "7 $ Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER �yi0��1�' Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER :f�Ol ���d� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: April 25, 1996
Transmitted herewith is a copy of application No. 1528 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool
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
•
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I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE -
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
RECEIVED 2
APR 2 9 1996
Signature
Town Clerk Southold ,f
Date
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y OFFICE OF THE TOWN CLERKaf'''",,,,,,` •
Town'of Southold ' tfilApplication No._/ Jrc .p
Judith T. Terry, Town Clerk ° �z ,,
Town Hail, 53095 Main Road ` Construction
P. O. Box 1179 Alteration
Southold, New York 11971 _
Telephone ' ®N ', $10.00 -Residential K,
(516) 765-1801 -- Or $25.00 -Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
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APPLICATION
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for
4A,
CONSTRUCTION or ALTERATION PERMIT
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SEPTIC TANK or CESSPOOL
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Permit No.
Fee $
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DATE ep'-, o 2 )P'‘
APPLICANT NAME: / 'c5 �/ *tc-
APPLICANT ADDRESS: -267.45 Sta„. 42 ,<-
/'7 X ,;-
SEPTIC CESSPOe1
DESCRIPTION OF PROPOSED CONSTRU TION OR ALTERATION
Cfrie-)."-474/4,,e.te) (2
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: (- -4-‘,... (441/2A) '
OWNER MAILING ADDRESS: 4:., ,,___-5-0 S9/0,1Q.,.Q u#. ,.-Q4.
OWNER PROPERTY ADDRESS:
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TELEPHONE NUMBER OF CONTACT PERSON: (s �� -eii
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TAX MAP NO. : Section k� Block 2 Lot 7 7
CROSS STREET: /e
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BUILDING
BUILDING PERMIT NUMBER CROSS REFERENCE:_
5").7_3%,/ 4 , ,
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Signature of pp iccannt
RECEIVED BY: /St.-/ v
Town Clerk#s 0 ice
DATE: L,/i S"- l6
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