HomeMy WebLinkAboutCornwell, Cliff "fsalFFO(/i.
JUDITH T.TERRY d Town Hall, 53095 Main Road
TOWN CLERK cN -
P.O. Box 1179
♦ rrt Southold,New York 11971
REGISTRAR OF VITAL STATISTICS � Fax(516) 765-1823
MARRIAGE OFFICER �J� `a�� Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER 1 iN[ �` .�
FREEDOM OF INFORMATION OFFICER yoo
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1438 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 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 CORNWELL, CLIFF
Mailing Address 1 BOX 89, WEST COVE ROAD
City St Zip CUTCHOGUE NY 11935
Property Address 1 500 WEST COVE ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 111 .00 block 2 lot 8.001
Cross Street
Building Permit Number Cross Reference:
r • . .
Issue Date: 2/13/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY t _ yet Town Hall, 53095 Main Road
TOWN CLERK ; y Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS %
$ Southold, New York 11971
y ��'10 Fax (516) 765-1823
MARRIAGE OFFICER =��91 " " Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER JL s,
FREEDOM OF INFORMATION OFFICER .s"a
OFFICE OF THE TOWN CLERK 11 -�--- U f
TOWN OF SOUTHOLD ";
JAN 3 01996
TO: Southold Town Building Department I
FROM: Linda Cooper, Southold Town Clerk's Office ?OWN OF SO PT.
DATED: January 30, 1996
Transmitted herewith is a copy of application No. 1495 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Cliff Cornwell ,
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 followin -
g recommendation:
APPROVE - !/
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
I ----- . 411 *
ignatur-
D/9 9
Date
OFFICE OF THE TOWN CLERK ,�,'",,,""'
Town of Southold �011c011./(6--....� Application No. /fir Y5
Judith T. Terry, Town Clerk ,%'O�
Town Hall, 53095 Main Road Z .G; Construction
P. O. Box 1179 ; o rn
Southold, New York 11971 :11 �; Alteration
Telephone ...v. Mg ��ir $10.00 - Residential `�
(516) 765-1801 : �l
,, $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATEjekd a ,/(,-q-
APPLICANT NAME: 4ej i/ S le,w,,L, -,(llf* _� '
APPLICANT ADDRESS: jr , _o- .
SEPTIC CESSPO:
DESCRIPTION OF '>*POSED CONSTRUCTION OR ALTERATION
•
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCT %,N• ALT RATION:
OWNER OF PROPERTY:
—
OWNER MAILING ADDRESS: � k 6 ? c: -(A- t;
OWNER PROPERTY ADDRESS: a00 60-0---0--/e C-62-c-� R—
C-L-c-9L
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TELEPHONE NUMBER OF CONTACT PERSON: 1) /711101--1--e--,--
TAX MAP NO. : Section iiit Block .2. Lot O -
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
C
07)0t ,
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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