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Home My WebLink AboutForemann, Errol •0Avg�FFO(,�co JUDITH T.TERRY � _ Gym Town Hall, 53095 Main Road TOWN CLERK ; ti P.O. Box 1179 2 Southold, New York 11971 REGISTRAR OF VITAL STATISTICS O 4'7g1 Fax (516) 765-1823 MARRIAGE OFFICER y �� RECORDS MANAGEMENT OFFICER ,( �� 10. Telephone (516) 765-1800 FREEDOM OF INFORMATION OFFICER • •,i6�� OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1628 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 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 FOREMAN, ERROL Mailing Address 1 1100 MARATOOKA ROAD City St Zip MATTITUCK NY 11952 Property Address 1 1100 MARATOOKA ROAD City St Zip MATTITUCK NY 11952 Tax Map No. section 115.00 block 3 lot 18.001 Cross Street ROUTE 25 Building Permit Number Cross Reference: Issue Date: 3/24/97 Judith T. Terry Southold Town Clerk (TOWN SEAL) 0 ' „ �o,Ocy11FF �,�co G%� JUDITH T.TERRY � � yt Town Hall, 53095 Main Road TOWN CLERK ; y = P.O. Box 1179 •REGISTRAR OF VITAL STATISTICS O I Southold, New York 11971 41 • MARRIAGE OFFICER �� ,�$ Fax(516) 765-1823 RECORDS MANAGEMENT OFFICER � .� * **.'"� Telephone (516) 765-1800 FREEDOM OF INFORMATION OFFICER '�� osi OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda Cooper, Southold Town Clerk's Office DATED: March 19, 1997 Transmitted herewith is a copy of application No. 1699 for an ALTERATION PERMIT for a cesspool or septic system submitted by Morris Cessepool for Errol Foreman 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: Maintain required setbacks from adjacent wells, buildings, property lines and water bodies. EXCAVATION INSPECTION REQUIRED. RECEIVED • Signatur- MAR 2 1997 Southold TownD a - Clerk / z OFFICE OF THE TOWN CLERK ',,,,,,,, Town of Southold Judith T. Terry, Town Clerk Application No. �/4,) Town Hall, 53095 Main Road Construction P. O. Box 1179 Alteration Southold, New York 11971 � t $10.00 - Residential Telephone �, i .�� (516) 765-1801 = 1 4 � $25.00 -Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ nn DATE ,1' 4 ( / 7177 APPLICANT NAME: / / 'S APPLICANT ADDRESS: a6U •�i . s SEPTIC CESSPOOL ^J DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION e-el/eAr46,) LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: ��i_,L� J 6eI . 7/9/' • OWNER MAILING ADDRESS: //PD /170_4.- /e(- t OWNER PROPERTY ADDRESS: TELEPHONE NUMBER OF CONTACT PERSON: 7jXYa TAX MAP NO. : Section //)--- Block 2 Lot /f CROSS STREET: BUILDING PERMIT NUMBER CROSS REFERENCE: ,O)ty/4- 79 '''26'14-4= Signature of Applicant RECEIVED BY: ,' To /Clerk's O e DATE: /1 9 7 7 3d 2,a 6