HomeMy WebLinkAboutHerrman, Philip p)1FOL/-1,IN
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Town Hall, 53095 Main Road
141 ve i P.O. Box 1179
X1% 1 Southold, New York 11971
JUDITH T.TERRY %`•�� ���.�— TELEPHONE
TOWN CLERK (516) 765-1801
RI:GIS'TRAR 01 VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1593 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL SERIVE
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 HERRMAN, PHILIP
Mailing Address 1 1645 EAST GILLETTE DRIVE
City St Zip EAST MARION NY 11939
Property Address 1 1645 EAST GILLETTE DRIVE
City St Zip EAST MARION NY 11939
Tax Map No. section 38.00 block 4 lot 24.000
Cross Street ROUTE 25
Building Permit Number Cross Reference:
Issue Date: 3/19/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY � =�0 Gym 1 Town Hall, 53095 Main Road
TOWN CLERK = C,3
P.O. Box 1179
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• Southold, New York 11971
REGISTRAR OF VITAL STATISTICS O ►�, Fax (516) 765-1823
MARRIAGE OFFICER y1 0�/
RECORDS MANAGEMENT OFFICER N. RI , �� 1.6 Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ,,����
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department t-L) 3
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: Feb. 6, 1997
Transmitted herewith is a copy of application No. 1664 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Philip Herrman
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
s
Signature
MAR1 ) /
� 1997 � /�
Date
Southold IOWA C '"
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t OF THE TOWN CLERK �,��'Jo''" - /
Town of Southold ,'� � fUz /lo C17
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-udith T. Terry, Town Clerk ; Gy Application No.
Town Hall, 53095 Main Road , � Construction
P. O. Box 1179 o ray+ Alteration
Southold, New York 11971 ; ;
‘10.4. ��C',' $10.00 - Residential
Telephone g"
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(516) 765-1801 1 $25.00 -Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ /O
DATE fc2 / 9 /,pq
APPLICANT NAME: - —�
APPLICANT ADDRESS:
SEPTIC CESSPOOL -1
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY :
OWNER MAILING ADDRESS: al?
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section LY? Block y Lot 2 `/
CROSS STREET: £T 2 5
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY: ,�p �
/ Town jerk's Office
DATE: c� C,, 7
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