HomeMy WebLinkAboutKatz, Blanche uUrest�1
$ Town Hall, 53095 Main Road
scf."j trl i P.O. Box 1179
,1 yO �0� Southold, New York 11971
JUDITH T.TERRY ,1l i�.41•1164,,000'"'"--
Ol� �•�•
+ TELEPHONE
TOWN CLERK ,• 4, "'� (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1711 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 WELLS,
BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION
REQUIRED.
Name Of Owner KATZ, BLANCHE
Mailing Address 1 1800 BROADWATERS ROAD
City St Zip CUTCHOGUE NY 11935
Property Address 1 1800 BROADWATERS ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 104.00 block 9 lot 10.000
Cross Street HAYWATERS ROAD
Building Permit Number Cross Reference:
Issue Date: 8/12/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
l77/
SUFFO4�o��
JUDITH T.TERRY
-'1s,‘ Town Hall, 53095 Main Road
TOWN CLERK c - i ! P.O. Box 1179
v- Southold, New York 11971
REGISTRAR.OF VITAL STATISTICS O
MARRIAGE OFFICER -R Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER ~ Oj 4 *, _ - Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER •• y ��.d�_- — -LL
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: August 4, 1997
Transmitted herewith is a copy of application No. 1781 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Blanche Katz
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.
v. _
RECEIVED ignatu re
AUG 1 1 1997 '45
Date
Southold Town Clerk
GFFICE OF THE TOWN CLERK """ -- / -�/
Town of Southold ,,,'�� irfllLKj� Application No. t 1(
Judith T. Terry, Town Clerk �� l..A
Town Hall, 53095 Main Road k :� ; Construction
P. O. Box 1179 Alteration ✓
Southold, New York 11971 ; /
Telephone ' ���o!
$10.00 - Residential J
(516) 765-1801 -711,1 �' $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 / /
APPLICANT NAME: te,
APPLICANT ADDRESS: )7‘C)
SEPTIC CESSPOOL—N/
DESCRIPTION F PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: in6
OWNER MAILING ADDRESS: /f b
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:? 5-33
TAX MAP NO. : Section /Z / Block Lot /6
CROSS STREET: Ofrefe-eird&c.- eeCe
BUILDING PERMIT NUMBER CROSS REFERENCE:
j- /do #111/"-z-z,-
A gnature of Applicant
RECEIVED BY: ¶999
TownClerk's Office
DATE: SOutiddraWILCIark
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