HomeMy WebLinkAboutKimogenor Point Co (2) 0° �OFFOLt
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JUDITH T.TERRY ��� •V7
Town Hall, 53095 Main Road
o
TOWN CLERK y Z P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
1
MARRIAGE OFFICER ��yif� �� 1' Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER 0l 4Foole 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. 1728 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : EDWARD PURCELL
Address 1 : P. O. BOX 661
City St Zip NEW SUFFOLK NY 11956
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 KIMOGENOR POINT
Mailing Address 1 C/O EDWARD PURCELL
P. O. BOX 661
City St Zip NEW SUFFOLK NY 11956
Property Address 1 JACKSON STREET
City St Zip NEW SUFFOLK NY 11956
Tax Map No. section 117.00 block 10 lot 1 .000
Cross Street
Building Permit Number Cross Reference:
Issue Date: 9/11/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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Co -
JUDITH T.TERRYy`� Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. Box 1179
v. v' Southold,New York 11971
REGISTRAR OF VITAL STATISTICS O
MARRIAGE OFFICER `�y ��� Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER ���.( + 4.
�.0Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ••�of��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: September 10, 1997
Transmitted herewith is a copy of application No. 1801 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Edward Purcell - Kimogenor Point (work by Ray Nine) •
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 applicati n and location map of the project listed
above and make the followi recommendation:
APPROVE -
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
gnatur
9(11 /97
Date
OFFirtE OF THE TOWN CLERK '' "
Town of Southold
Application No. / 8V/
Town Clerk
Judith T. Terry,
Town Hall, 53095 Main Road ;' Construction
P. O. Box 1179 Alteration
Southold, New York 11971 �'
(_ $10.00 - Residential
Telephone
(516) 765-1801 7471 ,, $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
Lai�k� u ATE ft/0797
1\j/al
lJ 2c t=
APPLICANT NAME: ./' /m o6b nf.S4- ro/ V
APPLICANT ADDRESS: Ait CJ SU f��U L(� /1/, /
b. 61
SEPTIC CESSPOOL —
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
Ct� 3eob1- vVe2FL_� w
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: k', 6116 .
OWNER MAILING ADDRESS: //fe o .3"..1k Fele uc,
OWNER PROPERTY ADDRESS: S4-me IlGKSO�
w - S
TELEPHONE NUMBER OF CONTACT PERSON: 734 .5-272. --_�" '(
TAX MAP NO. : Section X17 Block /U Lot /
CROSS STREET: C.(CSDtf $�/���� 1/ 4 " - 02'4,
BUILDING PERMIT NUMBER CROSS REFERENCE:
j‘a44,ea-7LLA.
Signature of Applicant
RECEIVED BY:
Town C of k's Office
DATE: 9_ (O - 7- 7
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