HomeMy WebLinkAboutMalgrath, Philip iiiS�FFO(,f�o
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y1• Town Hall, 53095 Main Road
JUDITH T.TERRY ti
TOWN CLERK ; y = P.O. Box 1179
^r �$ Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER yijJ m`� Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER RI jig � •,,' 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. 1511 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL
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 MALGRATH, PHILIP
Mailing Address 1 475 YOUNGS AVENUE
City St Zip SOUTHOLD NY 11971
Property Address 1 475 YOUNGS AVENUE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 61 .00 block 4 lot 28.000
Cross Street MECHANIC STREEET
Building Permit Number Cross Reference:
Issue Date: 7/24/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
1.
0004
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1 JUDITH T.TERRY
1 y • Town Hall, 53095 Main Road
TOWN CLERK ; H Z P.O. Box 1179
v. Southold,New York 11971
REGISTRAR OF VITAL STATISTICS '. %. ����� Fax(516)765-1823
MARRIAGE OFFICER O °
RECgRDS MANAGEMENT OFFICER RI � �a�°° Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER „•••'�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: July 22, 1996
Transmitted herewith is a copy of application No. 1576 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for m G-1214 T 11- •
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.
Signatur7
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OFFICE Or THE TUIWN CLERK ,�'''
Town of Southold COOLKce- Application No. / S 76
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road Construction
P. 0. Box 1179 7i
Southold, New York 11971 til ye$ Alteration
Telephone ` .►O ,i� $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 $
DATE / 4 020,? //1?*/
APPLICANT NAME: /� / :// • ._
APPLICANT ADDRESS:
SEPTIC CESSPOOL—I
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTI NOR ALTERATION:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS: /'7f �L
coz, dy
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section ‘/ Block Lot 26(1-
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
ignature of Applicant
RECEIVED BY :
Town Clerk's Office
DATE:
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