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Home My WebLink AboutMallon, Robert /,l_, ,�� OFF04 d�‘°0 COG JUDITH T.TERRY ��= yj • Town Hall, 53095 Main Road TOWN CLERK A ty i A P.O. Box 1179 REGISTRAR.OF VITAL STATISTICS 1�, Southold, New York 11971 MARRIAGE OFFICER yif, 0�•1�' Fax(516) 765-1823 RECORDS MANAGEMENT OFFICER O! * �a I� Fax (516) 765-1800 FREEDOM OF INFORMATION OFFICER �,.,„ ,0"� OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1732 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 MALLON, ROBERT Mailing Address 1 1250 SMITH ROAD City St Zip PECONIC NY 11958 Property Address 1 1250 SMITH ROAD City St Zip PECONIC NY 11958 Tax Map No. section 98.00 block 3 lot 26.000 Cross Street Building Permit Number Cross Reference: Issue Date: 9/19/97 Judith T. Terry Southold Town Clerk (TOWN SEAL) / 73,,,,,.z �g�FFO0,tc Hall • JUDITH T.TERRY Is= Towny : > 53095 Main Road TOWN CLERK ; y i P.O. Box 1179 rrtSouthold,New York 11971 REGISTRAR OF VITAL STATISTICS /��, O MARRIAGE OFFICER ��y �� Fax (516) 765 1823 RECORDS MANAGEMENT OFFICER =�e.( '' * $ '� Telephone (516) 765-1800 FREEDOM OF INFORMATION OFFICER ,•des OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda Cooper, Southold Town Clerk's Office DATED: September 19, 1997 Transmitted herewith is a copy of application No. 1805 for an ALTERATION PERMIT for a cesspool or septic system submitted by Morris Cesspool for Robert Mallon 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. ignatu Date OFFICE OF THE TOWN CLERK ��,,,''',,,•,•",' G Town of Southold ' .04fWire _ Application No. lad Judith T. Terry, Town Clerk ` Town Hall, 53095 Main Road ;� Construction P. O. Box 1179 : Alteration e/ Southold, New York 11971 ;� *.; _ _. 0-0 $10.00 - Residential Telephone , (516) 765-1801 _ �' $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 WT. 7 ? APPLICANT NAME: APPLICANT ADDRESS: jA SEPTIC CESSPOOL. DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION 4)--1)- A/464) LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY : OWNER MAILING ADDRESS: /2)-6) .57P,'�� /9 OWNER PROPERTY ADDRESS: TELEPHONE NUMBER OF CONTACT PERSON: 7 -54---....-?,ftfe) TAX MAP NO. : Section 9(f Block Lot ,F‘ CROSS STREET: BUILDING PERMIT NUMBER CROSS REFERENCE: ignature of Applicant RECEIVED BY: Town erk's Office DATE: ?-7Q-?7 NJ1-k c� 10 TT ^ te&ji (