HomeMy WebLinkAboutSarris, Alex e_O4�g�FFO1�CoG.
JUDITH T.TERRY � _ y�•` Town Hall, 53095 Main Road
TOWN CLERK ; N 2 P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS p �1�,
MARRIAGE OFFICER t. y O�'�1 Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER ��Q,( 4:00 Telephone (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. 1678 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 ADJACENT WELLS
BUILDINGS, PROPERTY LINES, AND WATER BODIES. EXCAVATION INSPECTION
REQUIRED.
Name Of Owner SARRIS, ALEX
Mailing Address 1 765 BAY AVENUE
City St Zip EAST MARION NY 11939
Property Address 1 765 BAY AVENUE
City St Zip EAST MARION NY 11939
Tax Map No. section 31 .00 block 10 lot 14.000
Cross Street ROUTE 25
Building Permit Number Cross Reference:
Issue Date: 6/02/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
4144'' 7.g/
-14$ tg's.
PR
Town Hall, 53095 Main Road
•I `Ow 0-1
� P.O. Box 1179
1�111 Southold, New York 11971
JUDITH T.TERRY `��� r' TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: May 29, 1997
Transmitted herewith is a copy of application No. 1753 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Alex Sarris
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.
I-
ignat re
Date
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OFFICE OF THE TOWN CLERK ,,,'"""'''
Town of Southold .0'1�4fil Lkee
Judith T. Terry, Town Clerk ;;'4 0l��; Application No. 17S 3
Town Hall, 53095 Main Road .�= Construction
P. O. Box 1179 : a, , Alteration
Southold, New York 11971 01 *'$
Telephone 0 �4' $10.00 - Residential
(516) 765-1801 1
•�' $25.00 -Non-Residential
- ,,,,,,0
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee •$
DATE /9y - / P
APPLICANT NAME: /14-042E,;
APPLICANT ADDRESS: ?�r, X Qo<
SEPTIC CESSPOOL i
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
6'" ,A-et_,,,,Lc,.),--- C2P
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: /9/,_,per S/"'-/ fr_S'
OWNER MAILING ADDRESS: 73 � /9, L-e
c41,. /- vr u , /-f / . 3 7
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 7 '5, 3C-) )
TAX MAP NO. : Section Block 76 Lot 7Y
CROSS STREET: 416.
BUILDING PERMIT NUMBER CROSS REFERENCE:
00'6 , ,,, 04/" .
Signature of Applicant
RECEIVED BY: , tO,(J--1-�
own Clerk's Office
DATE: � -Zg
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