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JUDITH T.TERRY � < Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. Box 1179
��� Southold, New York 11971
;
REGISTRAR OF VITAL STATISTICS t �4�� Fax (516) 765-1823
MARRIAGE OFFICER • .1
RECORDS MANAGEMENT OFFICER Ol * *D�,11Fax
(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. 1550 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL SERVICE
Address 1 : 2760 YENNECOTT ROAD
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, AND PROPERTY LINES. EXCAVATION INSPECTION REQUIRED.
Name Of Owner SWANN, FRANK
Mailing Address 1 560 FLINT STRRRET
City St Zip GREENPORT NY 11944
Property Address 1 636 SEVENTH STREET
City St Zip GREENPORT NY 11944
Tax Map No. section 48.00 block 2 lot 18.000
Cross Street FLINT STREET
Building Permit Number Cross Reference:
Issue Date: 9/30/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
•
.16
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JUDITH T.TERRY t �� yet Town Hall, 53095 Main Road
TOWN CLERK ` N = P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS �,
MARRIAGE OFFICER V' 0��11' Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER ; �1 * #aSII�6 Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ,0'°°
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: September 20, 1996
Transmitted herewith is a copy of application No. 1616 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Frank Swann
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.
Sig ature
Date
T^
OFFICE OF THE TOWN CLERK ,,,'"' -''-
Town of Southold ,�' ,cAFFO ce,
Judith T. Terry, Town Clerk �' � Application No,/ / �
Town Hall, 53095 Main Road Construction
P. 0. Box 1179 ; v Alteration
Southold, New York 11971 • cn
,0 0-/ $10.00 -Residential
Telephone �.j,�
(516) 765-1801 _ 11 $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ �j/
DATE O / v
APPLICANT NAME: fi700-,L5
APPLICANT ADDRESS: ..e ?‘
SEPTIC CESSPOOL
DESCRIPTION 0 P OPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ,e/ i4//f
OWNER MAILING ADDRESS: C.() FL1}- ,('_
OWNER PROPERTY ADDRESS: C3 ,5.4_e_er77,.,9
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section Lif" Block 2_ Lot 743---
CROSS STREET:______________________s-
BUILDING PERMIT NUMBER CROSS REFERENCE:
/91
ignature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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