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JUDITH T.TERRY �� = y< Town Hall, 53095 Main Road
TOWN CLERK k P.O. Box 1179
rrySouthold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICERjy 0� 'i� Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER ���.( * *;91. 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. 1481 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 WILLIAMS, JOE
Mailing Address 1 2060 REYDON DRIVE
City St Zip SOUTHOLD NY 11971
Property Address 1 2060 REYDON DRIVE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 80.00 block 3 lot 10.000
Cross Street
Building Permit Number Cross Reference:
Issue Date: 5/16/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
L I (15FT
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JUDITH T.TERRY ����� yt Town Hall, 53095 Main Road
TOWN CLERK ; N 2 P.O. Box 1179
171 1 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS %*, � �� Fax (516) 765-1823
MARRIAGE OFFICER �Q a0'��� Telephone(516) 765 1800
RECORDS MANAGEMENT OFFICER 1 l - .,
FREEDOM OF INFORMATION OFFICER ,•�,,
OFFICE OF THE TOWN CLERK Q U 1
TOWN OF SOUTHOLD
TO: Southold Town Building Department a I 0
FROM: Linda Cooper, Southold Town Clerk's Office ' ,
DATED: May 10, 1996
Transmitted herewith is a copy of application No. A5143 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Joseph Williams • .
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.
-ccs
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.
ignatur-
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OFFICE OF THE TOWN CLERK ,,r'",,,,---
Town of Southoldr'r'c'J\\VOLk`'- cit
,3
Judith T. Terry, Town Clerk s
Application No/� G
Town Hall, 53095 Main Road ;%a !G ; Construction
P. O. Box 1179
Southold, New York 11971 r"' Alteration
Telephone O,y 4,1
$10.00 - Residential
(516) 765-1801 �l ��
$25.00 -Non-Residential
• - ' ' I,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ ,Q
DATE
C7,-(7
APPLICANT NAME: �2y�
APPLICANT ADDRESS: i , i/ 91
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SEPTIC CESSPOOL'/
DESCRIPTION W'OPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR AL RAT ION:
OWNER OF PROPERTY: .4� %,/,"
OWNER MAILING ADDRESS: .490(d GI? _.
__S-10-eli:/-1/ 4 y
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:_____ de_.)
TAX MAP NO. : Section to Block 3 Lot /d
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
— ._ /frit //' / G �
Signature of Applicant
RECEIVED BY:` Z ■'f1
Town Zaee s-Office
DATE: MAY 1 0 1996
Town Cleric Solid
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