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JUDITH T.TERRY ��"� 4_
JUDITH Town Hall, 53095 Main Road
TOWN CLERK 1:3
.c P.O. Box 1179
x Southold, New York 11971
REGISTRAR OF VITAL STATISTICSk%%34 ��
MARRIAGE OFFICER = O�'�1 Fax (516) 765-1823
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RECORDS MANAGEMENT OFFICER `: 0,( sit $ �� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ..."•••-~„ �,i���
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1625 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 WASMUND, PAUL
Mailing Address 1 2075 REYDON DRIVE
City St Zip SOUTHOLD NY 11971
Property Address 1 2075 REYDON DRIVE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 80.00 block 2 lot 22.000
Cross Street
Building Permit Number Cross Reference:
Issue Date: 3/20/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY t _� 54, is Town Hall, 53095 Main Road
TOWN CLERK ; y Z • P.O. Box 1179
REGISTRAR OF VITAL STATISTICS 'sk � % 4 Southold, New York 11971
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER �! * _`a�'��� Fax(516) 765-1823
Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER +�� uF SC
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: March 14, 1997
Transmitted herewith is a copy of application No. 1697 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Paul Wanmund •
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.
RECEIVED
MAR 2 0 1991 ,/,"_.„•/
Signatur
Southold Town Clerk 3//y
Date
" OFFICE OF THE TOWN CLERK
Town of Southold ,,04AVDtke _ (p
./
Judith T. Terry, Town Clerk Application N
Town Hall, 53095 Main Road Construction
P. O. Box 1179 Alteration
Southold, New York 11971 ;� �;
Tele hone �y0,r Are. $10.00 -Residential
P ►'
4.7
(516) 765-1801 = 9/ $25.00 -Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE fiA,(-- 7 / 7
APPLICANT NAME: ✓ L(, �' 0,�'` '- 12`
APPLICANT ADDRESS: 22o , J2'c
SEPTIC CESSPOOL-4
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:�� JJ
OWNER OF PROPERTY: G
� Gla-oft ,
OWNER MAILING ADDRESS: ot7O75 /ey ,0<-
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:_,
TAX MAP NO. : Section YO yBlock . Lot s�
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
221-
(9--14. 612 ,7e41c-;
Signature of Applicant
RECEIVED BY: X.
(Cr9-rs ;l
Town erk's Office
DATE: - !_f•- ��
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