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JUDITH T.TERRY � _ y1 Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
�� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS `Dy ,411
MARRIAGE Fax (516) 765-1823
MARRIAGE OFFICER i .a' I Fax
(516) -1823 765-1800
RECORDS MANAGEMENT OFFICER 1 �►
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. 1551 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, AND PROPERTY LINES. EXCAVATION INSPECTION REQUIRED.
Name Of Owner UDELL, CLIFFORD
Mailing Address 1 755 KNAPP PLACE
City St Zip GREENPORT NY 11944
Property Address 1 755 KNAPP PLACE
City St Zip GREENPORT NY 11944
Tax Map No. section 34.00 block 2 lot 8.000
Cross Street BAILEY
Building Permit Number Cross Reference:
Issue Date: 9/30/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY Town Hall, 53095 Main Road
TOWN CLERK y Z P.O. Box 1179
W P � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER � 0� �1�' Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER ! '1►a�d� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER
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. 1617 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Clifford Udell
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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.
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Tiglature
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Date
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OFFICE OF THE TOWN CLERK ,''' '-
Town of Southold �FFO(x
Judith T. Terry, Town Clerk � Application No. /6/7
Town Hall, 53095 Main Road
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Construction
P. 0. Box 1179
Southold, New York 11971 Alteration
Telephone =oy $10.00 - Residential
(516) 765-1801 $25.00 y0.� '�
$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 $ ,l
DATE ,5CJ
APPLICANT NAME: di2efereej
APPLICANT ADDRESS:
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATIO :
OWNER OF PROPERTY: � Q
OWNER MAILING ADDRESS: -S-- !07/9,,,,e, "4
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section Block 2 Lot
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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