HomeMy WebLinkAboutThompson, Helen 3 I, O.
to"e 6SVFFco
G �
JUDITH T.TERRY � _% 1`� Town Hall, 53095 Main Road
TOWN CLERK ; y = P.O. Box 1179
REGISTRAR OF VITAL STATISTICS O Southold, New York 11971
��
MARRIAGE OFFICER yijJ Fax(516) 765-1823
�I
RECORDS MANAGEMENT OFFICER 0d * �all Fax
(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. 1661 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 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 THOMPSON, HELEN
Mailing Address 1 1595 BAYVIEW AVENUE
City St Zip GREENPORT NY 11944
Property Address 1 1595 BAYVIEW AVENUE
City St Zip GREENPORT NY 11944
Tax Map No. section 52.00 block 5 lot 9.000
Cross Street COLONY ROAD
Building Permit Number Cross Reference:
Issue Date: 5/12/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
, o
B Town Hall, 53095 Main Road
I�1�0 i P.O. Box 1 179
I ��� J Southold, New York 11971
JUDITH T.TERRY �, 'l _ TELEPHONE
TOWN CLERK ,`����� •_ (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
2/Y
TOWN OF SOUTHOLD
it:eAort_..
v
TO: Southold Town Building Department Ole
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: May 7, 1997
Transmitted herewith is a copy of application No. 1742 for a Cesspool/
Septic Tank Construction Permit submitted by:
Morris Cesspool for Helen Thompson
Please review the application and location map and advise if the project
has received Suffolk County Health Department approval and if this office
may issue the permit.
Please complete the form below and return it to me.
Thank you.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments:
RECEIVED
MAY 8 1997
Signatur
Southold Town Crena; s 77
Dated
OFFICE OF THE TOWN CLERK ,,,'",,
Town of Southold � D Application No. 1 ��
Judith T. Terry, Town Clerk
cc:
Town Hall, 53095 Main Road ;,� ; Construction
P. O. Box 1179
Southold, New York 11971 v� � Alteration /
Telephone � ,r tylow
.0/, $10.00 - Residential !//
(516) 765-1801 = 1 �,,''�� $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE '4'26-/
APPLICANT
�7 "
APPLICANT NAME:
APPLICANT ADDRESS: c 2k)
SEPTIC CESSPOOL
DESCRIPTION OF P OPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTIO R ALTERATION:
OWNER OF PROPERTY: � �.e*-8-,
OWNER MAILING ADDRESS: /5r5
7
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 7,4--37,5fCfa)
TAX MAP NO. : Section Block � Lot 9
CROSS STREET: ()0/04)/ /4eV
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY: 'l( /V—A-e---*t_frtre_
Town Clerk's 0
DATE: 7/-7
IP.
•