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JUDITH T. TERRY ; 1 �G : Town Hall, 53095 Main Road
TOWN CLERK v T P.O. Box 1179
REGISTRAR OF VITAL STATISTICS : Southold, New York 11971
MARRIAGE OFFICER VO Fax (516) 765-1823
_-4+ ��Q ��' Tel (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 778 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL
Address 1 :
City St Zip 00000
Descripton of Proposed Construction or Alteration
REPLACE EXISTING SYSTEM WITH NEW SEPTIC TANK AND CESSPOOL
APPROVED AS SUBMITTED. EXCAVATION INSPECTION REQUIRED.
Name Of Owner CENTRAL FEDERAL SAVINGS BANK
Mailing Address 1 CRITTEN LANE
City St Zip SOUTHOLD NY 11971
Property Address 1 CRITTEN LANE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 70.00 block 12 lot 1 .000
Cross Street PINE NECK ROAD
Building Permit Number Cross Reference:
Issue Date: 11/20/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY ��,�O Gj Town Hall, 53095 Main Road
TOWN CLERK _ P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS rr' Southold, New York 11971
MARRIAGE OFFICER y ���� Fax (516) 765-1823
04, .0-0 Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
November 20, 1991
To: Southold Town Code Enforcement Officer
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A799 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Central Federal Savings Bank
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 foli9w'ing recommendation:
APPROVE - ✓/
DISAPPROVE -
COMMENTS:
Signatur
iSRA
Date
OFFICE OF THE TOWN CLERK '"',"
Town of Southold Application No.
Judith T. Terry, Town Clerk7°
Town Hall, 53095 Main Road ;` G= Construction
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P. 0.. Box 1179 sem*,
Southold,
New York 11971 *. Alteration
Telephone ��
$10.00 - Residential
(516) 765-1801 - jIt 4047°7' $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 ice/& 2o,. /99/
APPLICANT NAME: ,t d/2& S GE-53,ov/APPLICANT ADDRESS: 27c . ' f!Co rr
�1 .c/; ( 97/
SEPTIC Y CESSPOOL-
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: � -//,°Q/ cJ `/ / :': Q7/ , �/`���► f' t�
f
OWNER MAILING ADDRESS: ee/ / 4'1 42_
OWNER PROPERTY ADDRESS: CC
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section � Block / ! Lot
CROSS STREET: �/7� ///sc
BUILDING PERMIT NUMBER CROSS REFERENCE:
7//4 (
Signature of Applicant
RECEIVED BY:
Town Clerk's OfRECOVED
DATE:
usin clerk SNOW Town Clerk
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