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Home My WebLink AboutConway, John '',�, ilii --- ,Oi„S0fO4c0 JUDITH T.TERRY ,I o� y< • Town Hall,53095 Main Road TOWN CLERK t P.O.Box 1179 PPI � ti Z � ,� Southold,New York 11971 REGISTRAR OF VITAL STATISTICS �` ,f,,L �1 Fax(516)765-1823 MARRIAGE OFFICER �_-q0 a�� Tlephone(516)765-1800 RECORDS MANAGEMENT OFFICER 1 Telephone 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. 1325 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 AN OVERFLOW 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 CONWAY, JOHN L. Mailing Address 1 HORTON LANE City St Zip SOUTHOLD NY 11971 Property Address 1 HORTON LANE City St Zip SOUTHOLD NY 11971 Tax Map No. section 63.00 block 1 lot 1 .003 Cross Street ROUTE 48 Building Permit Number Cross Reference: Issue Date: 5/04/95 Judith T. Terry Southold Town Clerk (TOWN SEAL) /3 .2( ••• 4t, JUDITH T. TERRY _ ` ; Town Hall, 53095 Main Road P.O. Box 1179 TOWN CLERK � Southold, New York 11971 REGISTRAR OF VITAL STATISTICS . VO �. �� Fax (516) 765-1823 MARRIAGE OFFICER ,�� Telephone (516) 765-1801 RECORDS MANAGEMENT OFFICER '.. ) ,� FREEDOM OF INFORMATION OFFICER � iiii°% °�� OFFICE OF THE TOWN CLERK ;'; + TOWN OF SOUTHOLD TO: Southold Town Building Department API? 2 8 1995 FROM: Linda Cooper, Southold Town Clerk's Office DATED: April 28, 1995 Transmitted herewith is a copy of application No. A1374 for an ALTERATION PERMIT for a cesspool or septic system submitted by Morris Cesspool for J Conway 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. c-1 ce Linda J. Cooper * * * * * * * * * * * * * I have reviewed the application and location map of the project listed above and make the following recommendation: APPROVE - r/ DISAPPROVE - COMMENTS: Maintain required setbacks from adjacent wells, buildings, property lines and water bodies. EXCAVATION INSPECTION REQUIRED. 411 Are % Signatu e ! t)- 395 Dat: OFFICE OF THE TOWN CLERK ,,,'""" Town of Southold ,� OC,UFFDt�I'�/; Application No.,3 7y Judith T. Terry, Town Clerk •� � y Town Hall, 53095 Main Road � ` Construction P. 0. Box 1179 Alteration Southold, New York 11971 w !•��` • $10.00 - Residential 1 � Telephone _ �0 � • (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 k a?Q /5P5.- APPLICANT 5SAPPLICANT NAME: j//7421Z-4-o ice/ - APPLICANT ADDRESS: 7 �d �' , v SEPTIC CESSPOOL-{ DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION %1 LOCATION MAP: ' Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: / (i ,- Jefvkr L-1 OWNER MAILING ADDRESS: f�� s • OWNER PROPERTY ADDRESS: TELEPHONE NUMBER OF CONTACT PERSON: TAX MAP NO. : Section b 3 Block / Lot `• ,5 CROSS STREET: BUILDING PERMIT NUMBER CROSS REFERENCE: )4 Si nature of Applicant RECEIVED BY: wn Clerk's Office DATE: �� / I , \\\\ t4I • t00