HomeMy WebLinkAboutCornwell, Margaret (2) f-
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Town Hall, 53095 Main Road
��� P.O. Box 1179
�� o'� Southold, New York 11971
JUDITH T.TERRY Ol ,,�.0'°• FAX(516)765-1823
TOWN CLERK TELEPHONE(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 515 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : DAYSMAN MORRIS
Address 1 : 2760 YENNECOTT DRIVE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
NEW CESSPOOL TO EXISTING SYSTEM.
APPROVED AS SUBMITTED. MUST STRICTLY ADHERE TO THE TWO (2) FEET ABOVE
THE WATER TABLE. NOTE: INSPECTION REQUIRED BEFORE BACKFILLING.
Name Of Owner CORNWELL, MARGARET
Mailing Address 1 HAYWATERS ROAD
City St Zip CUTCHOGUE NY 11935
Property Address 1 HAYWATERS ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 111 .00 block 1 lot 6.000
Cross Street BROADWATERS ROAD
Building Permit Number Cross Reference:
Issue Date: 7/27/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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BLDG.DEPT. �` Town Hall, 53095 Main Road
I P.O. Box 1179
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Southold, New York 11971
JUDITH T. TERRY "��� °° TELEPHONE
, TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
July 19, 1989
To: Victor Lessard, Southold Town Building Department
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No.A 528 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Daysman Morris for Margret Cornwell
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 - X
DISAPPROVE -
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Signature Cfp-t...-o °L.(j„,_,
JUL 2 61989 I --°\ I I
Date
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OFFICE OF T,HE TOWN CLERK c.OFU(,(r
Town of Sothold Clerk � Application No. 5l g
Judith T. Terry, Town e k ..
Town Hall, 53095 Main Road Construction_
P. O. Box 1179 *'$ Alteration i/
Southold, New York 11971 ��
Telephone �Ol �t �� �� Residential
p
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE )t,(, 1>/. /zj ' T
APPLICANT NAME: WICV2 iAh°,+C-L-
APPLICANT ADDRESS: //S— 1,1141-4 Wt. o274
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SEPTIC CESSPOOL I/
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION ›Z.cr/
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Ma/Z 3A.C- (e.17/32.44,d.Z6
OWNER MAILING ADDRESS:: 1.1--al tLi Pd
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OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 73 9 (A17
TAX MAP NO. : Section /1/ Block / Lot 6
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
6‘",--#02? de
S'gnature of Applicant
RECEIVED BY: ‘,7 Lk-rN-t
Town Clerk's Office
DATE: 77-7 �-�
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