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Home My WebLink AboutBeaury, Frank (2) SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 4089 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool 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 TO EXISTING SYSTEM. APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION REQUIRED. Name Of Owner FRANK BEAURY Mailing Address 1 35 RABBIT LANE City St Zip EAST MARION NY 11939 Property Address 1 35 RABBIT LANE City St Zip EAST MARION NY 11939 Tax Map No. section 31.00 block 17 lot 8.005 Cross Street BAY AVENUE Building Permit Number Cross Reference: Issue Date: 6/18/12 Elizabeth A. Neville Southold Town Clerk • ��'�g11FF0(,�►c • ELIZABETH A.NEVILLE,MMC � � G.j, Town Hall,53095 Main Road TOWN CLERK p P.O.Box 1179 ti 2 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS v' D .F Fax(631)765-6145 MARRIAGE OFFICER �� RECORDS OF MANAGEMENT OFFICER `_�0,� * �►`�;,�,0.� Telephone(631)765 1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department RECEI1WE FROM: Carol Hydell, Southold Town Clerk's Office JUN 62012 DATED: June 6, 2012 BLDG.DEPT. RE: Cesspool Construction Application TOWN OF SOUTHOLD Transmitted herewith is a copy of application No. 4089 for a Cesspool/Septic Tank Construction Permit submitted by: Morris Cesspool for Beaury 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 me. Thank you. * * * * * * * * * * * * I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE DISAPPROVE Comments: / de jr • r 441 - � Signature Dated `vV ELIZABETH A.NEVILLE ,0 \ Town Hall, 53095 Main Road TOWN CLERK ; O A , P.O. Box 1179 REGISTRAR OF VITAL STATISTICS � �; Southold, New York 11971 MARRIAGE OFFICER : G 1 Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER `�y�� •"•,'1 Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER - '1 4. ' " southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @ $10 or Non-Residential @$25 Application No. Permit No. Applicant Name /' b/�Q . L-45sSP ,�` Applicant Mailing Address 2 766 '/ ifr%co 7"t flie f o 4"s Septic Tank or Cesspool Brief Description of Proposed Construction or Alteration OZ.)-84-fiaz.) Location of Proposed Construction/Alteration: Owner of Property: / /�R� �� A/41 }/ Owner Mailing Address: ,21 4-- X74-rr /lit+IZ,'Q,1J Owner Property Address: Name and phone number of contact person Tax Map No: Section ,3/ Block / 7 Lot GP, r Cross Street /4 7 A-(A)7- NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL o-r-ty4 )z) /Z- Signature of Applicant Date Received by: �` 62- 01 p :tori G�"' 1 _ 1 r 115° f,6 1