HomeMy WebLinkAboutBetsch, Edward 4
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JUDITH T.TERRYtt = y1 % Town Hall, 53095 Main Road
TOWN CLERK •y Z P.O.Box 1179
,�� Southold,New York 11971
REGISTRAR OF VITAL STATISTICS 0,y,L �I Fax(516)765-1823
MARRIAGE OFFICER :_-q0 l Ali Telephone(516) -1823 00
RECORDS MANAGEMENT OFFICER 4 * . ,lP
FREEDOM OF INFORMATION OFFICER .'-'•~... s•'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1362 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 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 BETSCH, EDWARD
Mailing Address 1 BOX 92
City St Zip EAST MARION NY 11939
Property Address 1 625 RABBIT LANE
City St Zip EAST MARION NY 11939
Tax Map No. section 31 .00 block 17 lot 15.000
Cross Street BAY AVENUE
Building Permit Number Cross Reference:
Issue Date: 7/26/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERR' o= 1 Town Hall, 53095 Main Road
TOWN CLERK ti Z P.O.Box 1179
REGISTRAR OF VITAL STATISTICS O � Southold,New York 11971
MARRIAGE OFFICER J aQ� Fax(516)765-1823
RECORDS MANAGEMENT OFFICER 49.� * is�� Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER _ o't
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD JUL 0 1995
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: July 20, 1995
Transmitted herewith is a copy of application No. A1414 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Edward Betsch
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 -
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
RECEIVED
Signa ure
dill 2 4 1995 o S
1 own Clerk .Southold
OFFICE OF THE TOWN CLERK ",,,,,
Town of Southold �FF01.K
Clerk CD Application No./WY
Town
Judith T. Terry, ;�
Town Hall, 53095 Main Road ;Z Construction
P. O. Box 1179 a 'c : /
Southold, New York 11971 tJ� �'$� Alteration
Telephone ����' $10.00 - Residential
.
(516) 765-1801 =i1 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 ..42 fps'
APPLICANT NAME:
APPLICANT ADDRESS: . 7‘c)
SEPTIC 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: 25 4e_ Y-, L,e/'/ 45424-eA
OWNER MAILING ADDRESS:
eaK ;i( 7
OWNER PROPERTY ADDRESS: �� t-- ''Z
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section 3( Block / 7 Lot (>�
CROSS STREET: .J /
BUILDING PERMIT NUMBER CROSS REFERENCE:
ic") 2) //7/2- 1;
ignature of Applicant
RECEIVED BY: RECEIVED
Town Clerk's Office
DATE: JUL 2 0 1995
Southold Town Clerk
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