HomeMy WebLinkAboutBirkmier, John-Noir si
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JUDITH T. TERRY z,
Town Hall, 53095 Main Road
' P.O. Box 1179
TOWN CLERK �� Southold, New York 11971
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REGISTRAR OF VITAL STATISTICS %* �. ,' Fax (516) 765-1823
MARRIAGE OFFICER � �O • Tel (516) 765-1801
RECORDS MANAGEMENT OFFICER = "K/ + 'r'e
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. 1150 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 BIRKMIER, JOHN
Mailing Address 1 48850 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 SAME
City St Zip 0000
Tax Map No. section 70.00 block 7 lot 10.000
Cross Street PEANUT ALLEY
Building Permit Number Cross Reference:
Issue Date: 6/15/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY : ' 4 yA.
'L Town Hall, 53095 Main Road
TOWN CLERK : o T : P.O. Box 1179
VI W $ Southold, New York 11971
REGISTRAR OF VITAL STATISTICS "-T0,46,. �. �� Fax (516) 765-1823
MARRIAGE OFFICER _ .aO .�� Fax
(516) 765-1801
RECORDS MANAGEMENT OFFICER '7_�f(/I 4 'I,,i�
FREEDOM OF INFORMATION OFFICER ..„viii/
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OFFICE OF THE TOWN CLERK % I-A fa ..
TOWN OF SOUTHOLD
.11 1 51°94
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office g1,DG.DEPL
TOWN OF SOt w
DATED: June 15, 1994
Transmitted herewith is a copy of application No. A1192 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool Service for John Birkmier .
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. _
4-4X-‘?'"-
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - !� 1
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DISAPPROVE - :i
COMMENTS: __ r :a.f
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Signature
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OFFICE OF THE TOWN CLERK ,��'""�""'
Town of Southold .�' , ,\VOLI(4;
Town Clerk 3, OG Application No. /7 J t_
Judith T. Terry, y'
Town Hall, 53095 Main Road z Construction
P. O. Box 1179 Alteration
Southold, New York 11971 . U' W
Telephone .r0,� Q , $10.00 - ResidentialO
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(516) 765-1801 =�'1 � �, '' $25.00 - Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE
APPLICANT NAME: 4,f'A
APPLICANT ADDRESS: Pc 7r/Iiii �a c <
SEPTIC CESSPOOL 47
DESCRIPTION OF PR POSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR AJ..TERATION:
OWNER OF PROPERTY: p � Aftk5�,:ee
OWNER MAILING ADDRESS: /p erS`a /0lgC4 4ed
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section 76 Block 7 Lot /O
CROSS STREET: 'f .,(1
BUILDING PERMIT NUMBER CROSS REFERENCE:
/ Signature of Applicant
RECEIVED BY;A j
Town Cler 's Office
DATE:
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