HomeMy WebLinkAboutRobinson, David Dr JUDITH T. TERRY < ; Town Hall, 53095 Main Road
TOWN CLERK p T P.O. Box 1179
REGISTRAR OF VITAL STATISTICSs Southold, New York 11971
MARRIAGE OFFICER •yO 0 .4, Fax (516) 765-1823
� 1 1";0'.� Fax
(516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 39 N Residential Non-Residential X
Fee $ 25.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL
Address 1 : 2760 YENNECOTT DRIVE
City St Zip SOUTHOLD NY 11952
Descripton of Proposed Construction or Alteration
ADDITION OF AN OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED - MAINTAIN REQUIRED SCHD SETBACKS FROM PROPERTY
LINES AND BUILDINGS. EXCAVATION INSPECTION REQUIRED.
Name Of Owner ROBINSON, DR. DAVID
Mailing Address 1 56850 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 56850 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 62.00 block 4 lot 1 .000
Cross Street TOWN HARBOR LANE
Building Permit Number Cross Reference:
Issue Date: 8/04/93 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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ov '74 . 1 . 231993 `�y,� —
JUDITH T. TERRY : ` ; Tgwn Hall, 53095 Main Road
TOWN CLERK : p T L4 -------4,
'� P.O. BOX 1179
REGISTRAR OF VITAL STATISTICS ch •%` TOWN t+ , E-,r oSouthold, New York 11971
MARRIAGE OFFICER .yQ �- Fax (516) 765 1823
_',yo ��� �0 Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: July 23, 1993
• Transmitted herewith is a copy of application No. A1061 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
• Morris for Dr. David Robinson
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 - e-------- EXCAYA� 'NS�ON
DISAPPROVE - GA4A REQUIRED
COMMENTS: ., , . r ._!_d ",j
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AUG 3 19143 Sigriatu e1min Oa "di 3
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Date �/
OFFICE OF THE TOWN CLERK ,,,,'",,,,----,--
Town of Southold �.'�1 C��FF01x`'0 Application No. /0 to 7
Judith T. Terry, Town Clerk 1,`'% Gy
Town Hall, 53095 Main Road Z .4.1'. Construction
P. O. Box 1179 =v m Alteration
Southold, New York 11971492
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Telephone =�0,��0 �����' $10.00 - Residential
(516) 765-1801 - l l , ,Fe. $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ ate- 7
DATE („4 ' l'/7 / ( f-
; 1
APPLICANT NAME: /;&I't-c_ 7'
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APPLICANT ADDRESS: pallq ,/
/7
SEPTIC CESSPOOL _J
DESCRIPTION OF PROP* ED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTS"; TION:
OWNER OF PROPERTY: ,,{ AOPZ.I,/ // ' .ile-7,--7
OWNER MAILING ADDRESS: ,5:‘.4C. el
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: Xr--...13C):0---
TAX
MAP NO. : Section 6� Block j Lot /
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
1(14--e- ' ‘2-Aotior-Vii
Signature of Applicant
RECEIVED BY:
Town /
erk's Office
DATE: yol ./ 3
111
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