HomeMy WebLinkAboutJackson, Jesse JUDITH T. TERRY � :AC Town Hall, 53095 Main Road
TOWN CLERK Z P.O. Box 1 179
v '�' Southold, New York 11971
REGISTRAR OF VITAL STATISTICS tri Fax 765-1823
MARRIAGE OFFICER VO
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 30 N Residential Non-Residential X
Fee $ 25.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : ARLEEN J. MCCARVILL
Address 1 : 7390 SOUNDVIEW AVENUE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
NEW BUSINESS WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 6/18/91 .
Name Of Owner JACKSON, JESSE
Mailing Address 1 P. O. BOX 2066
City St Zip AQUEBOGUE NY 11931
Property Address 1 54195 MAIN ROAD
BAYSIDE DELI
City St Zip SOUTHOLD NY 11971
Tax Map No. section 61 .00 block 2 lot 8.000
Cross Street YOUNGS AVENUE
Building Permit Number Cross. Reference:
Issue Date: 7/26/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
INcNa\V
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Ellirts , - AL I T X91
JUDITH T. TERRY �� `: iI I, 53095 Main Road
TOWN CLERK �' BLDG. DEPT. P . Box 1 179
TOWN OF SOUTHOLp,,,th
REGISTRAR OF VITAL STATISTICS Z. � rT '� NeW YoCk 1 1971
*' , Fax (516) 765-1823
MARRIAGE OFFICER ‘V
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
July 17, 1991
To: Southold Town Code Enforcement Officer
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. 758 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Arleen J. McCarvill - Bayside Deli
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 - I<
DISAPPROVE - 1
COMMENTS: • _ _,, _� ` _ `..1_' .� l
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Signature
RECEIVED
Date
1 �'`°\C:t
' JUL z s 19e1
e 1 ,
1^V
OFI lCE OF THE TOWN CLERK
Town of Southold �.0'10fULA
Judith T. Terry, Town Clerk ;' � V.•_ Application No. �s
Town Hall, 53095 Main Road ;$ Construction
P. O. Box 1179 o rrn : Alteration
Southold, New York 11971 ;til W;
Tele hone 0� Q�i� $10.00 - Residential
p
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(516) 765-1801 . 1 4 �,, ' $25.00 -Non-Residential
• -- ,„,,,,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE41--cdcb /w -
APPLICANT NAME: // Le�N pc. (4At.it — Ap-s.,,, D-
APPLICANT ADDRESS: p/ne.- - 2'3 )e .) ---Ct.v--g__- ; N;y.
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SEPTIC / CESSPOOLZ
DESCRIPTION
�OFF PROPOSED CONSTRUCTION OR ALTERATION
- ,.._,,e)._,<_,.. c a. , c ____,
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 7,-Z ,5) ,,4ttja-e9-.---
OWNER MAILING ADDRESS: /20 Z -066/ `A I//3/
OWNER PROPERTY ADDRESS: ,,f-r/9,5" 7 Tae_ A. >efp-e.."--. 1-4)
TELEPHONE NUMBER OF CONTACT PERSON: 765C- 3377 7 c,___3&e,
'
TAX MAP NO. : Section 6./ Block �-- Lot
CROSS STREET am----
BUILDING PERMIT NUMBER CROSS REFERENCE:
OIA,--. ih- /
Signature of Applicant
RECEIVED BY: , LA-)X---e-fe--------,‘JI"ownClerk' ice
DATE: ( / Co 7 /
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APPROVED FOR CONSTRUCTION ONLY 4.`.7.—.4` .a.--'
H.S.REF.NO. CI r--�1(—°°"1
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This approval is granted for the construction of the sanitary � ;,
disposal and water supply facilities pursuant to Articles V8 and 1f<" +^`>
7 of the Suffolk County Sanitary Code and is not an expressed !,
nor implied approval to discharge from or occupy the s';; ' '�
structure(s)shown. THIS APPROVAL EXPIRES TWO(2)YEARS `f
FROM THE DATE BELOW. - f:
JUN 1 8 1991 $5t,141.:2,. a. c,rta. EE,. ,,,...i.:H .„
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