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04
JUDITH T. TERRY
' Town Hall, 53095 Main Road
Z P.O. Box 1179
TOWN CLERK C= T
REGISTRAR OF VITAL STATISTICS �` Southold, New York 11971
MARRIAGE OFFICER ‘y�` �- °, Fax (516) 765-1823
��0 � Telephone (516) 765-1801
ilt
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 31 N Residential Non-Residential X
Fee $ 25.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : SEA BREEZE CESSPOOL
Address 1 : P. O. BOX 156
City St Zip CUTCHOGUE NY 11935
Descripton of Proposed Construction or Alteration
ADDITIONS TO AN EXISTING SYSTEM.
APPROVED AS INDICATED ON ATTACHED SKETCH. AMENDED TO HOLD 12' SEPARA-
TION. EXCAVATION INSPECTION REQUIRED. ****NOTE**** SUFFOLK COUNTY
DEPARTMENT OF HEALTH SERVICES APPROVAL IS REQUIRED BEFORE STARTING.
Name Of Owner BILLY'S BISTRO
Mailing Address 1 ROUTE 25
City St Zip GREENPORT NY 11944
Property Address 1 ROUTE 25
City St Zip GREENPORT NY 11944
Tax Map No. section 45.00 block 4 lot 7.000
Cross Street CHAPEL LANE
Building Permit Number Cross Reference:
Issue Date: 3/06/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
- ,��,1o��F'FOLKCOG Mit 21992 � 3 i
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JUDITH T. TERRY ` ; BLD s SPT Town Hall; 53095 Main Road
TOWN CLERK :Z. G T . -• ' �w�''�� •S S. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ._ Fax Fax (516) 765-1823
MARRIAGE OFFICER Q �' •
1%� •• Telephone (516) 765-1801
MOVED
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MAR OFFICE OF THE TOWN CLERK
O" 1Q47
TOWN OF SOUTHOLD
term Omit Soottiefd
MARCH 2, 1992
To: Southold Town Code Enforcement Officer
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A829 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
SEA BREEZE CESSPOOL FOR BILLY'S BISTRO
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 - TC
DISAPPROVE - !! nn
COMMENTS: ck..G, .t rt�t Ca o� oicl?nn�,L �,w�t �. odia ocL
aka-AA-44 to 14- S 11'-o Q•lw :fir. . cpai ).„.c
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4I`O ```en Signature
Date
4 r
' j:7 V Y
OFFICE' OF THE TOWN CLERK ,,,'"',"'"'--
' Town of Southold �,0"c,Of01.1(
Judith T. Terry, Town Clerk �%' ,. O4:. Application No. :9?
Town Hall, 53095 Main Road �� i.1
/
t. Construction
P. O. Box 1179 Alteration
Southold, New York 11971 c�t� �.`
Telephone �Qorit $10.00 - Residential
(516) 765-1801 40.1 l' , " $25.00 - Non-Residential c�--
-
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 13 --2-, '7_
APPLICANT NAME: j,o�_ ' 4 4 I , - I
APPLICANT ADDRESS: /, r ��yy & dinna h.OI
a .,.,,X )/735 OF
SEPTIC CESSPOOL
DESCRIPTION OF PROPOS D CONSTRUCTION OR ALTERATION S Iii ,-
a/
...44.3
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: { 1
OWNER MAILING ADDRESS: It _ ,:9\, .„,g /7
OWNER PROPERTY ADDRESS: 1�4V o ) ,"J.,4„2 il_e_s-cm,
TELEPHONE NUMBER OF CONTACT PERSON: 3,,73 -3(7(4.-7
TAX MAP NO. : Section1/ 2
Block Lot
CROSS STREET: ' A e ,.& Q-------
BUILDING PERMIT NUMBER CROSS REFERENCE:
AO
7e// ( 441 0 al Pi i
Signatureof • pplicant
RECEIVED BY:
T wn Clerk's Office
DATE: - 3/7— .-
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