HomeMy WebLinkAboutLacey, Randy JUDITH T. TERRY ; Town Hall, 53095 Main Road
TOWN CLERK G T P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS tri Southold, New York 11971
MARRIAGE OFFICER =yQ` O�' �4, Fax (516) 765-1823
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(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. 1100 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL SERVICE
Address 1 : 2760 YENNECOTT DRIVE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITON OF AN OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED DISTANCES FROM ADJACENT WELL
WELLS, BUILDINGS, AND PROPERTY LINES. EXCAVATION INSPECTION REQUIRED.
Name Of Owner LACEY, RANDY
Mailing Address 1 (TENANT: DOROSKI)
City St Zip 0000
Property Address 1 6785 MAIN ROAD
City St Zip EAST MARION NY 11939
Tax Map No. section 31 .00 block 1 lot 1 .000
Cross Street GILLETTE DRIVE
Building Permit Number Cross Reference:
Issue Date: 3/21/94 Judith T. Terry
Southold Town Clerk
LTOWN SEAL)
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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK t p ' P.O. BOX 1 179
REGISTRAR OF VITAL STATISTICS ` Southold, New York 11971
MARRIAGE OFFICER yQ O�'eel
Fax (516) 765 1823
=_ Llwl �1D '� Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD ..
!' :\ MAR 18 ,
TO: Southold Town Building Department ;',1 :: ----
FROM: Linda Cooper, Southold Town Clerk's Office
DATED:
DATED: March 18, 1994
Transmitted herewith is a copy of application No. A1140 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cess•ool for a G, 8 e L.:
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. —
Yie-/kee-e-c
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation: EXCAVATION INSPECTION
APPROVE - REQUIRED
DISAPPROVE -
COMMENTS: tTaisfil
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Signat e
Date //AP
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OFFICE OF THE TOWN CLERK ,,,'",,,, _
Town of Southold VOLA'`'.
Town Clerk ' �� Ol/ Application No. / / 6
Judith T. Terry,
Town Hall, 53095 Main Road Construction
P. O. Box 1179 ` c rr,
Southold, New York 11971 �tiff Alteration
$10.00 - Residential r—
Telephone # 01 4' 01-
(516) 765-1801 $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 $ /6 - /pc,
DATE
APPLICANT NAME: '1"Y? G 1zr
APPLICANT ADDRESS: - 07t , 7v o
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ._/9 e�y SAN iv) cc_ (10evn 124.-( Sce. Fr oc44-
(cice�r
OWNER MAILING ADDRESS:
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OWNER PROPERTY ADDRESS: 1 cS A //v RI)
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TELEPHONE NUMBER OF CONTACT PERSON: 7 ' S – 3 3 C> c'
TAX MAP NO. : Section 3( Block / Lot
CROSS STREET: p�s
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED -
To
Town erk's Office
DATE: 3/ ---/Z? c./
OF1ICE-OF THE TOWN CLERK ,,,'",,,,-"--
Town of Southold .''I �FFOUKC, C)
Judith T. Terry, Town Clerk �' �� �l/y Application No.//Y
Town Hall, 53095 Main Road Z Construction
P. O. Box 1179 ; v n=+ ; Alteration
Southold, New York 11971 sto W —
O �� $10.00 - Residential -
Telephone '_�' 1►!
(516) 765-1801 "1 .4g •' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ DATE / / (/'
APPLICANT NAME: //).;i052W té4',/?/(
APPLICANT ADDRESS: A /U Iv<
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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: /17a1(.5 C
OWNER MAILING ADDRESS: 27‘d
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OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 7 ,Y.3 v G
TAX MAP NO. : Section �7 Block 7 Lot 2
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY:
Re k's Office
DATE:
MAR 1 8 1994
town Clerk &off
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