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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK . p rTi P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS � Southold, New York 11971
MARRIAGE OFFICER
�i Fax (516) 765-1823
�1�� �� Tel (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. 812 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
INSTALL OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. HOLD 10'0" SEPARATION. EXCAVATION INSPECTION
REQUIRED. CALL BUILDING DEPT. 765-1802 FOR AN APPOINTMENT.
Name Of Owner MCGORVEN, DAN
Mailing Address 1 OAK STREET
City St Zip SOUTHOLD NY 11971
Property Address 1 OAK STREET
City St Zip SOUTHOLD NY 11971
Tax Map No. section 77.00 block 1 lot 4.000
Cross Street CEDAR DRIVE
Building Permit Number Cross Reference:
Issue Date: 3/23/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK = P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER Fax (516) 765-1823
Telephone (516) 765-1801
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MAR 12 992OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
BLDG. LH. •
TOWN OF SOUTHOID.. n, March 12, 1992
To: Southold Town Code Enforcement Officer
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A831 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool Service for Dan McGorvan
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 -
DISAPPROVE -
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own clerk southold
Date
OFFICE OF THE TOWN CLERK
Town of Southold '" �FFULA /
Judith T. Terry, Town Clerk � Cil/ Application No. 8 3
Town Hall, 53095 Main Road Construction
P. O. Box 1179 ; o ' i
Southold, New York 11971 sct� �; Alteration
Telephone `�O,y r.t: $10.00 - Residential c/
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(516) 765-1801 = 1 1 %K $25.00 -Non-Residential
,,,,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ /O G�
DATE / 7 < //, 45'z_
APPLICANT NAME: �'71�t'!c' S Ctcrc melaf
APPLICANT ADDRESS: 2 7"0 di/4- ' -rt- ,
,7 /. //92/
SEPTIC CESSPOOL V
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
/4 x-4/7 11,z`Z(40 eiJ
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 2,9-/4 Cetevr„/
OWNER MAILING ADDRESS: Oc If
G rr.h/ n Y.
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: Cr4 /, & Pi /7d
TAX MAP NO. : Section 77 Block I Lot Ll
CROSS STREET: 2 4 �i
BUILDING PERMIT NUMBER CROSS REFERENCE:
at/y
Signature of Applicant
RECEIVED BY:
Town Cler s Office •
DATE: - RECOVER
MAR 1" 199Z
Town CIO 80
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