HomeMy WebLinkAboutAmiaga, Gil 0., FOL -C;
ELIZABETH A.NEVILLE � y Town Hall, 53095 Main Road
TOWN CLERK c < P.O. Box 1179
ti Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICSFax (516) 765-1823
MARRIAGE OFFICER �` �o ����
RECORDS MANAGEMENT OFFICER Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ', '
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1996 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL
Address 1 : 2760 YENNECOTT DRIVE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITION OF CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM WELLS,
BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION
REQUIRED.
Name Of Owner GIL AMIAGA
Mailing Address 1 52370 NORTH ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 52370 NORTH ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 135.00 block 3 lot 15.003
Cross Street
Building Permit Number Cross Reference:
Issue Date: 2/18/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
c �
/ 9S
, c
ELIZABETH A.NEVILLE Z�\ �l/y 1� Town Hall, 53095 Main Road
TOWN CLERK Z = , P.O. Box 1179
ti Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax (516) 765-1823
MARRIAGE OFFICER L y O A)-..1 Telephone
Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER % l� I, "
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: February 1 , 1999
Transmitted herewith is a copy of application No. 2080 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool
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 followinq,recommendation:
APPROVE -
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
natu e
igq
Date
dr4/std,
•
\/j{3tIS OE TEE TOWN
n 9. cam,
TOWN c otmoLn Application No. 090S-
A.MLLE,
10O.m�c 1179 Construction
SOUTHOLD,NEW YORK 11971
Alteration
Telephone D, $10.00 -Residential
(516) 765-1801 ,t' $25.00 -Non-Residential
and//r rD
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ a.
DATE
DATE ,�--�'" / /
APPLICANT NAME: /4'2° 12. -.5 (',C j'f/a,/
APPLICANT ADDRESS: 2 7t ' /'- /il/)E Co r r �2
cc •
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: 01,,f f-ifr
OWNER MAILING ADDRESS: 3-ZJ7O �y� r4
.tea /`�r:�
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 7/c - fives
TAX MAP NO. : Section
lir Block Lot /5--
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
of-
p /
Signature of Applicant
l
RECEIVED BY:
T I 's Office
DATE: 977/
_
641454.17-4-9
(19-
O41
Co) ,
r4
'62e
j
•