HomeMy WebLinkAboutWalden, William ti I�,o��S�FFO(�-cOG
ELIZABETH A.NEVILLE .Z. y Town Hall, 53095 Main Road
TOWN CLERK o < r P.O. Box 1179
ti 2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax (516) 765-1823
MARRIAGE OFFICER `� , O� Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER :45,/
FREEDOM OF INFORMATION OFFICER4.
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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. 1984 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
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 WALDEN, WILLIAM
Mailing Address 1 PO BOX 59
City St Zip SOUTHOLD NY 11971
Property Address 1 50495 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 70.00 block 1 lot 9.000
Cross Street JASMINE LANE
Building Permit Number Cross Reference:
Issue Date: 12/23/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE I 0 ,yam:= Town Hall, 53095 Main Road
TOWN CLERK Z� c < ,� P.O. Box 1179
Z N Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS % �. Fax (516) 765-1823
MARRIAGE OFFICER y 0�*' I Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER 'VI l '000/
4.Ate' -S
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: December 15, 1998
Transmitted herewith is a copy of application No. 2063 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Wm. Walden .
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 - ,t/
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
ignatu ii
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Date
OFFICE OF THE TOWN CLERK ,'"' UL*' -
TOWNOFSOUTHOLD ,'�� QQG= Application Noo.2O
ELIZABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 1GConstruction
SOUTHOLD,NEW YORK 11971 C r9
Alteration
Telephone ,j*0 ��D�� � $10.00 - Residential
(516) 765-1801 .. 1 l • ,e $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 I /1 '/
APPLICANT NAME:
APPLICANT ADDRESS: 22 , -c) /2
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: 41z
OWNER MAILING ADDRESS: lSQ yfI/�� /cep
OWNER PROPERTY ADDRESS: _ �+�r, .� i: , ,4 _
TELEPHONE NUMBER OF CONTACT PERSON: pir 2YC7)
TAX MAP NO. : Section <-715 Block r Lot 7
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
727
RECEIVED Signature of Applicant
RECEIVED BY: nncc�r+
'Pdrolifi kite Office
DATE:
Southold
Tbwn Clerk
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