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ELIZABETH A.NEVILLE 4S� y� v Town Hall, 53095 Main Road
TOWN CLERK = = .' P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER ,0Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER tif `��lf Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER '� * ¶j
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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. 1944 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 COLONIAL CORNERS
Mailing Address 1 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 62.00 block 3 lot 22.001
Cross Street LOCUST LANE
Building Permit Number Cross Reference:
Issue Date: 10/06/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE •,``1k �G.y�; Town Hall, 53095 Main Road
TOWN CLERK p 1 P.O. Box 1179
ti Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS v' 1
MARRIAGE OFFICER ���, �� 1� Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER : �0 a0 �1�1 Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ' •• �,��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: October 2, 1998 •
Transmitted herewith is a copy of application No. 2021 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Colonial Corners
•
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 followin recommendation:
APPROVE -
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
Signa re
i615‘'C
Date
OFFICE OF THE TOWN CLERK 'i'000f IBL%'
TOWN OF SOUTHOLD �; V Application No. _per/
FTI7ABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 : E, Construction
SOUTHOLD,NEW YORK 11971 . T
1 Alteration
Telephone
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$10.00 -Residential
(516) 765-1801 - '1 4',,"' $25.00 -Non-Residential
-,,,,,,,,-
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 6412 ;-.2d-
APPLICANT
NAME: 40/Mr
APPLICANT ADDRESS: 2 7 o �/�4 /Z4-ro r t- O�
SEPTIC CESSPOOL V
DESCRIPTION OF P OSED 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: .�Ohi / C c t1
OWNER MAILING ADDRESS: /q,.i?) i9
c,to 4P
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 6.�' 3 6
TAX MAP NO. : Section Block i Lot .22.
CROSS STREET: b4.' .'e.' - 41.,.../..( r,
c.
BUILDING PERMIT NUMBER CROSS REFERENCE:
, ICY77/4 99fi '--/ % 1
Signature of Applicant
RECEIVED BY: A6(
Town Cler s ice
DATE: /o/'g_ / 9
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