HomeMy WebLinkAboutFitzgerald, James A
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JUDITH T. TERRY % < ; Town Hall, 53095 Main Road
TOWN CLERK : =o rZ : P.O. Box 1179
to Southold, New York 11971
REGISTRAR OF VITAL STATISTICSVO ��� Fax (516) 765-1823
MARRIAGE OFFICER a�//A� 'b �" Fax
(516) 765-1801
RECORDS MANAGEMENT OFFICER rr�
FREEDOM OF INFORMATION OFFICER ,,,i,rr
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1078 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 AN OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED DISTANCES FROM ADJACENT
WELLS, BUILDINGS AND PROPERTY LINES. EXCAVATION INSPECTION REQUIRED.
Name Of Owner FITZGERALD, JAMES
Mailing Address 1 P. O. BOX 791
City St Zip CUTCHOGUE NY 11935
Property Address 1 50 OAK STREET
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 104.00 block 5 lot 25.000
Cross Street HAYWATERS DRIVE
Building Permit Number Cross Reference:
Issue Date: 12/23/93 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY ; Z .G Town Hall, 53095 Main Road
TOWN CLERK t p T P.O. Box 1179
REGISTRAR OF VITAL STATISTICS tali `�' ,� Southold, New York 11971
MARRIAGE OFFICER yQ O�' �� Fax (516) 765
_,`j�l jit NW. �� Telephone (516) 7665 5-1 1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department DEC 1 4 1993
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: December 14, 1993 1 i't7w+, ;
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Transmitted herewith is a copy of application No. A1113 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for James Fitzgerald ,
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.
t
Linda J. Cooper
* * * * * * * * * * * * *
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I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - EXCAVATION INSPECTION
REQUIRED
DISAPPROVE -
COMMENTS: `-vaLid72.,(4?
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Date
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OFFICE OF THE TOWN CLERK ,,s�'"
Town of Southold .�'e �Ff 14x
Judith T. Terry, Town Clerk ,' �� Cl/ ; Application No/ (2
Town Hall, 53095 Main Road ; Construction
P. O. Box 1179
Southold, New York 11971 ffs �' / Alteration
Telephone `y0•>f' Q $10.00 - Residential
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(516) 765-1801 '.Ol its �, •' $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 $
DATE / ./ /79-5
APPLICANT NAME:
APPLICANT ADDRESS:
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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 CONSTRUCTIN OR ALTERATION:
OWNER OF PROPERTY:
I'2
OWNER MAILING ADDRESS: - fl
. may.
OWNER PROPERTY ADDRES' P
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section / O`'/ Block S Lot
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
5)(9.
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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