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JUDITH T. TERRY Z L . Town Hall, 53095 Main Road
TOWN CLERK FT, P.O. Box 1179
REGISTRAR OF VITAL STATISTICS if' Southold, New York 11971
MARRIAGE OFFICER y0 , Fax (516) 765-1823
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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. 930 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. HOLD 10' BETWEEN POOLS AND NOT ANY CLOSER TO
CREEK. EXCAVATION INSPECTION REQUIRED. CALL 765-1902 FOR AN
APPOINTMENT
Name Of Owner FLANAGAN, MARY
Mailing Address 1 3825 WICKHAM AVENUE
City St Zip MATTITUCK NY 11952
Property Address 1 1430 CONKLIN ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 107.00 block 9 lot 5.000
Cross Street ROUTE 48
Building Permit Number Cross Reference:
Issue Date: 11/09/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY Town Hall, 53095 Main Road
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TOWN CLERK : rZTt P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS $ Southold, New York 11971
y0 •�1 Fax (516) 765-1823
MARRIAGE OFFICER
Telephone (516) 765-1801
* $80/
OFFICE OF THE TOWN CLERK
NOVA Z TOWN OF SOUTHOLD
NOVEMBER 2, 1992
To: Southold Town Code Enforcement Officer
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A955 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Mary Flanagan
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 - p
COMMENTS: k Q4 [O� PO4% 0140%.4 10 dr. al thi14,
RE�EI�ED
- Signature
Date \ \ L Town Clerk' z.
OFFICE OF THE TOWN CLERK ,,,,,,,,,,,,,,,
Town Town of Southold ,'"ICAVOLKe Application No. q �
Judith T. Terry, Town Clerk Gy';
Town Hall, 53095 Main Road s Construction
P. O. Box 1179 ,f
Southold, New York 11971 tJ'� � eration /
`'O '` $10.00 - Residential c/
Telephone '-_•�' ���,�-
(516) 765-18011 4�, !' $25.00 - Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 42) C
APPLICANT NAME: s7eieej � � � oC�/ G 1-0
APPLICANT ADDRESS: 2 ?6d v/'.ze,a rr 2# 13
SEPTIC CESSPOOL 1
DESCRIPTION OF PROPOSED 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: ,%
OWNER MAILING ADDRESS: �� ��-2-C 42/&&-7(
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OWNER PROPERTY ADDRESS: /
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TELEPHONE NUMBER OF CONTACT PERSON: 7/5 53'
TAX MAP NO. : Section 7 Block Lot
CROSS STREET: 7P
BUILDING PERMIT NUMBER CROSS REFERENCE:
P,(7149
Signature of Applicant
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RECEIVED BY: cY,
wow ctitdr�k"'s—Office
DATE:
KI a 1992
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