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JUDITH T. TERRY : . : i"... ;;x mTown Hall, 53095 Main Road
TOWN CLERK ® > :, r; :y P.O. Box 1179
,�' Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ems;. ' Fax (516) 765-1823
MARRIAGE OFFICER S `"� _ ®�s" Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER ' ®f �0
FREEDOM OF INFORMATION OFFICER "_ �. y•„„••
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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. 1211 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 TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS
BUILDINGS, PROPERTY LINES, AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner HESSEL, CRISTINA
Mailing Address 1 900 ROGERS ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 900 ROGERS ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 66.00 block 2 lot 38.000
Cross Street HIPPODROME DRIVE
Building Permit Number Cross Reference:
Issue Date: 9/26/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY % �^g4 t Town Hall, 53095 Main Road rs
TOWN CLERK ® �° �, P.O. Box 1179
-=,'•-t,t #� , 'W Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ems® � �0-1
Telephone
Fax (516) 765-1823
MARRIAGE OFFICER �r Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER -� /r
�iii� ! 0
OFFICE OF THE TOWN CLERK ,-- RnTOWN OF SOUTHOLD firi ._
SEP
TO: Southold Town Building Department �� ��
FROM: Linda Cooper, Southold Town Clerk's Office BLDG.DEPT :'
DATED: September 16, 1994 _____ �!IM OFS®u`How
Transmitted herewith is a copy of application No. A1256 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Cristina Hessel .
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 - ir 4 � Y T O HIRE .10
DISAPPROVE - REQ
COMMENTS: Maintain required setbacks from adjacent wells, buildings,
property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
SEP 2 3 1994 Signatur,
Town Clerk Southold
D.t-
N
CE OF- T,HE TOWN CLERK --- e '
' Town of Southold e'l Citfa/1'1> : ' '
Judith T. Terry, Town Clerk $ 14#, ..'t
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Application No.
Town Hall, 53095 Main Road Z !� Construction
P. O. Box 1179 v T ./
; Alteration
Southold, New York 11971 , to W .`
P
Tele hone O��'�, $10.00 - Residential
(516) 765-1801 4/0 �1, o $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 , Al
APPLICANT NAME: /1/0"/;10 r,etify40-,,,,), e u ,
APPLICANT ADDRESS: 2760 ' .ze
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SEPTIC CESSPOOL
DESCRIPTION OF "OPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY:__e
OWNER MAILING ADDRESS: (� -L a
,,i Y ft/
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section 66 Block 2 Lot 281---
CROSS STREET:
c
BUILDING PERMIT NUMBER CROSS REFERENCE: ...P j„,47---/--/---
. , /,-- ip'‘ /7/- /'1-1" •
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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