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JUDITH T. TERRY % ::�� Town Hall, 53095 Main Road
TOWN CLERK i P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ►T Southold, New York 11971
MARRIAGE OFFICER '�� Fax (516) 765-1823
� ,`" �r Fax
(516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 718 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. HOLD 10'0" SEPARATION AND CALL 765-1802 FOR
AN EXCAVATION INSPECTION.
Name Of Owner IACONO, LOUIS
Mailing Address 1 110 WASHINGTON AVENUE
City St Zip GREENPORT NY 11944
Property Address 1 110 WASHINGTON AVENUE
City St Zip GREENPORT NY 11944
Tax Map No. section 41 .00 block 1 lot 31 .000
Cross Street WILMARTH
Building Permit Number Cross Reference:
Issue Date: 5/30/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
.11 , Iiiir@mowiE
i! ik I MAY 2'0;1 , •
L ,, ji..`_ u` r` �j' 21, _ ,. - 0.=° , Town Hall, 53095
��vf' �_. t, . - . Main Road
tet' IP P.O. Box 1 179
�.4' it i��� �� Southold, New York 11971
JUDITH T. TERRY -'"'„N s” TELEPHONE
TOWN CLERIC (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD _
May 20, 1991
To: Southold Town Code Enforcement Officer
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A737 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Louis F. P. Iacono •
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.
4 -cc-
Linda J. Cooper
* * * * * * _ * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - x
DISAPPROVE -
COMMENTS:, g / O , amu.1/ - r 1 ,
Pc.A .-. .
SR S.,'
® 51,....31- Ita
� �� Si nature0 ,
0° 41ii 9) /
Date
FFt E OF THE TOWN CLERK ,,,,'",,,"''
Town of, Southold �'� qVUL/(e'. 73 7
Judith T. Terry, Town Clerk �� � �J Gy
Application No.
Town Hall, 53095 Main Road
Construction
P. O. Box 1179 v ,:rt°.y - rn
Southold, New York 11971 to �.• Alteration
Telephone ..a. ` '' ���'� $10.00 - Residential
(516) 765-1801 �1 �, $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ /D°r- •
DATE 1/% c/ , O M2/
APPLICANT NAME: ! _Ode/&5 eg-Sra-e,` Sia "/.rub
APPLICANT ADDRESS: 27,E /4t)/1/cca fif j2i
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION f
`7/7) S i s S - i
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION ,OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: LO&,_..i .c .Z 1 e,U C7
OWNER MAILING ADDRESS//C (-O4j,) 'Tb4,191) . /
2KFr /9,-r % /LJ / /(P
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section 271/ Block / Lot 3
CROSS STREET: Adr /maPA4
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signatu a of Applicant
RECEIVED BY: oY-
Town Clerk's Office
DATE: 1/
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