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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = VO. Fax (516) 765-1823
MARRIAGE OFFICER coo 4t z®I.1' Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER = ®1
FREEDOM OF INFORMATION OFFICERli/
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1136 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 OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS
BUILDINGS, PROPERTY LINES, WATERS BODIES, AND 2' ABOVE GROUND WATER.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner KAPLAN, ROBERT I.
Mailing Address 1 21 THE MAPLES
ROSLYN ESTATES
City St Zip ROSLYN NY 11576
Property Address 1 1700 INLET WAY
City St Zip SOUTHOLD NY 11971
Tax Map No. section 92.00 block 1 lot 7.000
Cross Street CEDAR BEACH ROAD
Building Permit Number Cross Reference:
Issue Date: 5/24/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY ;,' ` Town Hall, 53095 Main Road
TOWN CLERK zt O T P.O. BOX 1179
REGISTRAR OF VITAL STATISTICS �` • Southold, New York 11971 •
�' •� Fax (516) 765 1823
MARRIAGE OFFICER O ®� •
�,r0 ill �1� �� Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLDII I
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' ihTO: Southold Town Building Department MAY 7 �9��
FROM: Linda Cooper, Southold Town Clerk's Office
BLDG.DEPT.
DATED: May 17, 1994 TOWN F OLD
•
Transmitted herewith is a copy of application No. A1175 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Robert I. Kaplan
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 -
uY°', AV TI® I SP CT Os"•
DISAPPROVE - LIQ;,
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OFFICE OF THE TOWN CLERK ,��'" '
Town of Southold •1"%v��F01./(1'� ' Application N o. // 7
Judith T. Terry, Town Clerk �,�'0® v�
1
Town Hall, 53095 Main Road Z !� Construction
P. O. Box 1179c - rrime ,/
Southold, New York 11971 : V) •• Alteration
Telephone Y04, �AN-i $10.00 - Residential
(516) 765-1801 Ol �, $'f $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 Metir ''/7,
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APPLICANT NAME: Abse/e1.5 (2,0E02,425/,ri£eec%e/-4-
APPLICANT ADDRESS: 07co A.M)iro rr "r‹,
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION , -",
611,-ei4z......) G4-64102-9.,-eire
LOCATION MAP: Must 'beattached hereto before permit maybe issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 4/54/4 Ale/'i
_ OWNER MAILING ADDRESS: /7C /D?/,j't Gc)
OWNER PROPERTY ADDRESS: .9/ /‘ , # mss /(y�� ,e',/,9/r gL
TELEPHONE NUMBER OF CONTACT PERSON: 7‘.5.--- $7c16
TAX MAP NO. : Section 5 2 Block / Lot 7
rr
' CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
i
, Signature of Applicant
RECEIVED BY: RECEIVED
Town Clerk's Office ,
DATE: MAY 1 7 1994
[own Clerk Southold •
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