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JUDITH T. TERRY 747. Town Hall, 53095 Main Road
TOWN CLERK , ® P.O. Box 1179
REGISTRAR OF VITAL STATISTICS .�` Southold, New York 11971
MARRIAGE OFFICER �® 1! Fax (516) 765-1823
® T til Telephone (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. 846 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. EXCAVATION INSPECTION REQUIRED. CALL 765-1802
FOR AN APPOINTMENT.
Name Of Owner RINI, CARMEN
Mailing Address 1 1850 JOCKEY CREEK DRIVE
City St Zip SOUTHOLD NY 11971
Property Address 1 1850 JOCKEY CREEK DRIVE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 70.00 block 5 lot 20.000
Cross Street OAKLAWN AVENUE
Building Permit Number Cross Reference:
Issue Date: 5/28/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
cP%[%i2���'' P c/6
JUDITH T. TERRYc== tTown Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ( �.�� Southold, New York 11971
MARRIAGE OFFICER ® O �1! Fax (516) 765-1823
® - Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
MAY 22, 1992
To: Southold Town Code Enforcement Officer -
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A869 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
MORRIS CESSPOOL SERVICE FOR CARMEN RINI
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 - C
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OFFICE OF THE TOWN;, CLERIC= ,,'"'"""'
Town of Southold 0'. cOFQLIrel.
Town Clerk • - l/ Application No.g(p
Judith-T. Terry, 0 F,= y
Town Hall, 53095 Main Road;.•,.=: , Z G Construction
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P. O. Box 1179 • _ t•
Alteration
v
Southold, New York 11971 3 [-< .`
Tele hone � O $10.00 - Residential
P `a
(516) 765-1801 = 01 411 ' $25.00 - Non-Residential
• ,000
TOWN OF SOUTHOLD •
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 4.,.? /922
APPLICANT_ NAME: Mars-1( 6.6s )
APPLI CANT ADDRESS: ?kW/A6,7
SEPTIC CESSPOOL
DESCRIPTION OF PROP ED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: C•
r
OWNER MAILING ADDRESS: /ece) f ,e/f/
i,/ //
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 7‘C
- TAX MAP NO. : Section Block (.5Lot 20
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
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Signature of Applicant
RECEIVED BY: /� •
own C erk' Office •
DATE: - ' 2 �.Z
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