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JUDITH T. TERRY �,O : Town Hall, 53095 Main Road
TOWN CLERK rrri P.O. Box 1179
REGISTRAR OF VITAL STATISTICS CP �� Southold, New York 11971
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MARRIAGE OFFICER Fax (516) 765-1823
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s� Telephone (516) 765-1801
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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. 1053 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL
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. MAINTIAN REQUIRED DIESTANCES FROM ADJACENT
WELLS, BUILDINGS AND PROPERTY LINES. EXCAVATION INSPECTION REQUIRED.
Name Of Owner MAIORANA, MARTINE
Mailing Address 1 12690 MAIN ROAD
City St Zip EAST MARION NY 11939
Property Address 1 12690 MAIN ROAD
City St Zip EAST MARION NY 11939
Tax Map No. section 31 .00 block 14 lot 13.000
Cross Street
Building Permit Number Cross Reference:
Issue Date: 10/28/93 Judith T. Terry
Southold Town Clerk
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Town Hall, 53095 Main Road
JUDITH T. TERRY ; r+
TOWN CLERK Z, ® T % P.O. BOX 1179
REGISTRAR OF VITAL STATISTICS VS Southold, New York 11971
MARRIAGE OFFICER ® `®��r
�� Fax (516) 765-1823
`� � Telephone (516) 765-1801
1� 1 OCT B 31993 OFFICE' OF THE TOWN CLERK
p c___ TOWN OF SOUTHOLD ,
TOS �`-' ==-Souithold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: October 13, 1993
Transmitted herewith is a copy of application No. 1084 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Martine Maiorana
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:
VAI
APPROVE - F . INSPECTION
BRED
DISAPPROVE -
COMMENTS: 2 ,7qy /4
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OFFICE OF THE TOWN CLERK ,,, ,,,"'''*•
Town of Southold �'''' \\VWCK
N® Application No. Q (T
Judith T. Terry, Town Clerk 4' "4z=�
Town Hall, 53095 Main Road `== Construction
P. 0. Box 1179
Southold, New York 11971 ��tt9 sg ' Alteration
Telephone et 'gsr,' $10.00 - Residential
(516) 765-1801 ®1 i6 ., $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 D ti /3%122
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APPLICANT NAME: �S
APPLICANT ADDRESS: ?cap�.� j7
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SEPTIC CESSPOOL'I
DESCRIPTION 0 PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 7%Z '7/2,Z ,}/A,ea44
OWNER MAILING ADDRESS: / ��cz�, ,
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section c3/ Block / V Lot 1 7
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
c°,1 ?47/11-1-L-':
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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