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JUDITH T. TERRY : ° •" {. • . = Town Hall 53095 Main Road
TOWN CLERK ® P.O. Box 1179
6 Tie, Southold, New York 11971
REGISTRAR OF VITAL STATISTICS cote ta ' � Fax (516) 765-1823
MARRIAGE OFFICER 01:9o� Z)•• Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER pm til
FREEDOM OF INFORMATION OFFICER �� �ii /�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1176 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : ELEANOR V. MEEHAN
Address 1 : 2015 MARLENE LANE
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION OF CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS
BUILDINGS, PROPERTY LINES, WATER BODIES AND MINIMUM OF 2' ABOVE
GROUND WATER. EXCAVATION INSPECTION REQUIRED.
Name Of Owner MEEHAN, ELEANOR & MASTERSON, H
Mailing Address 1 BOX 1025
City St Zip MATTITUCK NY 11952
Property Address 1 2015 MARLENE LANE
City St Zip MATTITUCK NY 11952
Tax Map No. section 144.00 block 3 lot 11 .000
Cross Street ROUTE 25/PECONIC BAY BLVD.
Building Permit Number Cross Reference:
Issue Date: 8/01/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY : ..4. Town Hall, 53095 Main Road
TOWN CLERK •
® P.O. Box 1179
. , Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = �® ��' Fax (516) 765-1823
MARRIAGE OFFICER '=e�` lzb®t��' Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER : (if 0°.
FREEDOM OF INFORMATION OFFICER = „Artiis��
OFFICE OF THE TOWN CLERK aR
n
TOWN OF SOUTHOLD l'/
TO: Southold Town Building Department 11 2 0 1994 Li'
FROM: Linda J. Cooper, Southold Town Clerk's Office BLDG
DATED: July 28, 1994OFSHOLp
Transmitted herewith is a copy of application No. A1220 for a Cesspool/
Septic Tank Construction Permit submitted by:
Eleanor V. Meehan .
Please review the application and location map and advise if the project
has received Suffolk County Health Department approval and if this office
may issue the permit.
Please complete the form below a . RR�- RR
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Thank you. 15 � L5 V _E_ „
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4 ' '_' i � INISELEC
LDG.
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* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations: �
APPROVE �/ C AZ ®®pp'M�® OPE 1
DISAPPROVE
Comments: (71L��2t 0� _ � , > , :
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Signature -
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Dated 7
OFFICE OF THE TOWN CLERK ,,,,""""•', -
Town of Southold ,
Judith T. Terr Town Clerk ,'s �� =s" _ �G Application NowlO
Town Hall, 53095 Main Road ��� ` "'` �c. Construction
P. O. Box 1179 o :" rn
Southold, Kew York 11971
cn ;,' yc �• Alteration
Telephone ;y/40.l .0.`x
�O�••� $10.00 - Residential V
(516) 765-1801 : , • $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION ECEIVED
for JUL 2 8 1994
CONSTRUCT ION or ,ALTERAT ION PERMITSouthold Town Clerk
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE .r, /?9
APPLICANT NAME: 5.6_,,
APPLICANT ADDRESS: o/Sa,,��� �_,� _ �; "RP'
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: ' Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATIO : Off,
OWNER OF PROPERTY: l/ ��z¢-�. -� 0 ��i f--,-rntJ
OWNER MAILING ADDRESS: X /Oa/s
OWNER'PROPERTY ADDRESS: 20 /S ; j am
1'/W.' , W-
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TELEPHONE NUMBER OF CONTACT PERSON: �7(-
TAX MAP NO. : Section / 4 Block Lot /1
CROSS STREET: it �� Z- 7,( •
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
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RECEIVED BY: 4.1101A
own Ierk's ffice
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