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HomeMy WebLinkAboutMichel f _ v ',/, 011 FR JUDITH T.TERRY - Town Hall,53095 Main Road TOWN CLERK c g % P.O.Box 1179 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS �� O MARRIAGE OFFICER ;, �Q° rel Fax(516)765-1823 RECORDS MANAGEMENT OFFICER 1®.� it" Telephone(516)765-1800 FREEDOM OF INFORMATION OFFICER •'''' OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1268 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. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION REQUIRED. Name Of Owner MICHEL, CHARLES Mailing Address 1 BOX 105 City St Zip SOUTHOLD NY 11971 Property Address 1 50605 MAIN ROAD City St Zip SOUTHOLD NY 11971 Tax Map No. section 70.00 block 1 lot 8.000 Cross Street TUCKERS LANE Building Permit Number Cross Reference: Issue Date: 12/28/94 Judith T. Terry Southold Town Clerk (TOWN SEAL) b i iii ``/ i kill Wait ; 7 JUDITH T.TERRY „4 Town Hall, 53095 Main Road %TOWN CLERK C \® F:, `, `. , P.O.Box 1179 %REGISTRAR OF VITAL STATISTICS .:.y Southold,New York 11971 MARRIAGE OFFICER 4�,� - �� of Fax(516)765 1823 RECORDS MANAGEMENT OFFICER `�4 Cil V010. Telephone(516)765-1800 FREEDOM OF INFORMATION OFFICER ,,, ,,s0 1F77--7- 0111::EF-71 OFFICE OF THE TOWN CLERK;,..1 . DEC 2 ® 9gg4 TOWN OF SOUTHOLD TO: Southold Town Building Department B ' it LDG.DEpT. FROM: Linda Cooper, Southold Town Clerk's Office TOWN OFSOUTHOLD DATED: December 20, 1994 Transmitted herewith is a copy of application No. A1314 for an ALTERATION PERMIT for a cesspool or septic system submitted by Morris Cesspool for Charles Michel . 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 - E CAIJAT_® .NSPEC11®N DISAPPROVE - REQU RED COMMENTS: Maintain required setbacks from adjacent wells, buildings, property lines and water bodies. EXCAVATION INSPECTION REQUIRED. Alr, ...---- _,..9-,72a-7,--- ili 17---d\fe,e, Signature / Date Y . > OFFICE OF THE TOWN CLERK ,,,'"",.,,,,; Town of Southold ' •��FF��K�+, - y� Judith T. Terry, Town Clerk ir/y ,�'�O . Application No. / 3 " Town Hall, 53095 Main Road �� Construction P. O. Box 1179 Alteration Southold, New York 11971 � ••� Telephone O Q��• $10.00 - Residential (516) 765-1801 .� of° $25.00 — Non-Residential l,, TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee .$ DATE yai -0) /7� APPLICANT NAME: dge`y APPLICANT ADDRESS: P6// / 01 .12� SEPTIC CESSPOOL ?1 DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTI•N OR ALTERATION: OWNER OF PROPERTY: OWNER MAILING ADDRESS: _54-6 ��s � <Ik // 27/ OWNER PROPERTY ADDRESS: TELEPHONE NUMBER OF CONTACT PERSON: - TAX MAP NO. : Section /0 Block / Lot (� CROSS STREET: BUILDING PERMIT NUMBER CROSS REFERENCE: Signature of Applicant RECEIVED BY: Town le/rs Office DATE: /Z �D 7 - iv Lio r 5 0 1 / //" I