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JUDITH T. TERRYTown Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER ® '� Fax ( 16) 765-1823
�� ®� � �®��! 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. 800 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : LOUISE MOYLE
Address 1 : 1920 MINNEHAHA BLVD.
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
INSTALL AN ADDITIONAL SEPTIC TANK FOR THIRD BATHROOM.
APPROVED WITH ALTERATIONS. PLACE SEPTIC 5'0" OFF OF ROAD EDGE. EXCA-
VATION INSPECTION REQUIRED. CALL BUILDING DEPT. (765-1802) FOR AN
APPOINTMENT. (SEE ATTACHED)
Name Of Owner MOYLE, LOUISE
Mailing Address 1 1920 MINNEHAHA BLVD.
City St Zip SOUTHOLD NY 11971
Property Address 1 1920 MINNEHAHA BLVD.
City St Zip SOUTHOLD NY 11971
Tax Map No. section 87.00 block 3 lot 63.000
Cross Street OPECHEE AVENUE
Building Permit Number Cross Reference:
Issue Date: 1/24/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
62-o v
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JUDITH T. TERRY `f 4 y' Town Hall, 53095 Main Road
'' `-- - J P.O. Box 1179
TOWN CLERK v', we;;,.-4-
REGISTRAR OF VITAL STATISTICS t • Southold, New York 11971
MARRIAGE OFFICER .�CP w k &-;',V l� Fax (516) 765-1823
,p. ��� Telephone (516) 765 1801
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I ,I. Fl p` OFFICE OF THE TOWN CLERK
I i l u ` TOWN OF SOUTHOLD
i8 O or IS C;':.n i.`9 PO�D ria y
January 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. A822 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Louise Moyle .
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 - 7S
DISAPPROVE -
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EXCAVATION INSPECTION Signature
REQUIRED t\ ••,`-\\t\x._,
Date
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OFFICE OF THE TOWN CLERK
Town of Southold a'A-1.1f : •`Judith T. Terry, Town ClerkApplication No. �SZ�
Town Hall, 53095 Main Road 'xoi,F t.• ;; Construction
P. O. Box 1179
Southold, New York 11971 , Alteration t/
Telephone X01 x_1( ��� � Residential
• (516) 765-1801 " Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
•
Permit No. g oil
Fee $ j p
DATE . /4A/v4i,4 j 2 / 19-2-
APPLICANT
-APPLICANT NAME: ,70c,/56 / /C� 5✓L_�
APPLICANT ADDRESS: /q 20 /'//A./ / ,, -/7% L LU/2 •
I
SEPTIC ,X CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
5T/� L L ,fie✓ > T/o,c1,¢ L
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ,49 (,,s /p 4_6
OWNER MAILING ADDRESS: /9) /5•//,c/A/6-/41,4_,/44,4_, EG t/
•
OWNER PROPERTY ADDRESS: ��,►��®
TELEPHONE NUMBER OF CONTACT PERSON:0A/, 4 �OPLL f:24,(`�2,g6-2—
TAX MAP NO. : Section ''7 Block --'
� Lot
CROSS STREET: <z6"-- 44- O i
BUILDING PERMIT NUMBER CROSS REFERENCE:.
7R t
Signatur of, pp icant
RECEIVED BY: /
/ Town Clerk's Office
•
DATE: /74 '5_19