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JUDITH T. TERRY - ` Town Hall, 53095 Main Road
TOWN CLERK p T P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Ers Southold, New York 11971
MARRIAGE OFFICERyQ ?, Fax (516) 765-1823
= ', O a it'® .6 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. 1005 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL SERVICE
Address 1 : 2760 YENNECOTT ROAD
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or. Alteration
ADDITION OF AN OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. KEEP 10' APART. EXCAVATION INSPECTION
REQUIRED.
Name Of Owner MULLEN, RICHARD
Mailing Address 1 TERRY LANE
City St Zip SOUTHOLD NY 11971
Property Address 1 TERRY LANE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 65.00 block 1 lot 12.000
Cross Street HOBART AVENUE
Building Permit Number Cross Reference:
Issue Date: 6/03/93 - Judith T. Terry
Southold Town Clerk
(TOWN SEAL )
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JUDITH T. TERRY .8 Town Hall, 53095 Main Road
TOWN CLERK T P.O. Box 1179
crs Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ' t 0 �% Fax (516) 765-1823
MARRIAGE OFFICER ® ®�
=__�,y®1 �� �� Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD s- -
TO: Southold Town Building Department �, . ° I�iiiY
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FROM: Linda Cooper, Southold Town Clerk's Office ' 1?`�`L- _ �� i',1
DATED: May 27, 1993 h._ =i
Transmitted herewith is a copy of application No. A1034 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Richard Mullen
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.
c(YA---/„L<_-/
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the-application and location map of the project listed
above and make the following recommendation:
APPROVE -
DISAPPROVE - - -
COMMENTS•
RECEIVED
JUN 2 w- .
. • .... A _
EXCAVATION U SiPIEr Signature
REQUIR1I clA f7r3
Date
t,
S.
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OFFICE OF THE TOWN CLERK �0 '
Town of Southold ���'. ���Voj/(L'® ' Application No. /U 9L/
Judith T. Terry, Town Clerk - e�NC> „t.,.<-::.1:,,y ��
Town Hall, 53095 Main Road , s` F,'_° Construction
P. 0. Box 1179 • = .
Southold, New York 11971 Z tan _ �,;�' Alteration
Telephone =�0, . _ ���' $10.00 - Residential t---------
Telephone
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(516) 765-1801 - 0.1 B t ' ' $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 ifieZA, a ? /92-3
APPLICANT NAME: MAI/Ls (4-146Ve5"/"-9-ee -C1,-)"
APPLICANT ADDRESS: Oa 6 Qic
c7 Ar. --(17-11_ X• it/. :7
SEPTIC CESSPOOL-1
DESCRIPTION OF PROPOSED CONSTRUCTION OR LTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: J/,6�, � / ,�
OWNER MAILING ADDRESS: 7-fiz-t;W`' L
OWNER PROPERTY ADDRESS: ,f
TELEPHONE NUMBER OF CONTACT PERSON: p‘s--T-.77,57,
TAX MAP NO. : Section �p S Block / Lot /o•—'
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Pg
gnature o Applicant
RECEIVED BY: „ w Q.
Town Cl'erk's 0 fice
DATE: ,S/0t. V.s 3
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