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JUDITH T. TERRY C Town Hall, 53095 Main Road
TOWN CLERK ® rnn • P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS Southold, New York 11971vie Fax• Fax (516) 765-1823
MARRIAGE OFFICER �' •
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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. 983 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
REPALCE COLLAPSED CESSPOOL.
APPROVED AS SUBMITTED. EXCAVATION INSPECTION REQUIRED. CALL
765-1802 FOR NECESSARY INSPECTION.
Name Of Owner MURPHY, ROBERT
Mailing Address 1 18 BEACH ROAD
City St Zip GREENPORT NY 11944
Property Address 1 18 BEACH ROAD
City St Zip GREENPORT NY 11944
Tax Map No. section 3.00 block 3 lot 10.000
Cross Street SANDY BEACH ROAD
Building Permit Number Cross Reference:
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Issue Date: 4/23/93 Judith T. Terry
Southold Town Clerk
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,, ® �� Town Hall, 53095 Main Road
JUDITH T. TERRY v
TOWN CLERK C P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER '�® O ��,' Fax (516) 765-1823
_��® ��® i! Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: April 23, 1993
Transmitted herewith is a copy of application No. A1010 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Robert Murphy .
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 - x
DISAPPROVE -
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OFFICE OF THE TOWN CLERK ,''",,,"""'-
Town of Southold .''��� f111.Kei
Judith T. Terry, Town Clerk 4 •0 Gy'� Application No. /.07°Town Hall, 53095 Main Road ; Construction
P. O. Box 1179
Southold, New York 11971 ct� __ �• Alteration U
Tele hone ,j. _ �� '� $10.00 - Residential J
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(516) 765-1801 ' ®1 , $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 .0U/ 0_?
APPLICANT NAME: i„ , '
APPLICANT ADDRESS: ,2 'Oc �6orr p�
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SEPTIC CESSPOO LY ��nf'
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION ,OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: hietfr /d (,Cy •
OWNER MAILING ADDRESS: ifP X9/iid/l c4
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OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section /86 / Block — 3--Id Lot
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
d Signature of Applicant
RECEIVED BY: , •
Town Clerk's Office
DATE:
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